The objective of this study is to identify the essential hard and soft skills that healthcare professionals must develop when working in a low- and middle-income country (LMIC), where the socio-economic and cultural context differs significantly from that of Italy. The analysis was conducted following a period of observation conducted by a hospital pharmacy resident at a rural hospital in southern Tanzania. In order to ascertain the role and requisite competencies for hospital pharmacists (HPs) in LMICs, an investigation was conducted based on the 24 competencies identified by EAHP. The skills identified relate to patient care and clinical pharmacy, drug skills, management skills and professional skills. HPs in LMICs play a role in the final follow-up of hospital prescriptions, requiring in-depth knowledge of drugs. Communication, therapeutic education and follow-up are very important in a setting where primary care is lacking. Moreover, given the limited availability of resources, management and professional skills are crucial. The analysis has shown how, in different working contexts, health professionals are stimulated to develop and implement mainly specific skills, the sharing of which, through field experiences, can lead to a bilateral improvement of the services and health care offered.