When foundational competence fades: A call to rethink retention in pharmacy education

Pharmacy curricula often assume that early mastery of foundational skills predicts durable competence later in training. That assumption warrants closer examination.

This commentary argues that progression through a Doctor of Pharmacy curriculum should not be mistaken for retention of essential knowledge and skills. Using a hypothetical example of later-semester students struggling with first-semester calculations content, it examines the issue through the lenses of retrieval science, competency-based education, just culture, and professionalism. Just culture should not be interpreted as absolution from learner responsibility; rather, it requires fair accountability for both curricular design and student behavior.

Pharmacy programs should treat safety-relevant foundational skills as longitudinal competencies, embed cumulative retrieval and reassessment throughout the curriculum, and articulate more clearly when remediable incompetence becomes a professionalism concern.