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The Multistate Pharmacy Jurisprudence Examination (MPJE) is a law exam that pharmacists must pass to practice in most U.S. states. While a few states—such as Idaho and Ohio—do not require the MPJE, and California administers its own version known as the CPJE (which emphasizes clinical aspects of pharmacy practice), the MPJE remains a requirement for licensure in nearly all other states.

Many pharmacy graduates and licensed pharmacists seeking to practice in a different state find the MPJE particularly challenging. Law and regulatory topics are areas most pharmacists are neither deeply trained in nor comfortable with. The purpose of this post is to offer practical tips not only to improve your chances of passing the MPJE but also to help reduce the time, stress, and uncertainty associated with preparing for it.

You might reasonably ask, “Who are you to be giving advice on the MPJE?” It’s a fair question. After all, advice on a specialized pharmacy law exam coming from someone trained in data analytics may seem out of place. However, as of the date of this writing, I have passed ten MPJE exams on my first attempt—eight of them within a two-month span. At one point, I was taking one MPJE per week, with as little as four days between exams, due to the demands of my job, which required multistate licensure.

*Note: Guam result is not reported via NABP but I passed.

The above outlines my current progress with MPJEs. I was able to achieve passing scores while working 48 hours per week. Now, I’m not trying to brag about my time management skills or test-taking abilities (well—maybe just a little when it comes to time management), but my main point is this: preparing for the MPJE doesn’t need to take weeks or months of studying.

I’ve seen interns dedicate three months to studying for a single MPJE—longer than many people spend preparing for the bar exam! In my experience, about 20 hours of focused study is more than enough for the first MPJE. For subsequent exams, assuming your knowledge of federal law hasn’t completely faded, 8 hours of review is typically sufficient.

To be fair, the MPJE is a difficult exam. Personally, I found my first MPJEs—New Jersey (07/09/2005) and Mississippi (10/18/2021), which I consider equally “first” due to the 16-year gap—more challenging than the New York State Bar Exam. My pharmacist colleagues often laugh when I say this, but I genuinely mean it.

Why? Because unlike the bar exam, the wording of some MPJE questions is so convoluted that it can confuse even a licensed attorney with over 15 years of pharmacy experience across various settings. At least on the NYS Bar Exam, you can showcase your understanding through essays—demonstrating how laws apply and what outcomes are likely. The MPJE, however, is entirely multiple choice, often with “Select All That Apply” (SATA) questions, offering no opportunity to explain your reasoning.

By the way—don’t panic if you get several SATA questions in a row. That’s actually a good sign! While the NABP doesn’t release details about how the MPJE is scored (other than noting it’s adaptive), I believe SATA questions appear only when you’re performing well. Think about it: if you keep getting answers wrong, the algorithm likely responds with easier questions. To “unlock” those trickier SATA items, you probably need a streak of correct responses. So, if you’re seeing back-to-back-to-back SATA questions, chances are you’re doing great.

Conversely, if you don’t see many SATA questions—or if you get one here and there, followed by something overly simple like “Do you need a license to practice pharmacy?”—that might be a red flag. Again, this is purely my theory based on the adaptive nature of the exam, but I’m fairly confident it holds water.

Even though the MPJE is tough, achieving a passing score of 75 out of 100 shouldn’t be too difficult—if you know what to focus on. Keep in mind, a score of 75 doesn’t mean you need 75% of the questions correct. It’s a scaled score. NABP doesn’t disclose how scaling works, but in my opinion (again, speculative), correctly answering around 50% of the graded questions may be enough to pass. Remember, 20 out of the 120 questions are experimental and don’t count toward your score.

So, what do I study when preparing for the MPJE?

Most of the information can be found using the search function on each state’s pharmacy laws, rules, and regulations page—many states even offer them in downloadable PDFs. I also highly recommend reading the Board of Pharmacy’s FAQ section. These FAQs often clarify topics that are vague or confusing in the statutes, and they directly reflect real-world areas where pharmacists commonly struggle. In fact, I’ve seen questions pulled directly (sometimes verbatim) from state FAQ pages appear on the actual MPJE—making them rare freebies if you’ve read them in advance.

In addition, make sure to review recent Board of Pharmacy newsletters or letters (available via NABP or state board websites). These documents often contain the board’s interpretations of pharmacy laws in areas where compliance issues are frequent. Like the FAQs, I’ve frequently encountered exam questions based on these letters. Believe it or not, they’re often quite interesting—they cover the most debated or relevant topics of the moment.

Below, I’ll share the exact list of legal topics I always study before an MPJE. For clarity, I don’t study anything outside of these topics. If a question appears on something I didn’t cover, I just make an educated guess and move on. Remember: the goal isn’t to ace the exam. The goal is to hit that passing scaled score of 75—which, based on my experience, is achievable even if you have to guess on a handful of questions. And if you’ve studied federal law thoroughly, your “educated guesses” likely have a pretty decent chance of being correct.

FEDERAL LAW

Federal law serves as the foundation for every state’s MPJE, as the exam essentially tests three components: federal law, the state’s modifications to federal law, and state-specific laws not addressed by federal statutes. In other words, if the state law is silent on a particular issue, pharmacists must defer to the federal law. It is important to understand that when federal and state laws conflict, pharmacists must follow the stricter of the two. While state laws are often more stringent, there are exceptions – particularly regarding controlled substances – where federal law may be stricter.

Therefore, it is essential to first learn and memorize federal law before reviewing state-specific regulations. Establishing a solid foundation in federal law will make it easier to understand how each states builds upon or deviates from it. .

Study the history and background of laws related to pharmaceuticals, patient safety, pharmacy/medical practice which have led to current regulations. Key laws and legislation include the following:
1. Drug Importation Act of 1848: requires U.S. Customs to inspect imported drugs and stop the entry of adulterated drugs.
2. Pure Food and Drug Act of 1906: first major federal law regulating food and drugs in the US, which prohibits the manufacture, sale, or transportation of adulterated or misbranded food and drugs. The United States Food and Drug Administration (FDA) was created to enforce this Act.
3. Federal Food, Drug, and Cosmetic Act of 1938: enacted in response to a tragedy where a drug called “elixir sulfanilamide” containing a toxic solvent killed over 100 people, and requires evidence of safety before a drug could be marketed and expanded FDA’s regulatory authority to include cosmetics and medical devices.
4. Durham-Humphrey Amendment of 1951: established two classes of medications – prescription (Rx) and over-the-counter (OTC).
5. Kefauver-Harris Amendments of 1962: passed in response to the thalidomide tragedy and requires manufacturers to demonstrate the efficacy of a drug before it could be marketed in the U.S.
6. Poison Prevention Packaging Act of 1970: requires certain household substances such as prescription drugs, over-the-counter drugs, and hazardous chemicals to use child-resistant packaging. Note that there are some exemptions such as permitting non-child resistant packaging for certain medications if requested by the prescriber doctor or patient to accommodate the elderly and disabled.
7. Medical Device Amendments of 1976: requires safety and effectiveness safeguards to new medical devices following a U.S. Senate finding that faulty devices had caused thousands of injuries and deaths.
8. Drug Price Competition and Patent Term Restoration Act of 1984 (a.k.a. Hatch-Waxman Act): allows generic drugs to rely on the brand’s safety and efficacy data to gain approval while granting brand manufacturers years of exclusivity period where generics cannot be submitted to the FDA.
9. Health Insurance Portability and Accountability Act (HIPAA) of 1996: enacted to modernize the flow of healthcare information, provide national standards for electronic healthcare transactions, and protect the privacy and security of personal health information.
10. Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009: enacted to accelerate the adoption of electronic health records (HER) and other health information technology in the U.S healthcare system through a combination of incentives, standards, and enforcement mechanisms.

The list is not comprehensive and make sure you understand what effect the laws and regulations you encounter during your studies have on current pharmacy practice.

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Know the labeling requirements for prescription medications, OTC medications, unit dose medications dispensed in hospital, retail, and other practice settings. Memorize every component as MPJE frequently asks what is or is not required on a label.

For example, is NDC number required on the label of the vial dispensed to the patient at a retail pharmacy?

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How about on the labels of unit-dosed packages in an inpatient setting?

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Understand both the definitions and examples of misbranding and adulteration, as this distinction is frequently tested on the MPJE. A helpful way to differentiate between the two is that misbranding is about false or misleading labeling while adulteration is about issues with the actual composition, quality, or manufacturing of the product. In other words, misbranding relates to how the product is presented while adulteration relates to how the product is made. For example, if a patient receives a prescription labeled atorvastatin 20mg tablets on the vial from a retail pharmacy but it contains lisinopril 20mg tablets instead, it would be mislabeling as the vial’s label misrepresents the content inside the vial but there are no inherent defects in the lisinopril tablets itself. If the same vial contained atorvastatin 20mg but you see discoloration of tablets, then this would be considered adulteration as it has inherent defects. If the lisinopril tablets had discoloration in the atorvastatin vial, it would be considered both misbranded an adulterated. How about atorvastatin 20mg vial with a label indicating manufacturer A containing atorvastatin 20mg from manufacturer B? This would constitute misbranding even if the active ingredient, strength, and formulation is the same as the label has misinformation about the manufacturer. What if the pharmacist was compounding IV chemotherapy medications in the chemotherapy hood and starts compounding vancomycin bags without changing the gloves? That would be an example of adulteration even though there is no clear evidence of contamination. Note that the risk of contamination itself is sufficient to constitute adulteration. It is imperative that you understand the difference between the two definitions as it is frequently tested on the MPJE with many different scenarios.

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Know the various classes of FDA recalls and how to respond to them.

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Know the eligibility requirements for a facility to register as a 503B outsourcing facility with the FDA.

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Learn both the generic and common brand names of federally scheduled class drugs (CI-CV): Note that some states will classify federally non-controlled substances as a controlled substance in their state. A common example would be gabapentin in multiple states. Also, some states such as NY will have their own schedule within the controlled substance classes with certain classes of controlled substances.

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Understand how to determine controlled substance class based on codeine content by milligrams.

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Know what rating in the Orange Book would constitute bioequivalency between two medications. Note that there are various codes (AA, AB, AN, AO, AP, AT, BC, BD, BE, BN, BP, BR, BS, BT, BX, and B*) but only relevant codes for the MPJE are AB and BC. Know what AB and BC rating means.

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Know when patient package insert must be dispensed along with the medication.

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Learn the common floor plan for sterile compounding areas and be familiar with the common abbreviations used in sterile compounding settings such as ISO, PEC, LAFW, BSC, and ACPH. Know the ISO class level for areas that prepare low-risk, medium-risk, high-risk, and radiopharmaceuticals.

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CONTROLLED SUBSTANCES LAW

No other healthcare professionals other than pharmacists are required to pass a law exam to practice. Doctors, nurses, dentists, physician assistants, and others only need to demonstrate their clinical knowledge and practical skills prior to licensure. What makes pharmacists different from others? The major difference is that the pharmacists are involved in moving large amounts of controlled substances. Pharmacists must know every aspect of the controlled substance law as pharmacists order, store, distribute, and dispense controlled substances. In addition to the complex regulations on controlled substances, many states relying on pharmacists to identify inappropriate prescribing and dispensing of controlled substances in effort to combat opioid epidemic makes controlled substance law not only a key component, but also the most frequently asked topic in the MPJE.

The most effective way to study controlled substance laws is to categorize them based on real-world scenarios commonly encountered in pharmacy practice.

A good starting point is when pharmacists receive a prescription for a controlled substance.

Is this a CII or CIII-V?

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Does the prescription include everything that is required by law? (e.g., patient name, written date, prescriber’s signature, DEA number, etc.) If such information is missing or incorrect, can the pharmacist add or modify them with or without prescriber’s knowledge or approval?

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If it is a CII, is the prescription still valid based on the written date of the prescription? What if it is for a CIII-V?

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Is there a quantity or day supply limit for CII per prescription? How about CIII-V? How many refills are allowed on CIII-V and for how long are the refills valid?

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Are post-dated prescriptions allowed for CII? How about CIII-V? If not, how does the prescriber issue controlled substances if a patient needs it for long term and cannot see the prescriber for new prescriptions?

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Are emergency verbal orders allowed for controlled substances? If so, who can call in the order? Are only prescribers permitted to phone in or can their agents call them in? Any quantity or day supply limit for emergency verbal orders? When does the pharmacy must receive cover prescription by? To whom does the pharmacist report if such cover prescription is not received?

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Who can prescribe controlled substances in this state? Can nurse practitioners, physician assistants, or other non-MD/DO prescribe CII? Any quantity or day supply limits? Any restrictions or special circumstances for advanced practitioners in prescribing controlled substances?

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Can controlled substance prescriptions be transferred between pharmacies within the state? Pharmacies outside of the state? Any limits on how many times it can be transferred? What information must be communicated between pharmacies? Are licensed pharmacists the only personnel that can transfer in or out controlled substances?

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Any state-specific controlled substances that are different from the federal schedule?

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Can CII prescriptions be partially dispensed? If so, under what conditions? When does the remainder must be dispensed? How about for CIII-V?

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Can pharmacist use faxed CII prescription order as original? If so, in which practice settings under what conditions?

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If the prescriber dies after issuing controlled substance prescription? Can pharmacist still dispense it if the patient brings in the prescription? Would the answer be different if the prescription is CIII-CV instead of CII? How about refills on existing controlled substance prescriptions? Is a patient barred from receiving all remaining refills once the doctor dies? Are they allowed limited number of refills until they find a new prescriber?

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Can the prescriber order more than one controlled substance on a single prescription pad? How about a combination of one controlled substance and non-controlled substances?

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Understand the rules regarding electronic prescribing of controlled substances. Can these be transferred between pharmacies?

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Other common scenarios include ordering, receiving, storing, sending, selling, and dispensing controlled substances.

What form do DEA registered entities use to order or return CII? CIII-V?

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Know when to use DEA-222 form or invoice. Good rule of thumb is to memorize that any situation involving CII must use DEA-222 form while everything else uses invoice.

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Is the use of electronic CSOS required? Who has access to CSOS?

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Who can sign DEA from 222 and the CSOS?

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Know the layers and colors of the DEA-222 form and which copy goes to whom: Copy 1 (Brown) Supplier, Copy 2 (Green) DEA – submitted to DEA by the supplier, and Copy 3 (Blue) Purchaser or registration holder.

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Can prescribers prescribe controlled substances for themselves or family members? If so, any restrictions?

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Can prescribers dispense controlled substances? If so, any reporting requirements?

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Do patients must present government issued photo ID to pick up controlled substance prescriptions?

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How often does pharmacy must perform inventory for controlled substances?

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How do pharmacists deal with expired controlled substances? Damaged controlled substances? Controlled substances that arrived damaged when receiving the order?

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What is the state approved process for destructing controlled substances? Who can qualify as a witness?

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Do controlled substances must be locked in a cabinet? CII only?

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Is checking PDMP prior to dispensing controlled substances required by law or merely recommended? Who can access PDMP? Does the law require prescribers to review PDMP prior to prescribing new controlled substance prescriptions or refills? If so, how often?

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Is reporting controlled substance dispensing data to PDMP required? How soon and often does the pharmacy must upload or transmit the data? How soon does the pharmacy rectify errors in such data and upload or transmit to PDMP?

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What does the pharmacist must do when controlled substances get stolen? Contact the DEA? Local police? Board of Pharmacy? Any time frame it must be reported by? Does the report must be in writing or can it be verbal?

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Know the common DEA forms and registration rules: Which form is used to report theft or loss of controlled substance (DEA-106)? Destruction of controlled substances (DEA-41)? Registration (DEA-224)? How long is DEA registration good for? Does hospital pharmacy department with multiple satellite pharmacies require separate DEA registrations?
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Know the dispensing process of buprenorphine containing products in an outpatient setting and how to recognize DATA waiver ID number.

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Learn how to calculate whether the DEA number is valid.

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NON-CONTROLLED SUBSTANCES LAW

Understanding laws involving non-controlled substances are just as important as the controlled substance laws as most pharmacists will spend majority of their time dispensing non-controlled substances during their practice. The initial approach reviewing non-controlled substance prescriptions is the same as for controlled substance prescriptions.

Does the prescription include everything required by law? (e.g., patient name, written date, prescriber’s signature, etc.) If such information is missing or incorrect, can I add or modify it with or without prescriber’s knowledge or approval?

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Is the prescription valid based on the written date?

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What does prescriber must indicate on the prescription to disallow substitution? Is indicating DAW enough? Does “Brand Medically Necessary” must be written out?

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Can patients request generic to be dispensed if the prescriber indicated DAW or brand medically necessary for a brand name drug? Can patients request brand name when the prescription issued for a generic drug? Can patients request a different manufacturer of a generic product when the prescriber specified a certain manufacturer on the prescription indicating DAW? What about for medications that have NTI? How about biosimilar drugs? Can any of these be done without receiving prescriber’s approval solely based on patient’s request? Can pharmacists make substitutions based on their professional judgment prior to getting prescriber’s approval as long as prescriber is notified within a reasonable amount of time?

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Can pharmacists make substitutions on biosimilar drugs? If so, does this require prescriber’s approval prior to switching? Does the law allow pharmacists to substitute as long as the pharmacist notifies the prescriber after the switch?

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Can pharmacists make dosage form substitutions? If so, does this require prescriber’s approval prior to switching? Does the law allow pharmacists to substitute as long as the pharmacist notifies the prescriber after the switch?

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Can all non-controlled substance prescriptions be transferred between pharmacies within the state? Pharmacies outside of the state? Any limits on how many times it can be transferred? What information must be communicated between pharmacies? Are licensed pharmacists the only personnel that can transfer in or out prescriptions?

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Know the FDA’s various “colored” books and what information it lists (e.g., orange book, purple book, yellow book, green book, etc.).

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Understand the REMS and IPLEDGE program. Know the applicable mediations, rules, and the dispensing process. Know what can and cannot be done when each required step of REMS and IPLEDGE program has not been met (e.g., prescriber not enrolled, missing authorization #, patient showing up after the authorization expires, etc.). Also, can prescriptions requiring REMS/IPLEDGE transferred between pharmacies?

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How often does the inventory must be completed by law?

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Know the prescriptive authority. Who can prescribe in your state? Are certain prescribers restricted to certain therapeutic classes of medications? Can pharmacists prescribe? If so, what medications? CDTM for pharmacists? Eligibility requirements? What can pharmacists do under collaborative agreements (e.g., initiate/modify/end therapy, order labs, etc.)?

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Can pharmacists immunize? If so, what are the requirements to become an immunizer? What vaccines can be given via standing order? What vaccines need prescription? Which vaccines can be given to minors? Pediatric patients? Can pharmacy technicians give immunizations? Do they need to be certified or licensed? Pharmacy interns? Externs?

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Know the retention time for various documents and prescriptions (paper and electronic form) and understand which documents and prescriptions can be stored on-site or off-site.

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Can syringes be sold without a prescription? How about pen needles? Any quantity limits? Does the purchase must show any proof of medical necessity? ID required to purchase? If so, which IDs are acceptable? Does the ID must contain a photo? Can government issued ID without photo, such as social security card, be used?

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Naloxone – Can this be dispensed without a prescription? Any requirements that must be met prior to dispensing? Quantity limits?

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What happens when the prescriber dies after issuing a prescription? Can pharmacists still dispense it? How about refills on existing prescriptions? Is a patient barred from receiving all remaining refills once the prescriber dies? Are they allowed at least one refill until they find a new prescriber? Would the answer be different depending on whether the medication is controlled substance?

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Can pharmacists refuse to fill prescriptions? Based on clinical judgment? Based on moral/ethical/religious grounds? What are pharmacist’s obligations in such cases?

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PHARMACY OPERATIONS

Pharmacists must have a foundational understanding of pharmacy operations on all practice settings, not just hospital or community settings. In particular, you must know what part of operations can be performed only by a licensed pharmacist. Also, know which tasks can be delegated to pharmacy interns, externs, licensed/certified techs, non-licensed/certified techs, and clerks. In some practice settings, doctors or nurses can be designated to carry out certain pharmacy related tasks, so make sure you know who can do what under which circumstances.

Compounding – What is USP 795, 797, and 800? What constitutes compounding? Can pharmacists compound medications in advance? If so, how do pharmacists determine the quantity of compounded medications to be prepared in advance? What is the difference between compounding and manufacturing? Who can compound sterile products? Who can compound non-sterile products? Any training or certification requirements for compounding? Also, understand the general structure of the clean room and the order of wearing and taking off PPEs.

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Expiration and beyond-use dates – Know how to calculate expiration or beyond-use dates for medications that are repackaged and compounded. Understand the differences in use by dates depending on the type of compounding environment (sterile v. non-sterile), the number of medications being compounded, storage conditions (refrigeration v. room temperature), and other factors. Know the different categories of risks per USP 797 and how it affects the beyond-use date at controlled room temperature, refrigerator, and freezer. Know how the beyond-use dates differ depending on non-preserved aqueous compounds, preserved aqueous compounds, non-aqueous dosage forms and solid dosage forms. How about IV medications prepared at bedside for immediate administrations in emergency settings?

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Counseling – Is counseling required? Is offer to counsel sufficient? Does counseling law only apply to new prescriptions? Refills? Maintenance drugs? Whenever pharmacists feel appropriate? Who can counsel? Do you have to document refused or accepted counsels? If so, for how long? Can you counsel if patients are accompanying someone with them? Can you counsel patient’s agent instead? If so, how do you confirm whether patients are okay with the agent receiving counseling for his or her behalf? Can counseling be done via telephone, video-audio communication, or in writing?

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Behind the counter medications – Know which products (e.g. pseudoephedrine) must be kept behind the counter and the process of selling such products to the patient. For pseudoephedrine containing products, what is the maximum amount you can sell per day? Per 30 days? Would the answer be different if the product is sold via mail order? What type of IDs are accepted? For example, is social security card an acceptable form of ID?

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Emergency oral contraceptives – Who can buy them? Is ID required?

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Automated dispensing system – Who can stock them? Who can withdraw medications from the system? Any technological requirements (e.g., barcode)? How often does it have to be maintained? Any auditing requirements? Can anyone other than licensed pharmacists have access to them when pharmacists are unavailable? Any logging requirements?

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Medication Kits/ Emergency Kits – Who decides the contents of the kit? Any restrictions on the number of medications, class of medications (controlled substances okay?), and quantity of medication? Who legally owns the kit? Who can remove medications from the kit? By what time does the person who removed the medications from the kit must notify the pharmacy? By what time does the pharmacy must replenish the kit? Any logging requirements? Expiration date requirements?

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RPh to intern/technician ratio – How many interns can pharmacist supervise? Does this number depend on the type of intern (e.g., graduate intern, academic intern doing rotations, extern)? How about technicians? Does the ratio change depending on whether the technicians are licensed/certified/registered? Does an intern doing technician tasks count towards the intern ratio or technician ratio?

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Returns – Know at what point the actual dispensing occurs. Does the state law consider medication to be dispensed once it leaves the pharmacy premises or only when it is in patient’s possession? In other words, if the medication is in transit from the pharmacy to the patient (e.g., mail order, delivery service, etc.), has the medication been legally dispensed? When can medications be returned to the pharmacy for redispensing in a retail setting? Hospital setting? LTC setting? What conditions must be met in order to accept returns for redispensing? Are controlled substances returnable for redispensing? Are injectables returnable for redispensing? How about medications that require refrigeration? Can returned medications be donated to non-profit organizations? If so, what are the requirements?

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Remote filling and dispensing – If one pharmacy receives the prescription but the actual dispensing happens at another pharmacy, which pharmacy’s information should be on the label? Which pharmacy’s information should be on the label if pharmacy A receives the prescription, pharmacy B fills it and mails it back to pharmacy A, then pharmacy A dispenses the prescription? Which pharmacy is responsible for counseling? Can controlled substances be filled and dispensed remotely? Is there a restriction on whether the remote pharmacy must be in-state? Do pharmacists or the pharmacy managers at remote settings must be licensed in the state where the pharmacy that receives original prescription is located? Do pharmacists must be licensed in patient’s residing state to counsel?

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Can pharmacists administer medications? Retail setting? Hospital setting? Long-term care setting?

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What are the requirements to become a nuclear pharmacist?

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Can pharmacists work remotely? If so, what are the requirements? How about working remotely from a different state where the pharmacy is located? How about from a different country?

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BOARD OF PHARAMCY REQUIREMENTS & TIMELINES

Understand the organizational structure of the Board – How many members sit on the board of pharmacy? Any quota per member’s background (e.g., hospital, retail, public member, etc.)? What are the requirements to become a board member? Who chairs the board? How are board members selected? How long do they serve? How often does the board convene? Who can attend these meetings?

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Know the procedure and timelines for reporting when opening, closing, relocating, and temporarily closing the pharmacy.

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Know the procedure and timelines for reporting when there is a change in pharmacist in charge (PIC).

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Know the procedure and timelines for reporting when there is a change in name or the ownership of the pharmacy.

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Know the timelines for reporting changes in address, employment, and other information related to the licensee.

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Know the licensure and renewal requirements including renewal period, number of CEs, types of CEs required (how many credits must be from live CEs? Specific topic required as part of the CE?), and whether there are grace periods and fees for late renewals.

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Know the procedure and timelines for new registration and renewal of registration for facilities.

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Common deadlines: Immediately, as soon as possible, 1 day, 3 days, 5 days, 7 days, 10 days, 14 days, 30 days, 60 days, and 90 days. A good way of memorizing these timelines is by assessing the importance and urgency of the nature of the issue in question.

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BOARD OF PHARMACY NEWSLETTERS

Board of Pharmacy newsletters are arguably one of the best resources for learning pharmacy law, as they contain interpretations and clarifications issued directed by the Board itself. These newsletters often explain laws, regulations, and rules in greater detail – especially those that are frequently questioned by pharmacists and pharmacy technicians.

For example, the January 2024 Newsletter from the New Jersey Board of Pharmacy specific criteria for evaluating whether to fill a prescription, going well beyond the general guidance of “using professional judgment.” It also provides a more comprehensive explanation of when compounding semaglutide is permissible – offering more clarity than the statute alone. It is very common for MPJE questions to be based directly on content from these newsletters – sometimes verbatim – making them essential study material.

Most states provide links to their newsletters through the NABP website. For example, NJBOP newsletters can be found at https://nabp.pharmacy/bop_members/new-jersey/. Some states may only publish newsletters on their own websites, which can be easily searched and accessed using the internet via search engine of your choice.

FINAL TIPS

The following are some tips you should remember while taking the MPJE:

KNOW WHICH LAW TO APPLY

If state law is silent on a certain issue but federal law covers the topic, then follow the federal law.

If federal law is silent on a certain issue but state law covers the topic, then follow the state law.

If both federal and state law covers the topic, then follow the stricter law.

If both federal and state law are silent on the topic, make an educated guess.

KEEP MOVING

If you do not know the answer to a question, make an educated guess and move on. MPJE is a timed exam, and it is essential to answer all questions before time runs out. Make an educated guess – consider the intent of the question and whether the answer choice you are about to choose is realistic or logic in real world pharmacy practice – and hope for the best. Always keep in mind that your goal is not to get a perfect score but is simply to earn enough points to pass. Interestingly, research from the Center for Teaching at Vanderbilt University suggest that on 5-option multiple choice questions, the answers “None of the above” or “All of the above” are correct 52% of the time – a 90% improvement over random guessing. This is because test writers often use these choices when they want the correct answer to be indisputably accurate or to require qualifying language. So, if you encounter a question where you cannot even formulate an educated guess and one of those choices is available, go for it as we can consider it as an evidence-based guessing.

IDENTIFY THE LEGAL ISSUE & UNDERSTAND THE INTENT OF THE LAW

Oliver Wendell Holmes JR, an associate justice of the SCOTUS, once said “This is a court of law, young man, not a court of justice”. This is the mindset you must adopt to succeed on any law-related exam, including the MPJE. Your focus should always be on identifying the legal issue at hand – not on what may feel morally right or best for the patient.

What is legal is not always what seems ethically ideal. If a question includes extra details that tempt you to make a moral judgment or rely on personal opinion, don’t get distracted. Your job is to isolate and answer the underlying legal question.

It is also important to understand the intent behind laws, rules, and regulations. Consider what regulatory agencies or lawmakers are trying to accomplish. Grasping this intent will not only strengthen your comprehension but will also help you make informed, educated guesses when you are unsure of an answer.

DO NOT PANIC

It is common for test takers to feel anxious during the MPJE, especially when faced with a series of challenging questions. Do not panic if this happens to you – it probably is a good sign!

The MPJE is an adaptive exam, meaning the difficulty of questions increases as you answer correctly. If you begin seeing multiple SATA (select all that apply) type questions in a row, take it as a positive indicator. These complex question types are typically only presented when the test algorithm determines you’ve been performing well. In other words, seeing tougher questions means you are likely answering correctly. On the other hand, if you are not encountering many SATA questions or if you are consistently presented with easy questions, take a moment to rest. Breathe, focus, and read each question and answer choices carefully. This is likely why some test takers who describe the exam as difficult end up passing, while those who find it easy may fail.

Watch for keyword such as NOT, MAY, and SHALL – these can significantly change the meaning of a question. Missing them can lead to incorrect answers, even if you understand the topic in depth.

READ THE DEFINITIONS CAREFULLY

Make sure you understand the definitions of terms as stated in the statutes. For example, many students mistakenly equate the term “age” with “date of birth” while studying for the MPJE, which can cause confusion during the exam when both appear as answer choices.

If a term involves multiple components – such as processes, tasks, or duties – be sure to memorize each part. Take “drug utilization as an example: it includes several specific tasks. Ask yourself, Does it include checking for drug-food interactions?

Also, pay attention to how location-related terms are defined. Unless a question explicitly states the patient is traveling out of state or out of country, the phrase “out of town” means the patient is still traveling within the same state of the MPJE.

Reading definitions carefully and fully understanding what each term means will help you tremendously – especially on SATA questions.

COMMON SENSE & LOGIC

When in doubt during the MPJE, apply common sense and logic.

If you are unsure about an answer, consider the intent and urgency behind the regulation. For example, if a question asks about the deadline for reporting a pharmacist’s change of residential address to the Board, it’s safe to eliminate any answer choices with very short timeframes as it is likely a lower priority for the Board.

In contrast, if the question concerns a pharmacy robbery, eliminate any options with long timeframes. This is a high priority event that the Board would want to know about immediately.

Also, stay mindful of current issues in pharmacy practice. If a question touches on topics like the opioid epidemic, assume the correct answer will likely reflect a stricter regulatory approach aligned with public health concerns.

Take, for example, the New York state law stating: “Unless an earlier refilling is authorized by the prescriber, no prescription shall be refilled earlier than seven days prior to the date previously dispensed supply would exhaust if used in conformity with the directions for use.”

Many interpret this to mean that controlled substances can be refilled seven days early every month – NO! Given New York’s serious opioid crisis, allowing an extra 84 days of opioid supply per year clearly goes against legislative intent. When read carefully, the law actually means that the patient may have at most a 7-day surplus at any one time – not per every fill. This interpretation aligns more logically with the state’s efforts to curb opioid misuse.

No law is written without intent. Try to understand the purpose behind the law, and use context, logic, and current pharmacy issues to guide your answers.

Good Luck!

If you would like to purchase a paper copy of this guide, it is available for purchase at Amazon at MPJE Q-BANK: Study Guide with Questions Only & Interview Tips for Residency Programs: Lee, Alexander: 9798336993202: Amazon.com: Books.

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