Pharmacy

What interviewers look for

• Safe dispensing: you read every prescription carefully, check it before you pick, label clearly, and do a final check before the medicine leaves your hands.
• Clear counselling in plain Somali: what the medicine is for, how and when to take it, what to expect, and a check that the patient understood.
• Stock discipline: FEFO on every shelf, up-to-date stock cards, correct storage and cold chain, and early action on near-expiry items and stock-outs.
• Quality awareness: you buy only from licensed suppliers, check packs and batch details, and quarantine and report anything that looks suspect.
• Ethics under pressure: no antibiotics or other prescription-only medicines without a prescription, controlled medicines kept by the rules, and referral when a customer needs a clinician.

Questions they ask

1. 1“Walk us through how you dispense a prescription, from receiving it to handing it over.”

   Why they ask: The panel wants a fixed sequence with checks built in. Most dispensing errors happen when a step is skipped on a busy day.

   How to answer

   • Check the prescription: patient name and age, prescriber, date, signature, and that it is clear and complete.
   • Check it makes sense: the medicine, strength and form suit the patient; ask about allergies, other medicines and interactions.
   • Pick and prepare: match name, strength and form, check the expiry, count or measure, and label with the name and clear directions.
   • Do a final check, counsel the patient, and record the dispensing in the register or system.

   When I receive a prescription, I first check the patient's name and age, the prescriber, the date and the signature. Then I check that the medicine and strength suit the patient, and I ask about allergies and other medicines they take. I pick the medicine, compare the name, strength and form with the prescription, check the expiry date, and label it clearly with how and when to take it. Before handing it over I check everything once more against the prescription. Then I explain it to the patient in Somali, ask them to repeat the key points, and record it in the register.

2. 2“A father asks for amoxicillin without a prescription for his child's cough. What do you do?”

   Why they ask: Selling antibiotics without a prescription is common and drives antimicrobial resistance. The panel checks that you refuse politely, explain why, and still help the family.

   How to answer

   • Refuse kindly and explain: antibiotics need a prescription, many coughs are viral, and wrong use makes antibiotics stop working.
   • Ask a few safety questions: fast or difficult breathing, high fever, not feeding, very sleepy; any danger sign means a clinic today.
   • Offer help within your role, such as advice on fluids and feeding, and tell him where the nearest health centre is.
   • Stay firm even if he insists or says another pharmacy will sell it.

   I would greet him and ask about the child: how old he is, how long the cough has lasted, and whether he is breathing fast, has a high fever or is not feeding. If there is any danger sign, I would tell him to take the child to the health centre today. I would explain kindly that amoxicillin needs a prescription, because many coughs are caused by viruses, and using antibiotics without need makes them fail when the child really needs them. I would give advice on fluids and feeding, and tell him where the nearest clinic is.

3. 3“How do you manage stock so that medicines neither expire nor run out?”

   Why they ask: Poor stock control wastes money and leaves patients without medicine. The panel checks that you know FEFO, stock cards, reorder levels and physical counts.

   How to answer

   • Arrange by FEFO: first expiry, first out, with the nearest expiry at the front of the shelf.
   • Record every receipt and issue on the stock card the same day, and do regular physical counts to compare.
   • Use average consumption to set minimum and maximum levels, and order when an item reaches its reorder level.
   • Review expiry every month and act early on items that will expire soon, together with your manager.

   I arrange shelves by FEFO, so the batch with the nearest expiry is at the front. Every receipt and issue goes on the stock card the same day, and we do a physical count every month and compare it with the cards. I use average monthly consumption to set minimum and maximum levels, and I order when an item reaches its reorder level. Each month I list items that will expire within the next few months. In my last job I found a batch of ORS close to expiry and, with the manager's approval, sent it to an outreach team that used it in time.

4. 4“How do you recognise a medicine that may be counterfeit or substandard?”

   Why they ask: Falsified and substandard medicines are a real risk where supply chains are informal. The panel checks what you look for and what you do when you suspect a product.

   How to answer

   • Check the source first: only licensed suppliers, with invoices and batch records you can trace.
   • Inspect the pack: spelling mistakes, poor printing, batch number or expiry that differ between box and blister, broken seals.
   • Inspect the product and the price: odd colour or smell, crumbling tablets, cloudy solutions, or a price far below normal.
   • If in doubt, quarantine it, do not dispense it, and report to your manager and the national medicines regulator as required.

5. 5“A prescription includes two medicines that you know can interact. What do you do?”

   Why they ask: The panel checks that you use a reference, contact the prescriber and record the outcome, and that you never change a prescription on your own or ignore the problem.

   How to answer

   • Check a reliable reference, such as the national formulary, the BNF or a trusted interaction checker, to confirm how serious it is.
   • Contact the prescriber, explain the concern briefly, and offer options if they ask.
   • Record the call and the decision, and tell the patient what to watch for.

6. 6“How do you store medicines that need a fridge, and what do you do if the power goes off?”

   Why they ask: Insulin, oxytocin and vaccines lose their effect if they get too warm or freeze. The panel checks your cold chain routine and your plan for power cuts, which are common in many areas.

   How to answer

   • Keep them between +2 and +8 °C in a proper medicine fridge, not in the door, and never let them freeze.
   • Record the temperature twice a day and act on any reading outside the range.
   • Have a power-cut plan: backup power, a cold box with conditioned ice packs, and the fridge door kept shut.
   • After an excursion, set the product aside and follow your manager's or the manufacturer's guidance before using it.

   Insulin and oxytocin go in the medicine fridge between +2 and +8 °C, on the middle shelves, never in the door and never against the back wall where they can freeze. I record the temperature morning and evening. When the power went off for several hours at the hospital where I worked, I kept the fridge closed, checked the thermometer every hour, and moved the most sensitive items into a cold box with conditioned ice packs until the generator was repaired. I wrote the excursion in the log and informed the pharmacist in charge.

7. 7“How do you handle controlled medicines, such as strong painkillers?”

   Why they ask: Controlled medicines can be misused or stolen. The panel checks that you know the rules: locked storage, a separate register, running balances and clear responsibility.

   How to answer

   • Keep them in a locked cupboard, with the keys held only by the authorised person.
   • Record every receipt and issue in the controlled medicines register straight away, with a running balance.
   • Dispense only against a valid prescription, with a witness where the rules require one.
   • Report any difference in the balance at once; never adjust the register to hide it.

8. 8“How would you counsel a patient who is starting a new medicine?”

   Why they ask: Many treatments fail because patients do not understand how to take their medicine. The panel checks that you give the essentials in plain Somali and confirm the patient understood.

   How to answer

   • Cover the essentials: what it is for, how much and when, for how long, and with or without food.
   • Mention the common side effects, and which ones mean coming back or seeing a clinician.
   • Explain storage and what to do after a missed dose, following the leaflet or a reference.
   • Use teach-back: ask the patient to tell you in their own words how they will take it.

Example answers are in English, the language most panels use. Say it in your own words.

Topics to revise

• Prescription checkBefore dispensing, confirm the patient's name and age, the prescriber's name and signature, the date, and a clear medicine name, strength, form, dose, frequency and duration. A test may give you prescriptions with something missing and ask what you would do: the answer is to contact the prescriber, not to guess.
• FEFO vs FIFOFIFO means first in, first out; FEFO means first expiry, first out. FEFO is the rule for medicines, because a batch received later can expire sooner. Expect a question where you arrange batches on a shelf or choose which one to issue first.
• Stock card and physical countA stock card (or bin card) records every receipt, every issue and the balance for one item. A physical count compares the real quantity on the shelf with the card. Differences are investigated and reported, never just corrected on paper.
• Minimum and maximum stock levelsSet from average monthly consumption: the minimum (reorder level) tells you when to order, and the maximum is the most you should hold. They prevent both stock-outs and overstock that ends in expiry. A simple order quantity is the maximum minus stock on hand minus stock already on order.
• Cold chain (+2 to +8 °C)Medicines such as insulin, oxytocin and vaccines must stay between +2 and +8 °C and must not freeze. Use a proper medicine fridge, a thermometer and a temperature log checked twice a day, plus a plan for power cuts. Panels ask what you do after a temperature excursion.
• Storage conditionsMost medicines need a cool, dry place away from direct sunlight, on shelves or pallets off the floor, with space for air to move. In hot areas the storeroom temperature matters, so keep it recorded where your system requires. Liquids, creams and suppositories can spoil faster in heat.
• Expiry and quarantineExpired, damaged or suspect items are taken off the shelf, labelled “not for use”, kept in a separate quarantine area and recorded, then disposed of following the facility's and the regulator's rules. Expired medicines are never sold, discounted or donated.
• Prescription-only (POM) vs OTCOTC (over-the-counter) medicines can be sold without a prescription; prescription-only medicines (POM) cannot. Antibiotics are prescription-only. Panels test this with a customer who insists, and they want a polite refusal, safety questions and a referral.
• Controlled medicines registerA separate, bound register for medicines that can be misused, such as morphine and other strong painkillers. Each receipt and issue is written at once with the date, the patient or ward, the quantity and a running balance, and signed. Know who holds the keys and what you do if the count and the balance differ.
• Substandard and falsified medicinesWHO terms. Substandard: a real, authorised product that fails quality standards. Falsified: deliberately faked in identity, content or source. Know the warning signs on the pack and the product, and that suspected products are quarantined and reported to the national medicines regulator.
• Drug interactionsWhen one medicine changes the effect of another, or food changes a medicine's effect. Examples to know: warfarin with many painkillers and antibiotics (more bleeding risk), and some antibiotics with antacids or iron, which reduce absorption. Always say you would check a reference and contact the prescriber.
• Antimicrobial resistance (AMR)When bacteria stop responding to antibiotics, often because antibiotics are used without need or not as prescribed. Pharmacies help slow it by never selling antibiotics without a prescription and by counselling patients to take the full course as prescribed. Panels often link this to the ethics question.

Practical tasks you may get

1. 1Prescription reading test: several prescriptions, some with errors such as a missing strength, an unclear dose, an interaction, or an adult form given for a small child. Say what is wrong and what you would do. Practise with a formulary and old prescriptions with the names covered.
2. 2Stock exercise: work out balances on a stock card, an order quantity from consumption and minimum and maximum levels, or arrange batches on a shelf by FEFO. Practise the arithmetic on paper and in Excel before the day.
3. 3Counselling role-play: a panel member plays a patient collecting a new medicine. Explain it in plain Somali, check understanding with teach-back, and answer a question about side effects honestly, saying you would check if you are unsure.
4. 4Product knowledge check: the generic names behind common brands, POM or OTC for a list of medicines, or which of two packs looks falsified. Revise the generic names of the essential medicines you handle most.

Mistakes to avoid

• Talking about selling antibiotics without a prescription as normal, or saying the customer is always right.
• Describing dispensing with no final check and no counselling step.
• Saying you would change a prescription yourself instead of contacting the prescriber.
• Not knowing FEFO or how a stock card works, even when applying for a dispensing post.
• Quoting doses from memory to impress the panel instead of saying you would check the reference.
• Claiming experience with a pharmacy system or a controlled medicines register you have never used.

Quick check

5 questions. Answer each one to see the explanation.