{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:47:38Z","timestamp":1791823658320,"version":"4.3.4"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Geographic and sectoral maldistribution of pharmacists has become a critical challenge for Japan\u2019s healthcare system. While the number of community pharmacists continues to rise, the chronic shortage of hospital pharmacists persists. This study aimed to clarify longitudinal career trajectories, inter-sector mobility, and predictors of leaving employment among early\u2011career pharmacists in Japan, using nationwide census\u2011based data covering all licensed pharmacists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an eight\u2011year longitudinal cohort study using individual\u2011level data from the Statistics of Physicians, Dentists and Pharmacists from 2012 to 2020. The cohort included 7,242 pharmacists (3,458 men and 3,784 women) who obtained their pharmacist license in 2011\u20132012 and were continuously identified in all five survey waves. Employment sectors were categorized into 10 groups. Using generalized estimating equations (GEE), we analyzed the odds of being \u201cunemployed\u201d (defined as having no institutional affiliation), adjusting for gender, survey year, and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline (2012), hospital and community pharmacists accounted for 84.6% of the cohort. By 2020, the proportion of community pharmacists had increased, whereas the proportion of hospital pharmacists had substantially declined. Among those initially employed in hospitals, 34.5% left the hospital sector within eight years, and 83.6% of these individuals transitioned to community pharmacies. In contrast, 88.9% of community pharmacists remained in the same sector throughout the study period. The proportion unemployed among men remained below 1.0%, while the rate among women increased from 0.4% to 3.7%. GEE analysis demonstrated that women had a significantly higher ratio of being unemployed over time compared with men, independent of age (adjusted odds ratio 1.203, 95% CI: 1.118\u20131.293,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A substantial outflow from hospitals to community pharmacies was observed among early\u2011career pharmacists in Japan, suggesting that the hospital pharmacist shortage results not only from recruitment challenges but also from significant retention issues during the career continuation process. Additionally, women exhibited a distinctively higher ratio of career interruption. Policies that enhance retention through incentives for specialization in hospitals, along with targeted support for women\u2019s career continuity, are essential for sustaining the pharmacist workforce.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40780-026-00602-1","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:25:23Z","timestamp":1784093123000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An eight-year national follow-up study on the employment trajectories of early-career pharmacists in Japan up to 2020"],"prefix":"10.1186","volume":"12","author":[{"given":"Takahito","family":"Ando","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeru","family":"Shiroiwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinobu","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Yasuhara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"602_CR1","unstructured":"International Pharmaceutical Federation (FIP). 2012 FIP global pharmacy workforce report. 2012. The Hague: FIP."},{"issue":"1","key":"602_CR2","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1186\/s12913-021-07072-1","volume":"21","author":"D Terry","year":"2021","unstructured":"Terry D, Phan H, Peck B, Hills D, Kirschbaum M, Bishop JObamiro K, et al. Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review. BMC Health Serv Res. 2021;21(1):1052. https:\/\/doi.org\/10.1186\/s12913-021-07072-1.","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"602_CR3","doi-asserted-by":"publisher","first-page":"5741","DOI":"10.22605\/RRH5741","volume":"20","author":"KO Obamiro","year":"2020","unstructured":"Obamiro KO, Tesfaye WH, Barnett T. Strategies to increase the pharmacist workforce in rural and remote Australia: a scoping review. Rural Remote Health. 2020;20(4):5741. https:\/\/doi.org\/10.22605\/RRH5741.","journal-title":"Rural Remote Health"},{"issue":"1","key":"602_CR4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.3390\/ijerph19010034","volume":"19","author":"\u00c1 Miramontes Carballada","year":"2021","unstructured":"Miramontes Carballada \u00c1, Lois-Gonz\u00e1lez, Lois-Gonz\u00e1lez RC. Liberalization and governance in the geographical distribution of pharmacies in Spain. Int J Environ Res Public Health. 2021;19(1):34. https:\/\/doi.org\/10.3390\/ijerph19010034.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"602_CR5","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1186\/s12913-024-11882-4","volume":"24","author":"H Ni","year":"2024","unstructured":"Ni H, Yuan M, Wan P, Xiang Q, Hongling D, Minghai T, et al. The allocation and fairness of hospital pharmacist human resources in China: a time-series study. BMC Health Serv Res. 2024;24(1):1370. https:\/\/doi.org\/10.1186\/s12913-024-11882-4.","journal-title":"BMC Health Serv Res"},{"key":"602_CR6","unstructured":"World Health Organization. The world health report 2006: working together for health. 2006. Geneva: World Health Organization."},{"issue":"11","key":"602_CR7","doi-asserted-by":"publisher","first-page":"3884","DOI":"10.1016\/j.sapharm.2022.05.014","volume":"18","author":"SM Thin","year":"2022","unstructured":"Thin SM, Chongmelaxme B, Watcharadamrongkun S, Kanjanarach T, Sorofman BA, Kittisopee T. A systematic review on pharmacists\u2019 turnover and turnover intention. Res Soc Adm Pharm. 2022;18(11):3884\u201394. https:\/\/doi.org\/10.1016\/j.sapharm.2022.05.014.","journal-title":"Res Soc Adm Pharm"},{"key":"602_CR8","unstructured":"Ministry of Health, Labour and Welfare. Policies for securing pharmacists and pharmacist maldistribution index [Japanese]. https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/yakuzaishikakuho.html. Accessed 3 Feb 2026."},{"key":"602_CR9","unstructured":"Ministry of Education, Culture, Sports, Science and Technology. Overview of the pharmaceutical education System [yakugaku kyouiku seido no gaiyou]. https:\/\/www.mext.go.jp\/a_menu\/01_d\/1329586.htm. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR10","unstructured":"Cabinet Office. Annual Report on the Ageing Society [Reiwa 7-nen ban Koushi Shakai Hakusho]. 2025. https:\/\/www8.cao.go.jp\/kourei\/whitepaper\/w-2025\/zenbun\/07pdf_index.html. Accessed 3 Feb 2026."},{"key":"602_CR11","doi-asserted-by":"publisher","unstructured":"Al-Muallem N, Al-Surimi KM. Job satisfaction, work commitment and intention to leave among pharmacists: a cross-sectional study. 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Hum Resour Health. 2014;12(1):43. https:\/\/doi.org\/10.1186\/1478-4491-12-43.","journal-title":"Hum Resour Health"},{"key":"602_CR14","doi-asserted-by":"publisher","unstructured":"Hardigan P, Carvajal MJ. Job satisfaction among practicing pharmacists: a Rasch analysis. Internet J Allied Health Sci Pract. 2007;5(4). https:\/\/doi.org\/10.46743\/1540-580X\/2007.1172.","DOI":"10.46743\/1540-580X\/2007.1172"},{"key":"602_CR15","unstructured":"Yasuhara M. Survey research on effective initiatives for securing pharmacists in local communities [Chiiki ni okeru koukateki na yakuzaishi kakuho no torikumi ni kansuru chousa kenkyuu]. Health and labour sciences research Grant, regulatory science for medical devices and pharmaceuticals, project number: 21KC2009. 2022. https:\/\/mhlw-grants.niph.go.jp\/project\/163012. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR16","unstructured":"Takeda Y. Research on improving productivity and the ideal state of pharmacist duties based on the actual working conditions of pharmacists in hospitals [Byouin ni okeru yakuzaishi no hatarakikata no jittai wo fumaeta seisansei no koujou to yakuzaishi gyoumu no arikata ni kansuru kenkyuu]. Health and labour sciences research Grant, promotion of regional medical infrastructure development, project number: h29-iryo-ippan-011. Fiscal Year 2018. 2020. https:\/\/mhlw-grants.niph.go.jp\/project\/27985. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR17","unstructured":"Ministry of Health, Labour and Welfare. Medical service fee schedule (appended table 1) [Reiwa 6-nendo Beppyo Dai-ichi ika shinryo hoshu tensu-hyo]. Ministerial notification No. 57. 2024. https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/0000188411_00045.html. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR18","unstructured":"Cabinet Office. White Paper on gender Equality 2012 [Heisei 24-nendo Danjo Kyodo Sankaku Hakusho]. 2012. https:\/\/www.gender.go.jp\/about_danjo\/whitepaper\/h24\/zentai\/index.html. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR19","unstructured":"Cabinet Office. White Paper on gender Equality 2023 [Reiwa 5-nendo Danjo Kyodo Sankaku Hakusho]. 2023. https:\/\/www.gender.go.jp\/about_danjo\/whitepaper\/r05\/zentai\/index.html. Accessed 3 Feb 2026. (In Japanese)."},{"issue":"10","key":"602_CR20","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1093\/ajhp\/57.10.975","volume":"57","author":"DA Mott","year":"2000","unstructured":"Mott DA. Pharmacist job turnover, length of service, and reasons for leaving, 1983-1997. 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Report of the panel on the training and quality improvement of pharmacists [Yakuzaishi no yousei oyobi shishitsu koujou tou ni kansuru kentoukai torimatome]. 2021. https:\/\/www.mhlw.go.jp\/content\/11121000\/000799360.pdf. Accessed 3 Feb 2026. (In Japanese)."},{"key":"602_CR26","doi-asserted-by":"publisher","unstructured":"Alsetohy WM, El-Fass KA, El Hadidi S, Zaitoun MF, Badary O, Ali KA, et al. Economic impact and clinical benefits of clinical pharmacy interventions: a six-year multi-center study using an innovative medication management tool. PLoS ONE. 2025;20(1):e0311707. https:\/\/doi.org\/10.1371\/journal.pone.0311707.","DOI":"10.1371\/journal.pone.0311707"},{"key":"602_CR27","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.ijsu.2020.08.021","volume":"82","author":"V Chasseigne","year":"2020","unstructured":"Chasseigne V, Bouvet S, Chkair S, Buisson M, Richard M, de Tayrac R, et al. Health economic evaluation of a clinical pharmacist\u2019s intervention on the appropriate use of devices and cost savings: a pilot study. Int J Surg. 2020;82:143\u201348. https:\/\/doi.org\/10.1016\/j.ijsu.2020.08.021.","journal-title":"Int J Surg"},{"issue":"9","key":"602_CR28","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1093\/ajhp\/58.9.784","volume":"58","author":"TW Nesbit","year":"2001","unstructured":"Nesbit TW, Shermock KM, Bobek MB, Capozzi DL, Flores PA, Leonard MC, et al. Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. Am J Health-System Pharm. 2001;58(9):784\u201390. https:\/\/doi.org\/10.1093\/ajhp\/58.9.784.","journal-title":"Am J Health-System Pharm"},{"key":"602_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/00469580251343776","volume":"62","author":"D Buma","year":"2025","unstructured":"Buma D, Ngasa S, Ndesangia A. 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Inquiry. 2025;62:1\u20136. https:\/\/doi.org\/10.1177\/00469580251343776.","journal-title":"Inquiry"}],"container-title":["Journal of Pharmaceutical Health Care and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40780-026-00602-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-026-00602-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-026-00602-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:03:56Z","timestamp":1791821036000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40780-026-00602-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["602"],"URL":"https:\/\/doi.org\/10.1186\/s40780-026-00602-1","relation":{},"ISSN":["2055-0294"],"issn-type":[{"value":"2055-0294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"assertion":[{"value":"18 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The individual-level data used in this study (from the \u201cStatistics of Physicians, Dentists and Pharmacists\u201d) were provided by the Ministry of Health, Labour and Welfare (MHLW) in accordance with the Statistics Act of Japan. Under the \u201cEthical Guidelines for Medical and Biological Research Involving Human Subjects\u201d in Japan, studies using anonymized data provided based on the Statistics Act do not require approval from an institutional review board or informed consent from the participants. The research plan and publication of results in academic journals were reviewed and approved by the MHLW at the time of the data use application.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"87"}}