Pharmacy education in Romania: alumni perspectives on curriculum relevance and professional readiness.

Background: Pharmacy education is undergoing global transformation to better align with evolving healthcare demands. However, in Romania, pharmacy curricula remain centrally regulated and standardized, with limited input from graduates or employers. Objective: This study investigates the perceptions of Romanian pharmacy graduates (2009-2023) regarding the relevance of their curriculum, competency development, and professional preparedness across various employment sectors. Methods: A mixed-methods, cross-sectional survey was conducted with 473 alumni from all accredited pharmacy faculties in Romania. Quantitative data were analyzed using descriptive statistics, ANOVA, and logistic regression, while qualitative responses underwent thematic content analysis. Results: Graduates reported moderate overall preparedness (Mean = 3.08/5), with significant variation by institution, age, and job sector. High self-assessed competencies were noted in Pharmacology and Communication, while Management, Regulatory Affairs, and Therapy management were identified as key gaps. Disciplines such as Pharmacology and Clinical Pharmacy were rated highly useful, whereas Physics and Inorganic Chemistry were frequently cited as disproportionately difficult and less applicable. Open-ended responses emphasized the need for greater curricular flexibility, experiential learning, and integration of soft skills and entrepreneurship. Conclusion: The results highlight a misalignment between standardized pharmacy education and the diverse realities of professional practice. The study advocates for alumni-informed reforms, modular curricula, and the integration of transversal competencies to enhance workforce readiness and sector-specific applicability.