Before the Waters Rise: Building the Levee for Competency-Based Pharmacy Education

Pharmacy education stands on unstable ground; overloaded curricula, eroding professional identity, and widening gaps between training and practice signal a system under pressure. Though other health professions are moving toward coordinated, competency-based transformation, pharmacy education risks falling behind. Drawing on recent stakeholder-informed studies and international precedents in medical and veterinary education, this commentary proposes Competency-Based Pharmacy Education (CBPE) not as reform but as essential infrastructure, a levee that must be constructed before pharmacy education is consumed by a flood of diminishing returns. Adapting the "escape fire" metaphor applied in medicine, we argue that pharmacy's crisis is not a sudden blaze but rapidly rising waters. In response, CBPE must serve as the levee: a deliberate, system-level structure grounded in Van Melle's core components framework. These 5 components (outcome competencies, sequenced progression, tailored experiences, competency-focused instruction, and programmatic assessment) form a resilient system that addresses pharmacy's most urgent vulnerabilities. Though early adopter programs are piloting elements of CBPE, true transformation requires national coordination. Fragmented efforts will not withstand structural erosion. This commentary issues a collective call to action for national alignment, collective investment, and pharmacy professional organization leadership. The evidence is clear. The stakes are existential. Additionally, the blueprint is already in our hands. CBPE is not a theory; it is the structure pharmacy must build together now, before the waters rise further.