PEBC Part I (MCQ) · Competency 4 Leadership and Stewardship (about 3%)

Public Health & Stewardship

Leadership and Stewardship (about 3%) items test the pharmacist's role in population health: antimicrobial stewardship, screening, vaccination programs, harm reduction, health equity, travel health and safe medication disposal.

4 Leadership & Stewardship1 min read6 sections

Checked against the NAPRA Professional Competencies (2024), 4.2; Choosing Wisely Canada (2020-2023); Canadian Task Force colorectal screening (CMAJ 2016); NACI statements (2025-2026); CATMAT travel guidance; PHAC opioid surveillance (2025-2026); checked 13 Oct 2026. Not affiliated with or endorsed by The Pharmacy Examining Board of Canada (PEBC).

Must-know for the exam

Delayed prescriptions and symptom advice reduce antibiotic use for viral respiratory infections.
Do not culture or treat asymptomatic bacteriuria in long-term care.
Average-risk adults 50-74: FOBT or FIT every 2 years (Canadian Task Force 2016).
Harm reduction (needle programs, naloxone) reduces infections and deaths without increasing drug use.
Most opioid toxicity deaths in Canada involve illicit fentanyl and analogues.
Adults born in 1970 or later without measles immunity should receive MMR.
Older adults on diuretics or anticholinergics are vulnerable during extreme heat.
Return unused medications to pharmacy take-back programs.
Pharmacy BP screening needs validated devices, standard technique and referral pathways.
Address social determinants (housing, income) with practical supports such as blister packs.

On this page · 6 sections

Traps that cost marks

Thinking broad-spectrum antibiotics prevent complications of viral infections.
Assuming annual colonoscopy is the standard screening test.
Believing harm reduction increases drug use.
Treating structural barriers as individual non-compliance.
Promoting unproven products over vaccination.
Relying on repellent alone or antibiotics for malaria prevention.
Running screening without validated equipment or follow-up.
Encouraging people to keep or share leftover medications.

How this is tested on Part I

Items ask which program or intervention best improves population outcomes or equity; prefer evidence-based, scalable actions over individual quick fixes.

Stewardship

Shortest effective antibiotic durations (for example 5 days for uncomplicated CAP).

Audit and feedback, education and delayed prescribing in primary care.

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Exam-style questions

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Educational practice material for exam preparation only. Not medical advice and not a substitute for current product monographs, clinical guidelines or professional judgement. Questions have not yet been reviewed by a licensed pharmacist.