Objective. To explore first-year student pharmacist perspectives on the influence of individual, educational system, and health care system factors on their wellbeing during pharmacy school. Methods. As part of a required course, first-year student pharmacists were required to submit reflective essays detailing the factors that most significantly contributed to their wellbeing since starting pharmacy school. Reflections from students who consented to participate during the study period from February 2019 to July 2019 were included for analysis. Qualitative thematic analysis was performed using open and axial coding, hierarchical categorization, and representative theme determination through a process of iterative review and deliberation. Coders developed a codebook with operational definitions for each emergent code. Coders met biweekly with lead researchers to ensure consistency and reliability of data analysis and to address minor discrepancies in coding. All team members discussed and revised themes until consensus regarding final representative themes was achieved. Results. Forty-nine students (36.8% of the first-year class) submitted reflective essays for analysis. Five themes emerged for the factors most influential on student pharmacist wellbeing: workload; learning environment culture and values; meaningful pharmacy school experiences; relationships; and personal factors. Student pharmacists did not consistently identify health care system factors as influencing their wellbeing. Conclusion. Student pharmacists identified both education system and individual factors as influencing their wellbeing. Education systems should prioritize implementation of systematic strategies that address curricular and learning climate factors, maximize student engagement in meaningful experiences, optimize social connectedness, and provide individual student support.

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