<p>Pharmacists in Chinese public hospitals face multiple challenges, including a rapidly increasing workload and a severe human resource shortage, driven by the continuous advancement of healthcare reform. This study systematically investigated the content and responsibilities of hospital pharmacy work as well as the current state of workload and human resource allocation in pharmacy departments, and then analyzed the challenges and optimization strategies. A work list of pharmacy departments in public hospitals was developed for the investigation and then a structured questionnaire was designed based on the work list. A survey was conducted to collect and analyze the data on various duties within the pharmacy departments of 22 representative tertiary and secondary public hospitals covering all 7 regions of China. A work list for pharmacy departments in public hospitals was compiled. The proportion of pharmacists accounted for only 3.60% of all health technicians in the surveyed public hospitals. Significant disparities in human resource allocation were found between tertiary and secondary hospitals, with their current staffing levels meeting only 40.16% and 25.26% of the actual demand, respectively. Pharmacy departments in public hospitals generally face workload overload, severe human resource shortages, and structural imbalances in personnel, which in turn severely limit the application of pharmacists’ professional knowledge and hinder the quality improvement of clinical pharmacy services, ultimately restricting the patient-centered transition of pharmaceutical care. Therefore, it is urgently recommended to refine the corresponding mechanisms for pharmaceutical human resource allocation and value compensation.</p>