Moving on

My post on leaving academic clinical medicine was picked up by MedPageToday’s popular KevinMD blog and published on Christmas Day, where it’s been shared almost 1000 times. The main idea of the piece is: “…this is not burnout. It’s self-respect,” and it’s received almost 500 reactions and over 100 comments in Facebook doctor groups, especially from women. I share these numbers to illustrate that the message clearly resonates, though what I experienced was nothing compared to what many women described in their comments… Academia, you have a long way to go, baby.

I’ve received piles of messages and emails from fed-up physicians expressing solidarity, and also asking “How did you do it, and how can I, too?” So I promised to create a post entirely devoted to these “Hows”, and here it is.

How much time does it take to find a non-clinical job?

My nonclinical job search took just under four months, from “I have no idea what positions are even out there” to “I accept this job offer”. It helped that I had some great connections, I was intensely motivated, and I’m smack dab in the middle of a big biopharma hub… but generally, four to nine months would be a reasonable range to expect, based on my research and conversations.

How do you even start?

I started with a self-directed “crash course” in nonclinical careers, using free and easily available resources. There are many websites, blogs, podcasts, and Facebook groups that contain a wealth of information and helpful perspectives. I crammed as much material in as I could, whenever I could:

There’s a pretty active Facebook group called Physician Nonclinical Career Hunters that I lurked on and searched in. This is a highly recommended resource full of good insider information and supportive, understanding colleagues!

This website was pretty useful as an exploratory starting point (especially “7 steps to finding a nonclinical job”), if you can ignore all the annoying ads.

Nerissa Kreher’s Industry MD blog features physicians who have made successful career transitions, as well as many short and useful informational posts. She was also featured on a podcast that I found very helpful early on.

Marjorie Stiegler MD’s podcasts on career shifts are fantastic. She has some new ones describing where to start and what are the options, like podcasts #25, #63, #66+67.

There are more resources out there that I did not utilize, and I’ll list some that I came across here:

Marjorie Stiegler offers webinars and courses on career transitions.

Physicians Helping Physicians offers coaching/consulting on the nonclinical career shift.

The SEAK Non-Clinical Careers for Physicians conference has been recommended by other docs.

The Women in Pharma Careers website has alot to offer.

I also reached out to doctors who had already made the transition successfully, people I knew and also friends of friends. Most of these folks were eager to help and happy to chat. Every conversation was helpful in some way. I took lots of notes!

How does an industry career coach work?

After a couple weeks of cramming all this material and talking to anyone I could reach, I decided to contract an industry career coach. A friend of mine who had landed a solid work-from-home position in pharma highly recommended Nerissa Kreher, and while this is not an ad, I highly recommend her as well. I paid for several hours of 1:1 advising, which moved me along a lot faster than if I’d continued solo. Nerissa talked me through all the different pharma/ biotech job options for physicians, and counseled me as I began looking at different positions. She helped me to identify my own transferable skills and relevant experience, and we worked together to convert my 18-page academic CV into a 3-page resume (critical step), as well as to optimize my LinkedIn page (which is a very important tool in the industry job search). She also researched some of the companies I was interested in and gave me inside info, and set realistic expectations as far as compensation. And, she connected me with other women physicians who had made the transition recently, which was super-helpful, as they all had very different positions at different levels. I understand that most industry career coaches will offer similar services, and in my case, I felt it was worth every penny.

How does LinkedIn work?

Almost all industry jobs will be posted on LinkedIn, and for my search I paid for the “Premium Career” level membership (which I cancelled when I didn’t need it anymore). I spent a lot of time searching and scrolling through job listings. When I applied for any position (I applied for about ten or fifteen maybe?) I looked up the recruiter or HR person and sent a brief personal note as well, just a few sentences letting them know I had applied for a position with their company and would be thrilled to chat. In a few instances, the recruiter reached back out and offered an interview. I also looked at the companies’ LinkedIn profiles to see if I knew anyone anywhere, and this was actually very useful in one case, and helped me gain valuable inside information.

How do you know what positions and titles and companies to look at?

As far as positions, there are many options, but the main roles for physicians in biopharma are in clinical development, pharmacovigilance, regulatory affairs, and medical affairs. Very basic, big-picture explanations based on my impressions:

Clinical development: Encompasses so much, from discovery of new molecules and targets, to development of new biomarkers, to designing, writing, and leading early or late clinical trials protocols.

Pharmacovigilance: It’s all about patients’ safety. Monitoring clinical trials, communicating well with investigators and sites around any adverse events or problems, recording and interpreting data, reporting out adverse events and clinical outcomes.

Regulatory affairs: Lots and lots of very critically important documentation and filing very critically important documents to very critically important entities like the FDA.

Medical affairs/ medical science liasons: This is all about communication. The main idea is to share the science with different audiences. This can mean writing or coordinating scientific publications and presentations, communicating with key opinion leaders (KOLs), educating clinical trial sites.

This is basic basic, so for more details: The Women in Pharma Careers blog has a terrific post titled Important Jobs for Physicians in the Pharmaceutical Industry. I also came across a really detailed journal article titles Physicians in the Pharmaceutical Industry: Their Roles, Motivations, and Perspectives which takes a deeper dive.

Industry has their titles too, and these correlate pretty well with compensation tiers. Most physicians will be coming in at the “Assistant Director” and “Director” levels, and it’s more common nowadays to see “Head of”, which I understand is a wild card title of sorts. Specialists with clinical trials experience definitely can come in at the V.P. level, and I know one guy who landed as CMO (Chief Medical Officer, the big boss).

As far as companies, generally there’s biotech (biologics like vaccines, cell and immunotherapies), pharma (synthetic molecules), and now, more and more digital health (apps or big data systems). There’s startups vs young vs. well-established places, and small, medium, large and massive global companies. There’s also big differences in company cultures. I found it most helpful to talk to people who worked at various types of companies to get a feel for what to expect.

For me, I have a strong background in writing and communications, so I was most interested in medical affairs positions in biotech or pharmaceuticals, and at any content creation positions in digital health applications. I liked the idea of working at a startup or smaller company. By the end of three months, I had a number of interviews at four companies, and a very solid job offer as Head of Medical Communications at a small immuno-oncology biotech company. I know people there, the role promised a good deal of autonomy and creativity, and the culture felt like a good fit.

How do you know what salary to expect or ask for?

The first thing to know is that it’s not only the salary, it’s the whole package. There’s a huge list of things to consider– check out Nerissa Kreher’s brief post on Compensation Packages in Pharma/ Biotech. The biggest chuncks of this are the base salary (what you are paid every two weeks no matter what), target annual bonus (a percentage of your base salary that is paid out in the springtime usually, and can be more or less than the target depending on how the company is doing), and stocks or stock options (stock options are a number of stock shares that are “granted” to you at the market rate as of your start date, and after a year or more, you can sell them at the new market rate minus what they were worth when they were granted to you. Which hopefully, is more). For all of these, I believe it’s helpful to have some numbers to work with, but keep in mind that there is going to be a wide range depending on specialty, experience, position, company… Generally, I found that most physicians starting out in industry can expect a base salary in the 180-275K range, a target annual bonus that is 15-30% of that base salary, and some nice chunk of stocks or stock options. It’s also very good to know that it’s totally normal to take a week to ponder any offer and ask for more of any part of the compensation package. EVERYTHING is negotiable, and the worst they can say is no!

So, how is it working out for you?

I’m now about three months into my role in medical writing/ medical affairs at an immuno-oncology biotech firm, and very happy with my decision. I’m new, but already in my position I do all sorts of writing, from case studies for peer-reviewed journals to industry white papers to educational slide decks for trial site clinicians and more. I’m liasing between the clinical, communications, even preclinical development departments, and lately marketing as well, which is so cool. It’s a startup environment and very exciting, fast-paced. My work is project-based and deadlines have been reasonable, so my hours have been flexible and I’m mostly working from home.

But how can you sleep at night, knowing you went to the dark side?

As a practicing physician at a big teaching hospital, I put up with a lot of systemic crap for a long time. The things that held me down were all in my head, like the idea that I was lucky to be working where I was, that I was special, that I was one of “the good guys”. Once I realized that I was just another overworked and underappreciated employee within just another profit-driven corporation, I was able to consider all the other, much healthier possibilities. Personally, I’m impressed on a daily basis by the idealism and passion of my company and colleagues. We’re working to bring better, more affordable cancer treatments to patients around the globe. And in the big picture, it was industry’s massive collaborative effort that almost pulled us out of this pandemic. Yes, I made the switch for me and for my family– the things that truly matter– but I am so glad that I did, for many other reasons. It feels good, it feels right. So, I’ve never slept better, thank you.

I’m also kind of done writing about the whole career change thing. I’m ready to move on to more positive and creative topics, so expect something totally different in subsequent posts!

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