Interview with Dr. Melissa Choi
In today's episode, Dr. Melissa Choi takes us through her career journey to a position in clinical research. She shares the motivations behind her career pivot. And she offers valuable insights into how she navigated the transition to her first nonclinical position.
Dr. Choi is a family physician who successfully transitioned to a career in the Pharma Industry. With a background in clinical research, she now serves as a Principal Investigator (PI), leveraging her expertise and passion for medical advancements.
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Her Journey to Clinical Research
Dr. Choi embarked on a journey that led her from internships and bench research to the field of obesity medicine. As a family physician, she initially aimed to practice part-time but soon realized the challenges of solo practice and the lack of collaboration. However, her growing interest in obesity medicine sparked a change.
Driven by her desire for control and independence, Dr. Choi embarked on an entrepreneurial path. With the guidance of a business coach, she learned essential skills. These included creating a professional online presence, optimizing her LinkedIn profile, and understanding marketing strategies. These efforts eventually paid off. A recruiter noticed her updated LinkedIn profile and reached out to her about applying for her current role.
Dr. Melissa Choi's Advice
If physicians are interested in a role like this or even another nonclinical role, I would suggest doing a reflection of what you enjoy and what you're an expert in. Learn to market the skills and expertise you have, even if you may be frustrated with the job search. Figure out what you want to go toward, not just what you're running away from. And ask for help.
Summary
Dr. Choi's journey demonstrates the importance of patience, adapting to challenging circumstances, and seeking opportunities for personal growth. And she benefitted from applying entrepreneurial and marketing principles to shape her career path.
She highlights the role of LinkedIn. It served her as a:
- platform for recruiter outreach,
- place to build connections, and
- resource for conducting research.
She also noted the value of showcasing transferable skills and problem-solving abilities during interviews.
Dr. Choi provides an overview of her role as a PI in a research site. And she described her job duties:
- overseeing clinical trials,
- ensuring participant safety,
- collecting accurate data, and
- managing various tasks related to the trials.
Her proactive and enthusiastic approach contributed to her successful transition to a nonclinical pharma role.
NOTE: Look below for a transcript of today's episode.
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Transcription PNC Podcast Episode 306
How to Navigate the Challenging Pivot from Family Medicine to Clinical Research
- Interview with Dr. Melissa Choi
John: Today's guest transitioned from primary care medicine to clinical research. Something that can be difficult to pull off, at least from what I know. So, today I want to find out why she made that shift and how she did it. Dr. Melissa Choi, welcome to the podcast.
Dr. Melissa Choi: Thank you so much for having me here, John. I'm a big fan of your podcast. So, I'm looking forward to this discussion today.
John: Well, I'm happy to hear that. I like having people that have heard the podcast before, sometimes our guests never have, but that's cool. This is really interesting. We connected on LinkedIn and I saw what you were doing. I said, "Wow, how did she go from family medicine into clinical research now working as a PI", which you'll explain what that is. But we'll get started by you. Just tell us a little bit about your medical education, clinical background, and I know you did different things there, and then we'll get into the nonclinical part after that.
Dr. Melissa Choi: Absolutely. I sort of have a non-traditional medical background. I was admitted to Brown University's eight year combined Bachelor's MD program, which if folks aren't familiar with, you get admitted basically to medical school when you're 18 years old, a senior in high school. And the thing that I liked about Brown's program is there were fewer sort of prerequisite courses we had to take. I didn't have to take my MCATs, which was fantastic. I had all these great opportunities where I could study abroad and as an undergrad, take classes like architecture history. And I really loved that experience and I wouldn't trade it in. But I would say maybe one of the downsides of my medical experience was that I never really had to stop to think about if medicine was really what I wanted to do.
And I don't doubt that I wouldn't have chosen this path, but it was sort of like I just kept going through, which I think maybe many of us do. But I really didn't have to think about what I wanted to do from undergraduates through medical school. And so, I got to medical school, got onto my clinical rotations and I loved everything I did. I loved pediatrics. And then when I moved on to neurology, I loved that. When I did psychiatry, I loved that.
I think that's really what brought me to family medicine because I enjoyed everything. And when I was on rotation I was like, "This is great for four weeks, but I'm not sure if I want to do this every day of my life forever." And so, that's sort of how I ended up in family medicine.
John: Nice. Let me comment on a couple things there. First of all, making this lifetime decision when you're 17 or 18 years old, it sounds great. "Wow, it's locked in. I don't have to compete with anybody now that I already got this." But it reminds us that our child brain isn't even mature yet till we're like 23 years old. So, we're making these big decisions. They can go wrong sometimes when we do that.
Dr. Melissa Choi: Absolutely.
John: It sounds like you really enjoyed it. It doesn't sound like, this is a prequel to what we're going to talk about later, that you did a lot of, let's say, clinical research in there. Or did you? I didn't see any special master's degree or anything in that. Is that correct? You kind of did traditional and plugged right through.
Dr. Melissa Choi: During the summer times in college and right before medical school I did some internships. I did one opportunity doing a lot of bench research where working with pipettes, things like that, just to have that experience. But I knew that's not what I really wanted to do. But I got some experience understanding what an IRB was and what a protocol was. But compared to what I currently do, it really is not very similar at all.
John: No. Well, knowing what an IRB does, that's a good bit of knowledge. Some physicians have exposure to that as they go through their careers and some never do. But that I know could be a little bit helpful. Well, then tell us what happened. You went through and after medical school, you did the family medicine residency. Let's take it from there and what happened in the next few years after that.
Dr. Melissa Choi: Yeah. I will say I'm kind of one of those rare braids that loved residency. I had a great time. I loved working on teams and was excited to go into practice once I was done and I said, "Hey I'm just going to go into outpatient medicine. I'm going to practice part-time." And I thought it was going to be this great setup.
And I think early on I realized the challenge of sort of practicing on your own. Number one, I really missed working with the team. When you're in practice, it's sort of myself and the patient and there's not a lot of collaboration. So I realized I missed that early on. And then number two, while I enjoy studying all parts of the body, doing different systems, when you're in practice, when you have 20 or 30 minutes to solve everything, it's really challenging.
And so, early on I had a difficult time but I sort of wanted to think independently and say, "Okay, well, this is challenging." But I quickly realized that for family medicine, at least, a lot of these problems that I'm trying to manage like diabetes, hypertension, even osteoarthritis, a lot of these are caused by the same thing. People who are overweight or obese.
And so, I started getting really interested in obesity medicine maybe about three or four years into practice and sort of looked into what it entailed to become an obesity medicine physician and took it upon myself to become board certified in obesity medicine.
And then I basically started to set up my own clinic within my clinic to be a weight management physician in a primary care setting. I allowed my partners to even refer patients to me. And it really gave me an opportunity to do something that I was interested in and it helped sort of that burnout feeling I was starting to get.
John: Yeah, I think when one of the things as family physicians, because we're not specialists, we get to see everything and most of it is chronic, then the really acute sort of things we can't do much for anyway, like a cold or something in between. It gets overwhelming because it just never stops. And when you can do something like obesity medicine, weight management or whatever, you can focus and you can spend more time usually it seems like, you can educate people more. That's the thing I thought about when I was in practice is those kind of things were more interesting than just grinding through the office every day.
Dr. Melissa Choi: 100%. And what I liked about obesity medicine is sort of what drew me to family medicine in the first place. I wasn't just looking at one problem. Obesity medicine is multifactorial. There's behavioral, there's psychological, and I got to have the time and spend the time with my patients to discuss those things. And so, I was able to sort of feel like I had control of my clinic even though I was in an employed setting.
John: Did you feel like you were having some success with the patients too? If they came in and they were really motivated and interested, they would actually learn something and change their approach?
Dr. Melissa Choi: Absolutely. Many of my patients, you sort of look for at least a 10% to 15% weight loss and to be able to maintain it a year or more. And so, to be able to have those sort of metrics to see the progress that they've made and their gratitude toward you definitely helped my practice. And I think if it weren't for COVID, I may still actually be doing that right now.
John: Okay. It sounded like things are going pretty well. Everything sounds like they're going in the right direction. And for my audience you'll hear my voice is cracking because I've had COVID recently, so I'm just recovering from that. But anyway, tell us though, that was not the end point. You all of a sudden or at some point got interested in something else. So, tell me more about that.
Dr. Melissa Choi: I mentioned COVID kind of changed the trajectory for myself and I think for many of us. So when COVID hit in March, 2020, I'm working in an employed setting, they said, "Hey, we're trying to decrease the number of resources that we need. And since not that many people are even working in person, let's sort of hibernate your clinic and move you to another clinic." And I said, "Sure, no problem." Thinking this would be a couple months and I'd get back to with my partners, things like that. And the challenge came when a couple months became a couple more months and then they finally said, "You know what? We're shutting down your clinic." And like most people, you like the team that you're with, you like the MAs you have, you like the partners you have.
And even though I eventually settled at a good clinic, COVID changed so many things for our practice. And because I wasn't in an employed setting at the time, there were just a lot of things I didn't have control over. I didn't have control over my schedule. I was told that I needed to start early or work late until 6:00 PM. And it became really challenging for me. And so, what I actually did was, I told myself I needed to find an opportunity to do something where I felt like I had control and it was something within my own interest.
And so, I actually started doing some health coaching, but prior to that I actually found a business coach to work with. And I thought that that was really important because I'd never started my own business or even knew what that entailed. And having somebody that had done something prior to me stepping into this role was really important because they basically showed me the ropes. And along with creating a more professional looking website with professional photos, they told me I needed to spruce up other social media avenues, including my LinkedIn profile.
And so, I spent the money to get professional photos, spent a couple hundred dollars, spoofed up my LinkedIn profile and I actually was not doing too bad. And I think for myself at least having an outlet where I could pursue my interests, have control actually made the day-to-day clinic easier for me to get through, knowing that I had something that I could do on my own terms. And interestingly I think partially because of the way that I had updated my LinkedIn profile with a photo, sort of a brief blurb of what I did, I had a recruiter just reach out to me about my current role as a PI.
John: Okay. Now, I just want to clarify because that's pretty awesome. You were focusing, you had the business coach and you were focusing on being like a coach yourself. Was that the business model at the beginning?
Dr. Melissa Choi: Yes. That was the model. And this business coach wasn't necessarily for coaches, she was just a coach for physicians that were interested in starting their own businesses.
John: Right, right. The business side of it, finances, accounting and LLCs and all those kinds of things like how to actually set up your own business.
Dr. Melissa Choi: Yes. And in addition to that, I think a big thing that I learned was how to market either yourself as a brand or your business as a brand and how to really tap into what people are looking for. And I can talk about this later, but I think that actually helped in terms of me landing my current role.
John: Applying those marketing principles, was that basically on the website in the LinkedIn profile, other places?
Dr. Melissa Choi: I think it's the interactions that I had with people. From a business standpoint it was the way that I presented myself on Instagram at the time that was my avenue that I did. But like I said when this recruiter reached out to me, and I started interviewing, I really used a lot of those marketing strategies that I had learned to really market myself for this role.
John: Okay. Well yeah, take it from there in terms of the recruiter. Tell me more about that. What was it that appealed to them? And when you talked to the recruiter, what did the recruiter say that appealed to you and made you pursue this at that point based on what you could determine they were looking for?
Dr. Melissa Choi: Yeah, I just one day randomly got a DM in my LinkedIn inbox saying, "Hey, we have this nonclinical full-time role in the Twin Cities", which is where I'm based. "And we're looking for somebody that is motivated, looks to have some leadership skills. Are you interested in discussing?" And all those things piqued my interest. And so, I responded and got on a phone call with them.
And one thing that I learned early on too when I'm preparing for these interviews is to really research the person that I'm going to speak with, sort of their background. Even if it's something simple like, "Hey, they're from Arizona." In this situation, when I got on the phone call with them, we were talking about the weather because it was July and it was very hot there. So, we chatted about that and just being able to make a connection with that recruiter.
And at the time he told me this was a nonclinical position, but I wasn't even really sure what it was. And once he got on the phone with me, told me I would be a principal investigator and explain the role to me. Even though I wasn't quite sure what it was, I quickly tried to figure out what are the skills that I have, the leadership skills that I've gained in my clinical experience that I could sort of share with them. And I think he appreciated the enthusiasm, those skills that are transferable into this role. And he was then able to move me on and say that I could meet with the hiring manager.
John: Okay. And I'm going to ask you questions about that for sure. But before we do that, getting back to LinkedIn. LinkedIn has different ways of connecting people to you and you to them. So you didn't actually use the job board, you weren't looking in LinkedIn for reaching out to the recruiter. The recruiter found you. Now there's a setting in LinkedIn that says you're open to employment or open to jobs. I'm assuming that was on. Are those basically the parameters that you set up with your LinkedIn?
Dr. Melissa Choi: Yes, that is correct. And I had certain job titles. I think sometimes people talk about the medical director role, things like that. But to be honest, at this point in my career, there's medical directors for insurance companies, there's medical directors for pharma companies. I wasn't even quite sure what I was looking for, but I had those options on at the time and there must have been something that piqued his interest.
John: Yeah. At a high level, the fact that you're looking to do nonclinical, that was one thing that probably some of the recruiters key off of. And once they looked at your profile, there were probably examples of things you had done that, like you said, demonstrated transferable skills and into other settings. And like you said, you didn't even know this was in the pharma industry initially, right?
Dr. Melissa Choi: Correct.
John: Okay. So then the next person you talked to there, what was their role?
Dr. Melissa Choi: Yeah. He was basically the executive director overseeing multiple PIs within the company.
John: Okay. Now, were you able to do any research on that person? Or were they like a black box when they linked up with you?
Dr. Melissa Choi: Yeah, I did my homework before this interview. And that's one thing I would tell other physicians if they're looking to transition to a nonclinical role or a role that they didn't do. One of the first things I did was research all the people I would be interviewing with, including this hiring manager. And again even though he was in pharma, I also found out that he had a family medicine background.
And so, when I jumped on the call with him or the interview with him, I talked about bonding over this family medicine background. And interestingly the site that I work at, they really are like a general medicine research site. They oversee trials in all sorts of therapeutic areas. And so, they were really looking for somebody with my general background. Not somebody that was a specialist.
And some of the other things that I did to prepare for interviews was I listened actually to podcasts that talked about preparing for interviews and was prepared to answer common questions. And I would say one of the most common questions is "Tell me about yourself." And one thing that I learned from podcasts, from my coaching background is they want you to tell them about yourself, but not really tell them about yourself. They want to know what I can do to help solve their problem.
John: Yes.
Dr. Melissa Choi: When you're answering that question, you don't need to talk about how you were a chess champion when you were 12 years old. You need to talk about your experience that's relevant to what their problem is. And so, I made sure that I prepped those sorts of common questions, made sure I had a good answer for that.
And then I think the other thing that my background as a coach in business and also learning about marketing is being able to answer questions with stories. Because when somebody says "Tell me some things that you're good at." If you say I'm good at organization, that doesn't really say anything. But if you can tell a story about "this is what I did, this was the problem, and I was able to solve it in this particular way", that'll really give them an image of what you can complete. And so, I made sure I had some of those experiences that I was able to share with them.
John: Yeah. Perfect. You mentioned other podcasts where this has been discussed. I think I have discussed it, but Marjorie Stiegler comes to mind and Heather Fork and there's probably others who have really had guests on. Those are the kind of things you were listening to and preparing with?
Dr. Melissa Choi: Yes. I actually listened to both of their podcasts and I even just googled general interview podcasts because they don't necessarily have to be physician specialized, which is helpful. But I think just having the knowledge of common questions including behavioral questions, strengths and weaknesses, making sure you know how to answer those questions are important.
John: Yeah. It's interesting to talk to someone whose interview goes absolutely bad and then in retrospect they go, "Now I know what I did wrong but I didn't know it at the time." Now let's turn it around to you. So, what was it about this position that intrigued you enough or interested you enough to say, "Yeah, this sounds great, I'm going to take this after jumping through all the hoops?"
Dr. Melissa Choi: Yeah. Maybe to talk a little bit about the role as well too. Like I said, when I first heard about this job, I wasn't even sure what a principal investigator did. I sort of knew what a PI was because of some of the academic research I had done. And in those sort of academic settings, PI often will have a question or curiosity and they'll sort of create their own trial.
But in this instant, a principal investigator like myself working at a research site, basically, I'm working as the physician that takes responsibility of a trial that a sponsor which is like a pharma company asks us to do. So, let's say Pfizer has a new drug that they would like to run a trial on. They need to find somebody to manage that. My current role at my research site is that I'm the physician that will take on the responsibility of a trial and I will have multiple different trials that I'm responsible for currently. And what that means is I need to carry out that trial based on what the protocol has written. I oversee safety and make sure that safety is protected and also oversee all the data that's collected, making sure that it is clean and accurate. So, that's sort of the high overview of what I do.
And day-to-day, it is an onsite job. I don't work from home, but there are different tasks. I have to review charts that my coordinators have worked on. I do need to evaluate participants to make sure they're safe. And if an adverse event does occur, I need to report it based on the timelines of the protocol that they're asking for and make a determination whether I feel like this is associated with the drug or the IP that they're currently looking at or not.
And then there's lots of meetings, with either monitors, medical monitors, sometimes the protocol changes. So, I need to be up to date on that. And so, kind of going back to what I had mentioned earlier in terms of my personality. I really enjoy working as a team. And so, the role that I have, I need to work with a lot of different people. And that was one of the best things about taking this role.
The other thing is it's kind of the best of both worlds because I get to be in pharma and get to be part of potentially bringing a new drug to the market. But I still get to see participants, we don't necessarily call them patients, but I still get the interaction with participants during this time.
And then the other thing is I do need to use my medical background to sort of determine things such as eligibility criteria, if they're able to participate in a study. And again, being aware of adverse events, I need to be reviewing labs and EKGs. However, I'm not managing all of those things. I think one of the hard things for at least a family physician when we're in practice, we're often managing 10, 20 problems per patient.
And here even though I may see them and interact with them, if they is something going on, say their creatinine starts going up while they're in this trial, I need to make sure, "Oh, this is something that's concerning, but you need to go follow up with your PCP." And so, it takes off some of that pressure of managing every single problem.
John: Okay. I have questions. I have a lot of questions. I maybe won't hit you with all of them today, but as you were talking earlier about what a PI is and what a PI does, in my mind over the years, even way back before I went to med school I think of clinical researcher and a PI, it's like they're an academic person, they're creating this multi-site study, we're going to try this drug and on all these patients and they're the PI for that.
But you're talking about PI as it's a role. It's a position in this organization that has certain duties and it's basically to exceed at this particular study at this site, it's done properly and safely and all those things. Is that pretty much what I'm hearing?
Dr. Melissa Choi: Yes, that's correct. I think the biggest difference between my role and an academic's role is pharma companies or what we call sponsors are looking for people to sort of run their trial, but they need physicians to oversee it. And that's where my role as a PI comes in and they said, "Hey, we have this trial, can you help us oversee it at your site and help recruit patients to participate in this trial?"
John: Now would there be similar studies being done at other locations that are parallel that either someone else would be running or you would in your role, maybe if not now in the future, where you would run at other sites? How does that play out? Do you know?
Dr. Melissa Choi: Yeah, absolutely. I think it depends on what phase of the trial it's in. A lot of the studies that I'm currently participating in are in phase two or three. And when they're in a phase three trial, for example, they're looking for 18,000 plus subjects. And there's no way that one site can manage that. They're looking for a diverse patient population. So, a lot of these times, the sponsor or the pharmaceutical company will have the same trial running in all different countries around the world. So, it's really fun to see how this comes together. And so, in that instance, I'm just a small portion, but my data is still contributing to moving a potential drug forward to market.
John: And would there be occasions where you would be interacting with the other PIs kind of doing the same thing that you're doing at other sites and you're part of this massive team?
Dr. Melissa Choi: Absolutely. Before COVID, I didn't have this job until after COVID. I heard that before COVID, there were a lot of in-person investigator meetings. And those can be located anywhere. And they would be flying PIs like myself to these meetings.
It doesn't happen as often now because they've discovered they can do these meetings online via Zoom, but I have also gone to investigator meetings in person where you meet together and I actually really like the interactions. It's a great way to meet other investigators. You get to meet the sponsors who are the staff that I often interact with via email. Seeing them face to face is very helpful. And it's just easier to ask questions about the protocol, say, "Hey you wrote this, did you mean this?" when I have questions about the protocol.
John: Now, as I was trying to understand the pharma industry, which was really foreign to me, and I probably still don't understand it fully. In my mind, pharma companies have different divisions and the activities are separated from each other, but it's probably not really true because there's probably a ton of overlap. And what I mean by that is that in my mind, safety and pharmacovigilance, I think those terms are used interchangeably and separate from the clinical research or the clinical development division, which is separate from the medical affairs division. And so, are those sort of arbitrary distinctions? It sounds like you're doing a lot of safety, but is there another safety professional that you interact with as well that's part of the team?
Dr. Melissa Choi: Yeah. And I wouldn't even necessarily categorize the role of a PI in sort of the safety pharmacovigilance role because at least from my understanding, those folks are looking at data and signaling things like that. I feel like I'm actually independent of those three categories that you've mentioned and I am the physician that's basically running the trial that clinical development has developed, for example. But I do interact with the safety folks such as medical monitors. Say I have a question in terms of I'm not sure how to interpret this eligibility criteria. Is it okay to enroll this patient in this trial? And they would say, "Yes, based on what you've told us, go ahead and enroll this subject in the trial." And so, those are the times when I interact with the medical monitor.
John: Okay. Yeah, to me it always seemed too, as I got into it that all these people were interfacing with one another. Even in the hospital setting, you have departments, you have divisions, but everybody has what we call a matrix reporting in the sense that you just interact with whoever you need to interact with. You don't have to go through your boss to do something if there's an issue that you need to deal with at the hospital. Well, it sounds very similar in this kind of organization.
Dr. Melissa Choi: It really is. Because I would say I interact with the medical monitors, but then there are times that I have to interact with the trial managers. And so, they're all sort of separate but together. So yes, there's a lot of matrix leadership that's going on.
John: All right. Well, I've probably gone over my time here with you, but let me just put it out this way, a question. Is there anything that we've skipped over in terms of the process that you followed and the way that you've found this job, your feeling about the job, pros and cons, anything we've missed that you want to mention before I let you go?
Dr. Melissa Choi: Yeah, I think if physicians are interested in a role like this, or even another nonclinical role. Obviously, people say network and apply, but I think some of the other things that I would suggest is, first of all, really do a reflection of what it is you enjoy and what are you an expert in.
In my case, I sort of took this twisty, windy, unexpected role. I was doing health coaching and that was something that I was really interested in and I was really interested in obesity medicine. And I think when you learn to market the skills that you have and the expertise you have, and even though you may be frustrated that you're applying to lots of jobs, but not getting interviews or not getting offered a role, you get to do something that you can be the expert in.
And those believe it or not, will help sharpen the skills to lead you to where you may eventually want to go. And I always tell folks to figure out what you want to go toward, not what you're running away from. I know there are a lot of physicians that are burned out based on what we've gone through the last few years. But it's really important to kind of understand why you're burned out and figure out what it is you really do enjoy because that will make even the time that you're still practicing more enjoyable.
And I would say the last thing is ask for help. Look for physician coaches or people that have done something that you're interested in and speak with them. I think a lot of times as physicians, we are thinking that we're smart folks, which we are, but we think that we can figure it out on our own, which you may, but again, it may take you much longer if you do it on your own than if you speak to someone that's already done it.
And I always tell myself professional athletes, they all have coaches. Just because they're making millions and they're the top player, that doesn't mean they do things on their own. And so, I think if you're looking to build new skills or do something new, we should really ask for help.
John: All right. That's excellent advice in fact, but I do have one last question, kind of along these lines. Knowing what you know about the industry that you're in, does it seem like right now there's still a lot of jobs out there for physicians who might have an interest the way you do?
Dr. Melissa Choi: Absolutely. I think with where the economy is in general, right now, here we are in 2023, things have slowed down a little bit and maybe they're not doing as many vaccine trials, for example, as they were in 2020, 2021 when COVID was really big. So there have been some ebbs and flows, but I think we're always going to be in need of new treatment options and there's always going to be a need for new trials. And so, it might take a little bit longer than what your plan is expecting, but the jobs will always be there.
John: And it doesn't require a master's degree in research or a PhD in some esoteric area from what you're telling me today.
Dr. Melissa Choi: Absolutely not. Like I said, I wasn't even really sure what a PI did in this aspect at a clinical research site until I was interviewing for this role. So, even if you don't know anything about it, read about it, learn about it. I'm happy to talk to folks about it if they'd like. And I think that there's a place for pretty much anyone in any specialty.
John: Excellent. I really appreciate the time you've taken today. And yeah, we didn't mention that sometimes people do want to get in touch. So, as we spoke about before we got on the call here with the recording that you're on LinkedIn obviously, and that might be probably the easiest way to get in touch with you if they have questions about anything you discuss today and that sort of thing.
Dr. Melissa Choi: Absolutely.
John: Okay, Melissa, thank you very much. I found it very interesting and informative. I've learned myself a little bit more about how to understand how this whole industry works, so I greatly appreciate that. And with that, I will say goodbye until next time.
Dr. Melissa Choi: Thank you so much for having me on, John. It was great.
John: You're welcome. Bye-bye.
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Transcription PNC Podcast Episode 306
How to Navigate the Challenging Pivot from Family Medicine to Clinical Research
- Interview with Dr. Melissa Choi
John: Today's guest transitioned from primary care medicine to clinical research. Something that can be difficult to pull off, at least from what I know. So, today I want to find out why she made that shift and how she did it. Dr. Melissa Choi, welcome to the podcast.
Dr. Melissa Choi: Thank you so much for having me here, John. I'm a big fan of your podcast. So, I'm looking forward to this discussion today.
John: Well, I'm happy to hear that. I like having people that have heard the podcast before, sometimes our guests never have, but that's cool. This is really interesting. We connected on LinkedIn and I saw what you were doing. I said, "Wow, how did she go from family medicine into clinical research now working as a PI", which you'll explain what that is. But we'll get started by you. Just tell us a little bit about your medical education, clinical background, and I know you did different things there, and then we'll get into the nonclinical part after that.
Dr. Melissa Choi: Absolutely. I sort of have a non-traditional medical background. I was admitted to Brown University's eight year combined Bachelor's MD program, which if folks aren't familiar with, you get admitted basically to medical school when you're 18 years old, a senior in high school. And the thing that I liked about Brown's program is there were fewer sort of prerequisite courses we had to take. I didn't have to take my MCATs, which was fantastic. I had all these great opportunities where I could study abroad and as an undergrad, take classes like architecture history. And I really loved that experience and I wouldn't trade it in. But I would say maybe one of the downsides of my medical experience was that I never really had to stop to think about if medicine was really what I wanted to do.
And I don't doubt that I wouldn't have chosen this path, but it was sort of like I just kept going through, which I think maybe many of us do. But I really didn't have to think about what I wanted to do from undergraduates through medical school. And so, I got to medical school, got onto my clinical rotations and I loved everything I did. I loved pediatrics. And then when I moved on to neurology, I loved that. When I did psychiatry, I loved that.
I think that's really what brought me to family medicine because I enjoyed everything. And when I was on rotation I was like, "This is great for four weeks, but I'm not sure if I want to do this every day of my life forever." And so, that's sort of how I ended up in family medicine.
John: Nice. Let me comment on a couple things there. First of all, making this lifetime decision when you're 17 or 18 years old, it sounds great. "Wow, it's locked in. I don't have to compete with anybody now that I already got this." But it reminds us that our child brain isn't even mature yet till we're like 23 years old. So, we're making these big decisions. They can go wrong sometimes when we do that.
Dr. Melissa Choi: Absolutely.
John: It sounds like you really enjoyed it. It doesn't sound like, this is a prequel to what we're going to talk about later, that you did a lot of, let's say, clinical research in there. Or did you? I didn't see any special master's degree or anything in that. Is that correct? You kind of did traditional and plugged right through.
Dr. Melissa Choi: During the summer times in college and right before medical school I did some internships. I did one opportunity doing a lot of bench research where working with pipettes, things like that, just to have that experience. But I knew that's not what I really wanted to do. But I got some experience understanding what an IRB was and what a protocol was. But compared to what I currently do, it really is not very similar at all.
John: No. Well, knowing what an IRB does, that's a good bit of knowledge. Some physicians have exposure to that as they go through their careers and some never do. But that I know could be a little bit helpful. Well, then tell us what happened. You went through and after medical school, you did the family medicine residency. Let's take it from there and what happened in the next few years after that.
Dr. Melissa Choi: Yeah. I will say I'm kind of one of those rare braids that loved residency. I had a great time. I loved working on teams and was excited to go into practice once I was done and I said, "Hey I'm just going to go into outpatient medicine. I'm going to practice part-time." And I thought it was going to be this great setup.
And I think early on I realized the challenge of sort of practicing on your own. Number one, I really missed working with the team. When you're in practice, it's sort of myself and the patient and there's not a lot of collaboration. So I realized I missed that early on. And then number two, while I enjoy studying all parts of the body, doing different systems, when you're in practice, when you have 20 or 30 minutes to solve everything, it's really challenging.
And so, early on I had a difficult time but I sort of wanted to think independently and say, "Okay, well, this is challenging." But I quickly realized that for family medicine, at least, a lot of these problems that I'm trying to manage like diabetes, hypertension, even osteoarthritis, a lot of these are caused by the same thing. People who are overweight or obese.
And so, I started getting really interested in obesity medicine maybe about three or four years into practice and sort of looked into what it entailed to become an obesity medicine physician and took it upon myself to become board certified in obesity medicine.
And then I basically started to set up my own clinic within my clinic to be a weight management physician in a primary care setting. I allowed my partners to even refer patients to me. And it really gave me an opportunity to do something that I was interested in and it helped sort of that burnout feeling I was starting to get.
John: Yeah, I think when one of the things as family physicians, because we're not specialists, we get to see everything and most of it is chronic, then the really acute sort of things we can't do much for anyway, like a cold or something in between. It gets overwhelming because it just never stops. And when you can do something like obesity medicine, weight management or whatever, you can focus and you can spend more time usually it seems like, you can educate people more. That's the thing I thought about when I was in practice is those kind of things were more interesting than just grinding through the office every day.
Dr. Melissa Choi: 100%. And what I liked about obesity medicine is sort of what drew me to family medicine in the first place. I wasn't just looking at one problem. Obesity medicine is multifactorial. There's behavioral, there's psychological, and I got to have the time and spend the time with my patients to discuss those things. And so, I was able to sort of feel like I had control of my clinic even though I was in an employed setting.
John: Did you feel like you were having some success with the patients too? If they came in and they were really motivated and interested, they would actually learn something and change their approach?
Dr. Melissa Choi: Absolutely. Many of my patients, you sort of look for at least a 10% to 15% weight loss and to be able to maintain it a year or more. And so, to be able to have those sort of metrics to see the progress that they've made and their gratitude toward you definitely helped my practice. And I think if it weren't for COVID, I may still actually be doing that right now.
John: Okay. It sounded like things are going pretty well. Everything sounds like they're going in the right direction. And for my audience you'll hear my voice is cracking because I've had COVID recently, so I'm just recovering from that. But anyway, tell us though, that was not the end point. You all of a sudden or at some point got interested in something else. So, tell me more about that.
Dr. Melissa Choi: I mentioned COVID kind of changed the trajectory for myself and I think for many of us. So when COVID hit in March, 2020, I'm working in an employed setting, they said, "Hey, we're trying to decrease the number of resources that we need. And since not that many people are even working in person, let's sort of hibernate your clinic and move you to another clinic." And I said, "Sure, no problem." Thinking this would be a couple months and I'd get back to with my partners, things like that. And the challenge came when a couple months became a couple more months and then they finally said, "You know what? We're shutting down your clinic." And like most people, you like the team that you're with, you like the MAs you have, you like the partners you have.
And even though I eventually settled at a good clinic, COVID changed so many things for our practice. And because I wasn't in an employed setting at the time, there were just a lot of things I didn't have control over. I didn't have control over my schedule. I was told that I needed to start early or work late until 6:00 PM. And it became really challenging for me. And so, what I actually did was, I told myself I needed to find an opportunity to do something where I felt like I had control and it was something within my own interest.
And so, I actually started doing some health coaching, but prior to that I actually found a business coach to work with. And I thought that that was really important because I'd never started my own business or even knew what that entailed. And having somebody that had done something prior to me stepping into this role was really important because they basically showed me the ropes. And along with creating a more professional looking website with professional photos, they told me I needed to spruce up other social media avenues, including my LinkedIn profile.
And so, I spent the money to get professional photos, spent a couple hundred dollars, spoofed up my LinkedIn profile and I actually was not doing too bad. And I think for myself at least having an outlet where I could pursue my interests, have control actually made the day-to-day clinic easier for me to get through, knowing that I had something that I could do on my own terms. And interestingly I think partially because of the way that I had updated my LinkedIn profile with a photo, sort of a brief blurb of what I did, I had a recruiter just reach out to me about my current role as a PI.
John: Okay. Now, I just want to clarify because that's pretty awesome. You were focusing, you had the business coach and you were focusing on being like a coach yourself. Was that the business model at the beginning?
Dr. Melissa Choi: Yes. That was the model. And this business coach wasn't necessarily for coaches, she was just a coach for physicians that were interested in starting their own businesses.
John: Right, right. The business side of it, finances, accounting and LLCs and all those kinds of things like how to actually set up your own business.
Dr. Melissa Choi: Yes. And in addition to that, I think a big thing that I learned was how to market either yourself as a brand or your business as a brand and how to really tap into what people are looking for. And I can talk about this later, but I think that actually helped in terms of me landing my current role.
John: Applying those marketing principles, was that basically on the website in the LinkedIn profile, other places?
Dr. Melissa Choi: I think it's the interactions that I had with people. From a business standpoint it was the way that I presented myself on Instagram at the time that was my avenue that I did. But like I said when this recruiter reached out to me, and I started interviewing, I really used a lot of those marketing strategies that I had learned to really market myself for this role.
John: Okay. Well yeah, take it from there in terms of the recruiter. Tell me more about that. What was it that appealed to them? And when you talked to the recruiter, what did the recruiter say that appealed to you and made you pursue this at that point based on what you could determine they were looking for?
Dr. Melissa Choi: Yeah, I just one day randomly got a DM in my LinkedIn inbox saying, "Hey, we have this nonclinical full-time role in the Twin Cities", which is where I'm based. "And we're looking for somebody that is motivated, looks to have some leadership skills. Are you interested in discussing?" And all those things piqued my interest. And so, I responded and got on a phone call with them.
And one thing that I learned early on too when I'm preparing for these interviews is to really research the person that I'm going to speak with, sort of their background. Even if it's something simple like, "Hey, they're from Arizona." In this situation, when I got on the phone call with them, we were talking about the weather because it was July and it was very hot there. So, we chatted about that and just being able to make a connection with that recruiter.
And at the time he told me this was a nonclinical position, but I wasn't even really sure what it was. And once he got on the phone with me, told me I would be a principal investigator and explain the role to me. Even though I wasn't quite sure what it was, I quickly tried to figure out what are the skills that I have, the leadership skills that I've gained in my clinical experience that I could sort of share with them. And I think he appreciated the enthusiasm, those skills that are transferable into this role. And he was then able to move me on and say that I could meet with the hiring manager.
John: Okay. And I'm going to ask you questions about that for sure. But before we do that, getting back to LinkedIn. LinkedIn has different ways of connecting people to you and you to them. So you didn't actually use the job board, you weren't looking in LinkedIn for reaching out to the recruiter. The recruiter found you. Now there's a setting in LinkedIn that says you're open to employment or open to jobs. I'm assuming that was on. Are those basically the parameters that you set up with your LinkedIn?
Dr. Melissa Choi: Yes, that is correct. And I had certain job titles. I think sometimes people talk about the medical director role, things like that. But to be honest, at this point in my career, there's medical directors for insurance companies, there's medical directors for pharma companies. I wasn't even quite sure what I was looking for, but I had those options on at the time and there must have been something that piqued his interest.
John: Yeah. At a high level, the fact that you're looking to do nonclinical, that was one thing that probably some of the recruiters key off of. And once they looked at your profile, there were probably examples of things you had done that, like you said, demonstrated transferable skills and into other settings. And like you said, you didn't even know this was in the pharma industry initially, right?
Dr. Melissa Choi: Correct.
John: Okay. So then the next person you talked to there, what was their role?
Dr. Melissa Choi: Yeah. He was basically the executive director overseeing multiple PIs within the company.
John: Okay. Now, were you able to do any research on that person? Or were they like a black box when they linked up with you?
Dr. Melissa Choi: Yeah, I did my homework before this interview. And that's one thing I would tell other physicians if they're looking to transition to a nonclinical role or a role that they didn't do. One of the first things I did was research all the people I would be interviewing with, including this hiring manager. And again even though he was in pharma, I also found out that he had a family medicine background.
And so, when I jumped on the call with him or the interview with him, I talked about bonding over this family medicine background. And interestingly the site that I work at, they really are like a general medicine research site. They oversee trials in all sorts of therapeutic areas. And so, they were really looking for somebody with my general background. Not somebody that was a specialist.
And some of the other things that I did to prepare for interviews was I listened actually to podcasts that talked about preparing for interviews and was prepared to answer common questions. And I would say one of the most common questions is "Tell me about yourself." And one thing that I learned from podcasts, from my coaching background is they want you to tell them about yourself, but not really tell them about yourself. They want to know what I can do to help solve their problem.
John: Yes.
Dr. Melissa Choi: When you're answering that question, you don't need to talk about how you were a chess champion when you were 12 years old. You need to talk about your experience that's relevant to what their problem is. And so, I made sure that I prepped those sorts of common questions, made sure I had a good answer for that.
And then I think the other thing that my background as a coach in business and also learning about marketing is being able to answer questions with stories. Because when somebody says "Tell me some things that you're good at." If you say I'm good at organization, that doesn't really say anything. But if you can tell a story about "this is what I did, this was the problem, and I was able to solve it in this particular way", that'll really give them an image of what you can complete. And so, I made sure I had some of those experiences that I was able to share with them.
John: Yeah. Perfect. You mentioned other podcasts where this has been discussed. I think I have discussed it, but Marjorie Stiegler comes to mind and Heather Fork and there's probably others who have really had guests on. Those are the kind of things you were listening to and preparing with?
Dr. Melissa Choi: Yes. I actually listened to both of their podcasts and I even just googled general interview podcasts because they don't necessarily have to be physician specialized, which is helpful. But I think just having the knowledge of common questions including behavioral questions, strengths and weaknesses, making sure you know how to answer those questions are important.
John: Yeah. It's interesting to talk to someone whose interview goes absolutely bad and then in retrospect they go, "Now I know what I did wrong but I didn't know it at the time." Now let's turn it around to you. So, what was it about this position that intrigued you enough or interested you enough to say, "Yeah, this sounds great, I'm going to take this after jumping through all the hoops?"
Dr. Melissa Choi: Yeah. Maybe to talk a little bit about the role as well too. Like I said, when I first heard about this job, I wasn't even sure what a principal investigator did. I sort of knew what a PI was because of some of the academic research I had done. And in those sort of academic settings, PI often will have a question or curiosity and they'll sort of create their own trial.
But in this instant, a principal investigator like myself working at a research site, basically, I'm working as the physician that takes responsibility of a trial that a sponsor which is like a pharma company asks us to do. So, let's say Pfizer has a new drug that they would like to run a trial on. They need to find somebody to manage that. My current role at my research site is that I'm the physician that will take on the responsibility of a trial and I will have multiple different trials that I'm responsible for currently. And what that means is I need to carry out that trial based on what the protocol has written. I oversee safety and make sure that safety is protected and also oversee all the data that's collected, making sure that it is clean and accurate. So, that's sort of the high overview of what I do.
And day-to-day, it is an onsite job. I don't work from home, but there are different tasks. I have to review charts that my coordinators have worked on. I do need to evaluate participants to make sure they're safe. And if an adverse event does occur, I need to report it based on the timelines of the protocol that they're asking for and make a determination whether I feel like this is associated with the drug or the IP that they're currently looking at or not.
And then there's lots of meetings, with either monitors, medical monitors, sometimes the protocol changes. So, I need to be up to date on that. And so, kind of going back to what I had mentioned earlier in terms of my personality. I really enjoy working as a team. And so, the role that I have, I need to work with a lot of different people. And that was one of the best things about taking this role.
The other thing is it's kind of the best of both worlds because I get to be in pharma and get to be part of potentially bringing a new drug to the market. But I still get to see participants, we don't necessarily call them patients, but I still get the interaction with participants during this time.
And then the other thing is I do need to use my medical background to sort of determine things such as eligibility criteria, if they're able to participate in a study. And again, being aware of adverse events, I need to be reviewing labs and EKGs. However, I'm not managing all of those things. I think one of the hard things for at least a family physician when we're in practice, we're often managing 10, 20 problems per patient.
And here even though I may see them and interact with them, if they is something going on, say their creatinine starts going up while they're in this trial, I need to make sure, "Oh, this is something that's concerning, but you need to go follow up with your PCP." And so, it takes off some of that pressure of managing every single problem.
John: Okay. I have questions. I have a lot of questions. I maybe won't hit you with all of them today, but as you were talking earlier about what a PI is and what a PI does, in my mind over the years, even way back before I went to med school I think of clinical researcher and a PI, it's like they're an academic person, they're creating this multi-site study, we're going to try this drug and on all these patients and they're the PI for that.
But you're talking about PI as it's a role. It's a position in this organization that has certain duties and it's basically to exceed at this particular study at this site, it's done properly and safely and all those things. Is that pretty much what I'm hearing?
Dr. Melissa Choi: Yes, that's correct. I think the biggest difference between my role and an academic's role is pharma companies or what we call sponsors are looking for people to sort of run their trial, but they need physicians to oversee it. And that's where my role as a PI comes in and they said, "Hey, we have this trial, can you help us oversee it at your site and help recruit patients to participate in this trial?"
John: Now would there be similar studies being done at other locations that are parallel that either someone else would be running or you would in your role, maybe if not now in the future, where you would run at other sites? How does that play out? Do you know?
Dr. Melissa Choi: Yeah, absolutely. I think it depends on what phase of the trial it's in. A lot of the studies that I'm currently participating in are in phase two or three. And when they're in a phase three trial, for example, they're looking for 18,000 plus subjects. And there's no way that one site can manage that. They're looking for a diverse patient population. So, a lot of these times, the sponsor or the pharmaceutical company will have the same trial running in all different countries around the world. So, it's really fun to see how this comes together. And so, in that instance, I'm just a small portion, but my data is still contributing to moving a potential drug forward to market.
John: And would there be occasions where you would be interacting with the other PIs kind of doing the same thing that you're doing at other sites and you're part of this massive team?
Dr. Melissa Choi: Absolutely. Before COVID, I didn't have this job until after COVID. I heard that before COVID, there were a lot of in-person investigator meetings. And those can be located anywhere. And they would be flying PIs like myself to these meetings.
It doesn't happen as often now because they've discovered they can do these meetings online via Zoom, but I have also gone to investigator meetings in person where you meet together and I actually really like the interactions. It's a great way to meet other investigators. You get to meet the sponsors who are the staff that I often interact with via email. Seeing them face to face is very helpful. And it's just easier to ask questions about the protocol, say, "Hey you wrote this, did you mean this?" when I have questions about the protocol.
John: Now, as I was trying to understand the pharma industry, which was really foreign to me, and I probably still don't understand it fully. In my mind, pharma companies have different divisions and the activities are separated from each other, but it's probably not really true because there's probably a ton of overlap. And what I mean by that is that in my mind, safety and pharmacovigilance, I think those terms are used interchangeably and separate from the clinical research or the clinical development division, which is separate from the medical affairs division. And so, are those sort of arbitrary distinctions? It sounds like you're doing a lot of safety, but is there another safety professional that you interact with as well that's part of the team?
Dr. Melissa Choi: Yeah. And I wouldn't even necessarily categorize the role of a PI in sort of the safety pharmacovigilance role because at least from my understanding, those folks are looking at data and signaling things like that. I feel like I'm actually independent of those three categories that you've mentioned and I am the physician that's basically running the trial that clinical development has developed, for example. But I do interact with the safety folks such as medical monitors. Say I have a question in terms of I'm not sure how to interpret this eligibility criteria. Is it okay to enroll this patient in this trial? And they would say, "Yes, based on what you've told us, go ahead and enroll this subject in the trial." And so, those are the times when I interact with the medical monitor.
John: Okay. Yeah, to me it always seemed too, as I got into it that all these people were interfacing with one another. Even in the hospital setting, you have departments, you have divisions, but everybody has what we call a matrix reporting in the sense that you just interact with whoever you need to interact with. You don't have to go through your boss to do something if there's an issue that you need to deal with at the hospital. Well, it sounds very similar in this kind of organization.
Dr. Melissa Choi: It really is. Because I would say I interact with the medical monitors, but then there are times that I have to interact with the trial managers. And so, they're all sort of separate but together. So yes, there's a lot of matrix leadership that's going on.
John: All right. Well, I've probably gone over my time here with you, but let me just put it out this way, a question. Is there anything that we've skipped over in terms of the process that you followed and the way that you've found this job, your feeling about the job, pros and cons, anything we've missed that you want to mention before I let you go?
Dr. Melissa Choi: Yeah, I think if physicians are interested in a role like this, or even another nonclinical role. Obviously, people say network and apply, but I think some of the other things that I would suggest is, first of all, really do a reflection of what it is you enjoy and what are you an expert in.
In my case, I sort of took this twisty, windy, unexpected role. I was doing health coaching and that was something that I was really interested in and I was really interested in obesity medicine. And I think when you learn to market the skills that you have and the expertise you have, and even though you may be frustrated that you're applying to lots of jobs, but not getting interviews or not getting offered a role, you get to do something that you can be the expert in.
And those believe it or not, will help sharpen the skills to lead you to where you may eventually want to go. And I always tell folks to figure out what you want to go toward, not what you're running away from. I know there are a lot of physicians that are burned out based on what we've gone through the last few years. But it's really important to kind of understand why you're burned out and figure out what it is you really do enjoy because that will make even the time that you're still practicing more enjoyable.
And I would say the last thing is ask for help. Look for physician coaches or people that have done something that you're interested in and speak with them. I think a lot of times as physicians, we are thinking that we're smart folks, which we are, but we think that we can figure it out on our own, which you may, but again, it may take you much longer if you do it on your own than if you speak to someone that's already done it.
And I always tell myself professional athletes, they all have coaches. Just because they're making millions and they're the top player, that doesn't mean they do things on their own. And so, I think if you're looking to build new skills or do something new, we should really ask for help.
John: All right. That's excellent advice in fact, but I do have one last question, kind of along these lines. Knowing what you know about the industry that you're in, does it seem like right now there's still a lot of jobs out there for physicians who might have an interest the way you do?
Dr. Melissa Choi: Absolutely. I think with where the economy is in general, right now, here we are in 2023, things have slowed down a little bit and maybe they're not doing as many vaccine trials, for example, as they were in 2020, 2021 when COVID was really big. So there have been some ebbs and flows, but I think we're always going to be in need of new treatment options and there's always going to be a need for new trials. And so, it might take a little bit longer than what your plan is expecting, but the jobs will always be there.
John: And it doesn't require a master's degree in research or a PhD in some esoteric area from what you're telling me today.
Dr. Melissa Choi: Absolutely not. Like I said, I wasn't even really sure what a PI did in this aspect at a clinical research site until I was interviewing for this role. So, even if you don't know anything about it, read about it, learn about it. I'm happy to talk to folks about it if they'd like. And I think that there's a place for pretty much anyone in any specialty.
John: Excellent. I really appreciate the time you've taken today. And yeah, we didn't mention that sometimes people do want to get in touch. So, as we spoke about before we got on the call here with the recording that you're on LinkedIn obviously, and that might be probably the easiest way to get in touch with you if they have questions about anything you discuss today and that sort of thing.
Dr. Melissa Choi: Absolutely.
John: Okay, Melissa, thank you very much. I found it very interesting and informative. I've learned myself a little bit more about how to understand how this whole industry works, so I greatly appreciate that. And with that, I will say goodbye until next time.
Dr. Melissa Choi: Thank you so much for having me on, John. It was great.
John: You're welcome. Bye-bye.
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