research Archives - NonClinical Physicians

Why the Midcareer Physician Must Achieve Financial Freedom – 316

John Jurica — Tue, 05 Sep 2023 12:45:38 +0000

Interview with Dr. Brian S. Foley

In today's episode, Dr. Brian Foley shares valuable insights on how the midcareer physician can achieve financial freedom.

Dr. Brian Foley, known as the Wealthy Doc, pursued a medical degree at Upstate Medical University of the State University of New York and completed his Physical Medicine and Rehabilitation Residency at the Ohio State University College of Medicine. Alongside his clinical career, he attained a traditional MBA in Finance from Indiana University's Kelley School of Business. Since then he dedicated himself to educating medical professionals on financial matters through his blog and book.

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Wealthy Doc's Guide to Achieving Financial Freedom

Dr. Brian Foley's background stems from a humble upbringing in rural upstate New York. His journey through medicine and later an MBA in finance, drove his desire to help fellow physicians make better financial decisions. This led him to create the Wealthy Doc blog and write the book Wealthy Doc’s Guide to Achieving Financial Freedom.

Dr. Brian Foley's blog, “Wealthy Doc,” initially began as a resource to help students and residents navigate financial complexities while pursuing their medical careers. Over the years, it has evolved to cover a wide range of financial topics. These include insurance, investing, and real estate, with a focus on providing valuable insights to physicians and high earners.

His book, “Wealthy Doc’s Guide to Achieving Financial Freedom,” delves deeper into these subjects, offering guidance tailored to the unique financial challenges faced by physicians.

Strategies for Midcareer Physicians to Enhance Their Incomes

Dr. Brian Foley mentioned several ways for physicians to increase their income:

Negotiating Contracts: Physicians can negotiate better compensation packages before accepting a job, utilizing leverage when they are in demand. It's important to understand one's value in the job market by researching salary surveys and talking to colleagues.
Expense Reduction: Reducing personal expenses can be an effective way to improve financial health, with tax advantages for those who spend wisely.
Multiple Income Streams: Diversifying income sources through investments like stocks, bonds, real estate, and other passive income streams can boost income with minimal investments of time.

Regarding real estate, Dr. Foley emphasized that while it's a popular choice, it's not obligatory for physicians. Real estate can be a valuable asset class, and options range from passive investments like Real Estate Investment Trusts (REITs) to more active ones like owning rental properties, syndications, or funds.

He noted that syndications have higher risks and require more knowledge, making them more suitable for experienced investors. Funds offer a middle ground, providing diversification with passive management.

Summary

Dr. Brian Foley emphasizes the importance of achieving financial freedom for the midcareer physician. He wrote his book, “Wealthy Doc's Guide to Achieving Financial Freedom,” as a resource for physicians starting to practice. This insightful guide offers a physician's perspective on financial management and practical tips from real-life experiences. You can find his book on Amazon.

NOTE: Look below for a transcript of today's episode.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 316

- Interview with Dr. Brian Foley

John: Today's guest is a fellow online educator, but in his case, he uses a blog to help educate physicians and other clinicians about finances, investing, and other important topics. I've been following him for years, but when he published his book recently, I knew it was time to invite him onto the podcast. So let's welcome Dr. Brian Foley to the show. Hello, Brian.

Dr. Brian Foley: Hey, thanks. I'm honored to be here. I have a lot of respect for you and your work, John. I've been following you for a long time. I enjoy your podcast and I've had many friends and colleagues on your podcast, so I'm glad to finally be included.

John: Excellent. I'm glad to hear that. We're just among friends here, so I thought I could pick your brain, and basically what I think, the way I look at it is my listeners, for the most part are either just interested in learning something new about careers or about finances. They may be burned out, they may just be frustrated, maybe looking for a new career. But I think there's a lot of things you can teach us today that our listeners will benefit from. So I appreciate you being here today.

Dr. Brian Foley: Yeah, I hope to help.

John: All right. Now, we usually start with just getting a little bit of background. I do have a little intro that I will record separately before we actually start talking. But I'd like to get your version of a little bit of what you think is important about your background and how you came to create the blog and write the book and all that kind of thing.

Dr. Brian Foley: Sure. Yeah. I grew up rather poor, which becomes relevant when I talk about these financial issues. Kind of a loving family in upstate New York. When I say New York, people think of the city, but it's really quite rural. And I was interested in science and I liked people. So like a lot of people that go into medicine and trying to figure how to combine those two interests. I was a chemistry major. I thought I'd be a scientist, but then I realized, one, I'm not that great at it and two, I didn't want to live in a lab. A lot of my friends were pre-med and I just learned more about it and went with that route.

After medical school, I specialized in physical medicine and rehab. And that's kind of a wide field. It's one that a lot of even doctors don't know much about. But briefly, the inpatient work is with spinal cord injury, head injury, traumatic brain injury, things like that. I do more of the outpatient, which is musculoskeletal, kind of non-operative orthopedics, nerve testing. We overlap a little bit with anesthesia pain, things like that. And like a lot of neuro docs especially, I think we tend to have a lot of outside interests. And so I was always interested in a lot of things, reading, writing, different kinds of career, and business.

And after meeting a lot of physicians who weren't really making a lot of good financial decisions, and were a little bit overconfident maybe in their burgeoning skills, I decided to get an MBA. I specialized in finance in the MBA and that became very helpful in my own life and in helping fellow colleagues as well.

John: That's a lot. I want to reflect on a couple of things. There's a picture of your house in the book, by the way, which we're going to talk about in a minute. That'll give the listeners and the readers an idea of what you're talking about in terms of the starting out in a more of a poverty situation. I'm just thinking of things where I can relate to you. So I was a chem major too, so go chem school.

Dr. Brian Foley: All right. All right.

John: I actually worked as a food scientist for two years before finally getting into med school.

Dr. Brian Foley: Yeah, I worked for one year at DuPont actually.

John: Did you? Okay.

Dr. Brian Foley: Yeah. Yeah.

John: That came in handy, didn't it?

Dr. Brian Foley: Yes. Yes.

John: It comes in handy every day actually, if you think about it.

Dr. Brian Foley: It does.

John: And I really love physiatrists. As a family physician, I worked in occupational medicine. Nobody could help me out better than a physiatrist when I couldn't get someone feeling better. And you're still doing that, right? You're practicing full-time?

Dr. Brian Foley: That's good to hear. I'm part-time, yeah.

John: Part-time.

Dr. Brian Foley: Part-time.

John: Okay. Now, you decided along the way to do a little segue or a little squeeze in a little MBA. Now, that's not typically, especially the school you went to is very well known. And so, tell us how you managed to fit that in and balance that with what you were doing clinically.

Dr. Brian Foley: Yeah. I didn't realize how unusual my path was, but the North American Spine Society asked me to give a talk in Toronto to the spine surgeons mostly about my background because they said, they've been looking around, they haven't really found anybody who's a physician who has a business degree, who worked in private practice, who worked in academia and who is employed physician, salaried and non-profit. And I've done all three. I was in private practice for about five years. And then I went into academia and at that time I found out that when you're on the faculty, the school will pay for your tuition.

John: Perfect.

Dr. Brian Foley: And so I said, "Does that count even the MBA because per credit, that's a lot more." They said, "Yeah, it doesn't matter." I had a friend who's a colleague, I don't know if he's smarter than I am or not, but he chose wine tasting as his choice semester after semester. So I did my MBA instead. That was a great opportunity for me. Because in academia it was a pretty light schedule and there's a lot of flexibility. So in the evenings, I was already on campus, so I did in-person. Hard-core full MBA was three years, the evenings and weekend. So it was definitely a lot of work, but I really got a lot of that and I enjoyed it.

John: Well, you answered a question a lot of times I get, and that's "Should I get an MBA? Do I need to get something like that?" And my answer usually is "It's great if you can do it, but get your employer to pay for it, if at all possible." Why go spend $60,000 or whatever it might be? Now my podcast is sponsored by an MBA program at the University of Tennessee. So I definitely am not going to bad mouth the idea.

Dr. Brian Foley: Yeah. There's a lot of benefits to that formal training if you have the interest. Now, I did it mainly because I have the interest. I actually gave a talk at the White Coat Investor annual conference on that very topic. Should physicians get an MBA? And if I had to pick one word, I would say no. But it's mainly because if you go to a talk and someone says don't do it, and that talks you out of doing it, then you probably didn't have enough motivation to get yourself through it because it's a lot of work.

But I think if you have interest and you want formal training, it was helpful to me. The job I have now was from that, directly from that. I was recruited because of my business training and it's helped me be more rigorous in my own financial investments and advice to others. It gives me credentials. It opens up doors for speaking and writing. So it's very, very helpful for those who are interested and can pull it off.

John: Okay. Then I'm going to ask one other question that's kind of related to that and to see what your answer is here. Let's say that I happen to have the opportunity to get the MBA during or immediately after med school, or should I go wait and do the executive MBA, which I think basically is what typically we would call what you did. What's your answer to that question?

Dr. Brian Foley: Well, technically mine was not the executive MBA, but the executive MBA I think there's a more brief kind of accelerated version, especially in healthcare. If they take advantage of your healthcare experience, they might be a year, a year and a half. So it's maybe more expensive, but less of a time commitment. So, there's pros and cons of different MBA programs.

When to do it. I think a lot of these decisions are very personal. What's going on in your life, what's your situation. From a pure financial standpoint, I would say start your medical career. That's the way I did it. Or do an MD/MBA. If you have that option, that's a really affordable and good time to do it. When you're a starving student, you're studying anyway, you add on an extra semester or a year even, and you come out with dual degrees. That's a nice option. A lot of my colleagues have done that. But later in life, I think you can afford it. You can take time off, do it on weekends and add your credentials.

Now, most people who get an MBA just across the country, not physicians, but all people who get MBAs generally look for an income boost. And generally, they do get a very significant boost. For physicians that isn't necessarily the case. I think we have to be very focused on what exactly do I want from that degree? Could I get those skills and talents in some other fashion?

If I want to learn negotiation, if I want to learn finance, there's a lot of ways online, some of them even for free. There's actually a book and a website called the No-Pay MBA. So there's a lot of online sources. For me I need formal structure in the school and the class to go to, it's just how I learn best personally. But there's a lot of options out there.

John: Now, it sounds like you had a lot of interest in finance and investing and planning for the future and so forth, but if I remember correctly, you did finish the MBA before you started the blog or somewhere in there.

Dr. Brian Foley: Yes.

John: I have a feeling you could have probably started before that, but anyway, that's the way it was. So tell us now, what's going on with the blog? You've been doing that a long time. There is a lot of information. When I look at it, basically it's just tons of free information, not just blog posts, but how-to and other things. Tell me more about the blog so people understand what they might get from that.

Dr. Brian Foley: Great. Thanks for your compliment. I appreciate that. I started the blog really to help the students and residents that I was working with. They were really interested in finances, and they're overwhelmed with how much they have to learn just to be a good doctor. So they couldn't sit down and read textbooks and finance, even if that were interest of theirs. At the time, this was 2007 when I started this, so there were blogs that started a few years earlier, but it was still kind of fledgling.

And the students would say, "Well, the books you recommend are great, but is there a website I can go to?" And at the time I searched and there wasn't really. But Bernstein has post Efficient Frontier that he wrote starting in 1998 that I followed, but it was really only investing. It was very technical, so it wasn't helpful to the residents. I started this really to help them. And I've just added it as I add content and have thoughts, I'll put that in. A lot of attendings have told me that's helpful. I gave lectures and it kind of spun off from there to give public speaking and eventually the book.

John: Okay. Now, if I remember, again, I haven't read every page of the blog, but, there's stuff about insurance, there's stuff about investing, and then you get a little bit into real estate. Actually, a lot of this is covered in the book. I'm assuming some of it you've written about before as well. So tell us more about just kind of the smattering of different types of related topics you might cover.

Dr. Brian Foley: Yeah. I try to focus mostly for physicians or other high earners who don't know a lot about finance. Probably 80% to 90% of it is really basic finance is true for anyone, helpful to anyone. But some of it is specific to physicians starting late, maybe being overconfident, over trusting, having a lot of debt. Those kind of things that resonate a lot with physicians.

I have several posts that are just overview of the basics. And then how to structure the overview thinking of personal finance, but then I do deep dives into disability or other things that may interest the readers as well. So, hopefully there's something for everyone if you search in there.

John: Now, because I have a different perspective in terms of talking to a lot of physicians that are frustrated and find that medicine isn't exactly what they thought it was going to be. It doesn't mean they don't want to continue to do it in some fashion but there's a lot of unrest and dissatisfaction.

I was toying with calling today's episode of the podcast "Why the Mid-career Physician Must Achieve Financial Freedom." And so, I put that question to you, and I have my own ideas, but I feel like it's important that a mid-career physician do achieve financial freedom. And so, maybe you can give me your thoughts on why that might be, and then we can talk about some of the simple things we should probably do to achieve that.

Dr. Brian Foley: Yes, I agree completely with you. Sure, I hear that a lot, but I think we probably should hear it more. A lot of physicians don't have a lot of interest or experience in finance, and a lot of them are very confident, especially starting out at 30, 35 years old. "Hey, I have a good income. I love my career. Why should I care about finance? I have a money guy for that. I want to delegate it."

And my answer, and this is what I would tell my 30-year-old self. I'm in my mid-50s now. I would tell my 30-year-old self, okay, I'm glad you love it. I'm glad you're good at it. I'm glad it's a nice career, but work may change. Your regulatory environment may change. Instead of having private practice, maybe you're working for a big company, you'll always agree. Maybe you'll run into some health crises or you need to take time off for your spouse. Maybe your interest will change. You'll find, "Hey, I'm really more interested in the psychology and psychiatry than I am in my interventional things that I'm doing."

I told a lot of names from my blog. At one point I thought maybe FI by 50 was a title. FI is financial independence, meaning you don't necessarily need to work to cover your expenses. And that's what I recommend for most physicians. Now, I started out age 31, and at the age 48 I was financially independent. That's about 17 years. The numbers say that if you save somewhere between 30%, 35%, 40% of your gross income, that's about 50% or half of your net income in 17 years you'll be financially independent.

Now, I never had a fixed savings rate, but it worked out about that in the end. So, for some, especially physician couples that have two incomes or they're married to an attorney with a high income, some people just save one and live on the other. And by 50 they are usually independent.

Now, does that mean you have to quit your work? Absolutely not. But what I found is it gave me the confidence to say, "You know what, at 50 I'm going to go part-time." So, I do three days a week clinical now, and I've done that for the last six years. And that's been wonderful.

Now, physicians think that they don't have the clout to negotiate, especially for a big employer like I work for. A $3 billion eight-hospital system. But being financially independent gave me a little boost of confidence to say, "You know what? I can do this. And if it doesn't work, it doesn't work." And they said, "Oh, yeah, I would love to have you in any capacity. Of course." To replace a physician who's experienced and live with the system is very expensive to them. And so, they're willing to help. For that reason, I think it's great to be financially independent, to give yourself options.

John: Yeah, absolutely. Again, because I have a biased view, I'm talking to people as they're burned out and so forth, it's like, I think a lot of the specialties that we are in, they're interesting, they can be very exciting, but they can be draining. To practice 20, 25 years doing something intense with long hours, you don't realize that stamina doesn't always persist. And if you are not financially free or already set in some fashion, then you really start to feel trapped. And like you said, if you do have the financial freedom and you decide you want to keep working, like you said, three to five days a week, whatever it might be, you don't have that burden anymore that you don't have options.

Dr. Brian Foley: I agree completely. If you had asked me "Are you burned out at 50?" let's say, I would've said, "No. I love what I do." But I cut back and after looking back, I have a fellow, friend, blogger, and he has this blog called Crispy Doc. He was a little bit crispy.

John: Crispy, yeah.

Dr. Brian Foley: He wasn't burned out. And that's kind of how I felt looking back. I love my job. I love my clinical work, but I will say I do love it a lot more now that I do less of it. And I'm less dependent on it, and I'm a lot more willing to mentor and teach. And I even had meetings on my day off. I really enjoy it more now that I'm not forced to be on that treadmill counting every WRV and worried about covering overhead while I'm on vacation, things like that, that add stress that you may not even realize until it's gone.

John: Now, all these things are covered in the book, right? And how to achieve that, and how do you get more income. I wanted to get a little deeper into that particular topic. You brought it up about how you were able to get a little more leverage. But I think you go in the book a little more detail. So, what kind of things can a physician do to get more income without changing their career or moving to another facility or something?

Dr. Brian Foley: Yeah. I think there's a lot that physicians can do on the front end, especially that's the best time to negotiate your job is before you sign up. And once you set that track, that salary, if you're at that same institution for a long time, it's really tough to have a big change, 20%, 50% increase. But before you start and they really want you there, that's a great time. You have a lot more leverage than you realize. I think learning some basics of contract negotiation or getting someone to help you with it, reviewing your contract, knowing your value in the marketplace, looking at surveys.

There's a lot of them out there now. AMGA, MGMA, SullivanCotter Online, Medscape, Doximity, there's PayScale and salary.com. Look at all those for your specialty and get an idea and talk to your friends and colleagues if you have a few that are willing to talk to you about salary and options. So that you know you're going into that getting your value because there's a lot of variation within this chosen specialty that you have.

Some people feel like, "Well, I'm in this X specialty, or I'm in primary care and my income is limited." And there's some truth to that for sure, but there's a lot of leeway in negotiation. In anything, if you do a work job negotiation, you don't need an MBA to learn some basics from negotiation. That will help you a lot.

The second point I would say is we're talking about income and that's great. I'll talk a lot about that if you want me to, but reducing your expenses is the best way for physicians to get ahead, in my opinion. They don't always want to hear that, but most doctors overspend in my opinion. And it's easier to cut your expenses. There's tax advantages to doing that. If you're already making $200,000, $250,000, $300,000, you're in the top 5%, maybe 3%, 10% depending on where you live and what you do. So, getting that extra $20,000, $30,000, if that takes you a lot of work, a lot of risk, a lot of stress may not be the best way to achieve your goal.

And thirdly, I was really sold the idea of multiple streams of income early on. And this passive income is maybe not the best phrase for it, but latent income, recurring income, horizontal income, something like that where you put out a book or a course or a project, and you continue to get income. Or you buy a bond or a stock, a dividend paying stock or invest in a private company, and that continues to produce income. Real estate, obviously is a great choice for a lot of physicians. Produces ongoing income and capital appreciation. Those are great ways to boost income without doing the extra labor as well.

John: Do you have a favorite, since you brought up real estate. There's a lot of ways to invest in real estate. It's not always as easy, it's not always passive, but what about you? Do you have a particular preference when it comes to using real estate as part of your overall approach to maintaining that income?

Dr. Brian Foley: I do. I've been invested in real estate my whole career, which is basically 25 years as a physician. I will say clearly, emphatically is absolutely not required. It's very popular right now. There's a lot of blogs and conferences and it's a booming market and a lot of doctors are interested for very good reasons, but realize it is not required. And everybody from Harry Markowitz who started Modern Portfolio Theory to Warren Buffet, to the Vanguard founder, Jack Bogle, all say a mix of stocks and bonds is all you need. So, you can do investing simply as a physician without any difficulty.

But having said that, if you want to add real estate, I do think it makes sense. It's a separate asset class, so it doesn't always go up and down when stock and bonds go up and down. You can buy it fairly easily and passively as a REIT, Real Estate Investment Trust. From companies like Vanguard, Fidelity, TIAA-CREF, they all sell these that you can just buy in. You don't have a tenant to worry about.

AAA leases are a little more involved, but they're still kind of passive. I've invested in medical office buildings, surgery centers, some physicians have options for hospitals. I've owned several single-family homes as rental units. And now I'm doing more funds and syndications and apartment buildings, things like that. The benefits are many, but appreciation. These assets tend to grow over time. Depreciation, which is a tax benefit to physicians. Then you can write off some expenses and then you get some cashflow coming in. So there's a lot of arguments to get involved if you have some interest.

John: Yeah, it sounds like start with the simpler ones perhaps unless you have to invest a lot of time. I'm not investing in the syndicate, for example, but it sounds very attractive. And when I get hit retirement, if I'm getting some kind of cash out from real estate or I am a part owner in an urgent care network, blah, blah, blah. Well, then I might have a bunch of cash, I would consider it, but I would definitely have to really dig into to learn about those, but they sound like an interesting option.

Dr. Brian Foley: Yeah. For those who don't want to, I think funds are another option somewhere between REITs and syndication. A fund is private, usually you have to be an accredited investor, which almost all physicians are if they work, and make $200,000 for an individual or $300,000 a couple, or have a million dollars in assets, you can be eligible for a fund.

And they buy multiple properties, usually in multiple regions of the country. So you have more diversification. Syndications are a very concentrated investment in one facility, and so you're susceptible to economic changes, to fraud, and there's a lot of risks. So you really have to be pretty knowledgeable. And I'm a little aware, there's a lot of physicians jumping in the syndication without really understanding what it is, and they've gone really well in the past, but that doesn't mean they're going to continue.

John: I think the pandemic threw things for a loop for a while there. I don't know if they've recovered from that or not at this point.

Dr. Brian Foley: They did. Yeah. I was lucky. I had some single-family homes at the time. But everybody was able to pay the rent. I didn't have to worry about eviction, but I was lucky.

John: Nice.

Dr. Brian Foley: If you have just one or two rental houses and you lose your tenants, you can be really hurting. So that's the argument for having a small investment in a larger property with a group of other people. You get a little more protection there.

John: Good advice. Yeah. You always got to be diversified and protecting yourself and also do your research. Okay. First, I don't think we mentioned the website's address, maybe you did, but it's wealthydoc.org, right?

Dr. Brian Foley: That's correct. If you go to wealthydoc.com, you'll be diverted to the .org.

John: Okay. Cool. And like I said, we talked a little bit about what's on there, but now tell us more about the book in terms of why should I buy the book and where should I buy it?

Dr. Brian Foley: Yeah. I wrote the book for those who are starting out in practice. Basically I wrote it for my 30-year-old self of the things I wish I had known that would kind of set me on the right track for the future. I tried to make it pretty readable. I had a lot of help. Writing a book, it's a lot harder than it seems it should be. To make it readable, I put in some personal stories about what I've been through, try to share some tips from school of hard knocks. If you just want straight-up good financial advice, you can go to the Personal Finance For Dummy series or something like that. But if you're interested in a fellow physician who is doing his best to be honest and teach what he has learned, it's a good source for that. It's not the only one out there, but I wanted to put my voice in the mix.

John: Well, I think too, because it's from the physician's perspective, we all kind of go through the same things, more or less. Everyone's path is a little different, but we all put things off while we're in our training. Most of us have loans we have to deal with. As I read through it, it just flows naturally. Oh yeah, this is what I needed then, and then later on I needed this.

And so, I definitely recommend it. You can get it at Amazon, like you said, very easy. And it's easy to read and it's probably not 600 pages, it's not scientific, it's an actual good advice and information. I think it didn't hurt that you got the MBA along the way to talk about some of the slightly more technical things.

Dr. Brian Foley: Great. Thank you.

John: All right. Any advice you have for us before we go? I guess we're running out of time here in terms of just knowing a little bit about my audience, they might be in the middle career since that's what we were focusing on. Mid-career, feeling a little frustrated, a little helpless. What advice do you have for them in general and regarding their finances?

Dr. Brian Foley: Yeah. I think there's a lot of time for hope. There's a lot of resources out there now like websites and blogs and podcasts like yours, groups on Facebook and other social media outlets can bring people together, physicians to collaborate on what's a good side gig and how do you benefit from.

I didn't talk about the tax benefits, but having a little bit of side income can help. You can have a solo 401(k) or a SEP IRA to put aside a little bit more money there. And you can write off some of your expenses. As well as having a creative outlet outside of medicine can sometimes, even if you're going to continue, like my blog, I really enjoy the creative writing outside whether it's financially successful or not. And that helps me feel a little bit rejuvenated when I go back to my career.

If you're thinking about another career outside of medicine, my advice is to dabble in it while you're a physician. And I certainly did a lot of that. If you can cut back a little bit, maybe drop a call or cut back a half day here and there and add some moonlighting daylighting. Some of the things that I have done despite me saying increasing your income isn't the way to go. I did find benefits of doing that.

Some examples, because I think a lot of your audience may be interested in some of those. I've done IMEs. I've done some medical consulting for investment banks. I've had five or six different medical directorships. I've done some medical informatics where I taught fellow physicians how to use our EMR well.

There's paid surveys, file reviews, lawyers and insurance companies and state workers' comp boards are really interested in physicians and input and want to pay them. They realize they make good money and they want to. There's opportunities for coaching your peers. Once you learn something, you're a little bit ahead of someone else. You don't need to be the world's best expert, but just being a little ahead of your peers, you can give other people hope and encouragement and show them how.

Next thing you know, you'll be doing what I'm doing, paid speaking and teaching and writing and you can open up a whole new world. And then if you find, "Hey, I love this better and I'm making a good income" then you can transition maybe a little bit earlier out of medicine.

John: Yeah. I like that. The coaching, the lecturing, speaking, and so forth for particularly what you're combining what you know about medicine and then about, in your case, finances and where those two things meet. And so, there's this whole audience of people that haven't gotten there yet that just want to learn something either face to face or in written format or whatever. And so, that's a great side business.

Dr. Brian Foley: Yeah, I agree. And if I can help anyone please feel free to reach out. If you go to my website, there's a contact section. You can email me. I don't have any paid services. I'm not here to make money off my colleagues, but I'm glad to share what I know.

John: And they can reach out at LinkedIn too, I believe. Is that possible?

Dr. Brian Foley: Yes, sure. Yeah. About most of the social media platforms out there.

John: Okay. Excellent. Well, we are out of time now, so we could go on for hours I think. We've only touched on three chapters in the book if that. But I really appreciate you being here today, Brian. This is very useful and educational and I encourage everyone to get the book and follow up with you if they have questions.

Dr. Brian Foley: Thanks, John. My pleasure.

John: All right. I hope to see you again sometime and maybe get you back on the podcast. And with that, I'll say goodbye.

Dr. Brian Foley: That'd be great. I'll see you.

John: Bye-bye.

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Develop These Essential Skills to Be a Visionary Medical Affairs Leader – 315

John Jurica — Tue, 29 Aug 2023 13:00:57 +0000

Interview with Dr. Savi Chadha

In today's episode, Dr. Sava Chadhi returns to the podcast to explain the steps he took to advance his career as a Medical Affairs Leader.

Dr. Savi Chadha's pharmaceutical journey began as an MSL with Amplity Health in 2016 and later advanced to Supernus Pharmaceuticals in 2017, where he thrived. Once he was working as an MSL he completed board certification by the Medical Science Liaison Society. And his two nominations for MSL of the Year by the MSL Society reflect his exceptional contributions to the industry.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete.

Becoming a Medical Affairs Leader

John and Dr. Chadha discussed the topic of advancing one's career in the field of Medical Affairs. Savi provided his unique insights and shed light on strategies for listeners who aspire to fast-track their career growth.

Proactivity: Being proactive is crucial for career advancement. Expressing interest in tasks, taking the initiative, and letting your manager know about your aspirations are key steps.
Leadership: Stepping up as a leader within your team showcases your initiative and can accelerate your career progression.
Management Experience: Gaining experience in managing other team members, by onboarding or participating in employee training can be valuable for career growth.
Certification: Pursuing the MSL certification shows dedication and expertise in your role.

Remember, your initiative, leadership skills, job knowledge, and relevant certifications all play a role in accelerating your career.

Strategic Tips for Starting Your MSL Career

When seeking opportunities in the field, engaging with pharmaceutical representatives can prove highly advantageous. These professionals regularly visiting medical offices and hospitals are sources of valuable information and pathways to meaningful networking.

Taking the initiative to connect MSLs and sharing your resume if job openings arise, can create a pathway into these nonclinical roles. This often-overlooked resource can open doors to new career prospects.

Dr. Savi Chadha's Advice

Be persistent and patient. Transitioning takes time. It may not happen right away; it could take months or even years. Don't take rejection personally; stay resilient and work through it. Despite the stress prompting the transition, give it the time it needs.

Summary

Dr. Savi Chadha's insights provide advice for those aiming to excel in Medical Affairs. As a seasoned Medical Science Liaison (MSL), his journey from entry-level to senior positions offers a unique perspective.

He emphasized proactive engagement, leadership, and expanding skillsets. Additionally, he encourages listeners to persist in the journey towards nonclinical roles with patience, persistence, and “thick skin” to achieve that goal.

NOTE: Look below for a transcript of today's episode.

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Transcription PNC Podcast Episode 315

Develop These Essential Skills to Be a Visionary Medical Affairs Leader

- Interview with Dr. Savi Chadha

John: Today's guest was the first MSL I ever interviewed almost five years ago on episode number 50 of the podcast. And I'm really happy to have him back with us to provide his insights and his advice about working in the pharma industry. So, welcome back, Dr. Savi Chadha.

Dr. Savi Chadha: Thank you very much, John. Great to be here. Great to be back.

John: It's good to see you. I have a lot to follow up on with you. I know you were so helpful the first time we talked. I don't have too many guests that have been in pharma, a new job with pharma and moved up the chain and that kind of thing. Maybe at the most it might be one other person. So I'm really glad you can help us today.

Dr. Savi Chadha: I'm glad I could do it. I'm glad I can be here.

John: Now my audience can go back and listen to the original episode. But why don't you go ahead and give us the short version of what you were doing before you became an MSL and then basically how you landed your first job, and then we'll take it from there.

Dr. Savi Chadha: Sure. Well, I think like a lot of your audience members, I was a clinician. I was going to the hospital, writing, seeing patients, and I think like a lot of physicians these days, I was starting to lose some of my satisfaction with the work. The same frustrations that I think a lot of us have, in terms of day-to-day patient care.

A friend of mine, actually, he had made the transition from clinical work into the MSL world. And he knew about my background. He knew that I had some business experience before I went to medical school. I actually worked in advertising. So he knew that I had some good relationship building skills. And so, he introduced me to the MSL role.

After quite a bit of thought into it, I started doing more research into it. And eventually I decided to take the plunge and I started interviewing, researching, and networking was a big one. And eventually, back in 2016, I did land my first MSL position, and I've been working as an MSL ever since.

John: Excellent. Looking back, if you have any pearls of wisdom about getting your first MSL job? We're not going to spend a lot of time on that, but anything that you would put out there in terms of advice for physicians looking for that?

Dr. Savi Chadha: Yeah, I would, and this is a question I do get a lot. Getting an MSL job is plain and simple. It's a competitive type job. There are a lot of people applying in addition to us, MDs and DOs. PhDs apply, PharmDs apply, and now the field is taking more advanced practitioners, so nurse practitioners as well as physician's assistants.

So, it's becoming more and more competitive to get MSL jobs. That being said, as MDs we certainly bring a wealth of knowledge and a lot of experience to that. Even though it is a competitive landscape, I encourage people to be confident in their interviewing abilities and their skills, and also to have a good amount of patience and fortitude because I think most people I've spoken to did not get their first offer, or I should say did not get their first interview, excuse me. And it was disheartening.

The trick I think for a lot of people is not to personalize rejection. Just maintain your focus, stay the path, if you will, and be patient and just be persistent. I think in most cases, the people that I've talked to that have made it or that have succeeded, have done that.

John: Well, I think that is a job where you can't have an MSL degree or something that's going to say, "Okay, you're the perfect person for this job", from what I know. You learn a lot. You could learn when you're interviewing, you learn when you're looking at job descriptions. I think it would make sense, correct me if I'm wrong, but to join the MSL society, even if you're not an MSL, because they have things that support people looking for that job, I believe.

Dr. Savi Chadha: They do. And I utilized them when I was searching, and I still work with them regularly. They have a wealth of information. In terms of both, about the MSL position itself and in terms of landing a position, interviewing, they go into a lot of detail. They're a great resource, fantastic resource.

John: Yeah. It's not like looking for your first medical school app job. Not a job but getting into med school, getting to your residency. There's kind of a prescribed process for that, but switching to a new career like this can be somewhat scary and the unknown.

Dr. Savi Chadha: It certainly can be. Especially in healthcare, I think a lot of our career paths have a strongly laid out career path. And this certainly goes off that beaten path, and we're sort of shredding our own way. So, it can very much be anxiety inducing.

John: Now you've been doing this job in different forms for a while. So, has it lived up to what you thought it would be? That would be of interest to us.

Dr. Savi Chadha: I'd say, yeah, I would say it has. It's a very enjoyable, satisfying job. In terms of being at the sort of cutting edge of clinical research, I get exposed to the newest treatments in my therapeutic area. I find out what clinical trials are going off or what new drug out there. So that's really fascinating. It's really nice actually to really have that excitement and enthusiasm of a new product coming out to treat a disease. From that aspect, it's certainly very satisfying and I think that's always been there. I foresee that always continuing to be there. That's just in the nature of the position.

John: Now, from talking to yourself I think previously and others, I've heard that it can have a fair amount of travel involved. It's just part of the job, although it can vary depending on whether you have a giant territory or a small territory or what have you. But has that changed at all in the last five years? I know with the pandemic a lot of nonclinical jobs where they're allowing them to do more remotely. So, tell us what that's like right now for you, or has been.

Dr. Savi Chadha: That's actually a great question, and certainly the pandemic had a very significant impact on MSLs day-to-day activity. All of our in-person discussions moved online, like I think many peoples are. Now that the pandemic has sort of wound down, a lot of us are back in the field. So, we are meeting with clinicians and researchers in person. That does require a lot of travel which is very much similar to what it was prior to pre pandemic. So it certainly has gone back to that model. Yeah.

John: Okay. I'm sure it varies by, again, the situation. That's just something to remember. But now you have been working there, and I know you ended up switching companies and now you've got some different roles. So, why don't you explain what's happened over those last five years for you?

Dr. Savi Chadha: Sure. Yeah. I think as I've been there at my current company longer, I've certainly gotten more projects and more type of administrative roles given to me. And some of these things are projects like interviewing new potential MSLs, training new MSLs, and then certainly managing them as well. Those are some of the things that I do in terms of my current MSL team.

Additionally, I also go outside of some medical affairs and do other aspects I should say within medical affaire but aside from just working with my MSL team. I also do work a lot with our promotional review committee. Any type of material that's printed, any type of advertisement that people see in terms of a pharmaceutical company or a product, I have to approve that and make sure that any claims that are made on there, specifically scientific claims or clinical claims, that they are backed up by clinical research and that they are 100% truthful. Additionally to that, I also do advisory boards, and I put those together and quite a bit of speaking engagements too. In addition to MSL work, there's other projects I should say that I do.

John: Now, can you explain a little bit about how the medical affairs division in a pharma company is structured? Most of us, it's really a black box. When we look in, it's like, "Okay, what the heck? I know an MSL might be in there, there might be medical directors, but what are they medical directing?" Maybe you can give us an insight into either the way it's set up in your company and or other companies if you're aware of how they typically structure things.

Dr. Savi Chadha: Sure. One easy way to say it is I think most people are familiar with pharmaceutical reps. They can go to physician's offices. I think a lot of us know about them. And then pharmaceutical companies also have clinical research teams, entire research divisions.

We tell people, and what I tell people is that medical affairs would be fall sort of in between those two divisions. And what I mean by that is, oftentimes the clinicians will ask the reps questions that the reps may not have the immediate information on and may not be able to answer right away. So what they'll do is they'll say "Let me refer you to our in-house medical liaison."

And so, we in medical affairs work a lot with the current products that are already on the market, whereas clinical research oftentimes will be working with products that are still in maybe phase one or phase two trials. Those products are usually not on the market as of yet. What we can do is we provide medical support for products that have already been FDA approved and are currently being utilized by clinicians.

John: Okay. I know the MSLs work with sometimes they're called key opinion leaders. I don't know, what term do you use in your company for your context?

Dr. Savi Chadha: Across the industry, KOL, which is what you said, key opinion leader, that's the most common one. But different companies will use different terms. Some will say thought leaders, some will say stakeholders. There's a lot of different terms for it.

John: Okay. So in the way you're set up now is that anything that's been approved and is out there in the market. You definitely can have those conversations. But when it comes to having conversations about things that have not been approved by the FDA that would shift to somebody else or would that be something that the MSL could talk about as well?

Dr. Savi Chadha: That's actually a great question, and that is actually something that we MSLs can do. And because clinicians do frequently ask about the company and say, "What products do you have in the pipeline, can you tell us a little bit about them?" And the commercial division and members of the commercial team due to legislation are not allowed to say, speak on that. Whereas as in medical affairs, we can. That's what I mean when I say that we're sort of a bridge between clinical research on one hand as well as commercial on the other. We support the commercial, and yet we can also talk something about the clinical.

John: All right. Because I was a little bit confused about that. But that makes sense because it's all about education, right? And to your KOLs, it's really not promotional at all. And the FDA doesn't like it if you ever do anything promotional on that side of the equation. But you're strictly by the book. But if it's scientific, if there's evidence for it, you can discuss it from what I've heard.

Dr. Savi Chadha: That's correct. Yeah. If it's scientific, we absolutely can discuss it. Yeah.

John: You've got a little bit more responsibility it sounds like in what you're doing. You got some seniority. Tell us a little bit more about that. What other things you might be doing? If somebody is in a position that you were in five or six years ago, are there things they can do to help get that kind of experience and maybe what you're even looking forward to doing in the future?

Dr. Savi Chadha: I would say for somebody, if they're sort of a new MSL, if they're looking to advance their career, certainly being proactive it goes without saying. As in most careers, being proactive about letting your manager know that you want whatever said task that they have. Certainly stepping up and being a leader on your team is big and can be very useful to your career. And that shows initiative, that shows proactivity, and certainly obviously it shows leadership. Also if you've managed say another employee or assisted another employee in terms of interviewing them, in terms of getting onboarding, those would also certainly be very, very useful. Onboarding specifically.

John: Now, I think looking at your LinkedIn profile, I saw that you've actually taken some additional steps to become board certified. And so, what was that about? What was included in that kind of education and did it have leadership and management components to it? Or was it all focused specifically on the job that you do as an MSL?

Dr. Savi Chadha: It's been a little while since I had got my MSL certification, but from what I remember, it required a written examination that talked a lot about some of the different roles and some of the different aspects of being an MSL and what MSLs are legally allowed to say and are legally not permitted to discuss, and how we can bring about those discussions.

I remember the test had a lot to do with that in terms of how we can appropriately bring about those discussions. The certification also required a certain amount of work experience at that point in order to receive the certification. So, it was a combination of knowing, I would say the job itself and what it entails and what it does not entail. And then having an appropriate amount of work experience already under one's belt, if you will.

John: Now, I have to assume at some point some people in your position will end up getting even more into the management side of things, leadership and that sort of thing. A couple of questions about that, if you know the answer. One is, is it beneficial or less beneficial to be a physician as opposed to let's say a PharmD or an RN or a master's nurse or other specialties in terms of the leaders? Who do you see are the leaders? Is it more of the physicians or not necessarily?

Dr. Savi Chadha: It really runs the gamut, really truthfully. I look at my managers and I look at managers in other companies, and it really does run the gamut. Some are MDs, some there are DOs, lots of PharmDs, certainly. That's simply because PharmDs make out the most MSLs. So inevitably simple math there. But there are PhDs. I've had nurse practitioners who were managers who were great. It really does run the gamut. The degree is really secondary to people's both hard and soft skills once they get in.

John: I'm trying to get a little more insight into the rest of the medical affairs division. You kind of explained this. The way I look at the medical affairs is responsible for getting the new drug out into the world, I guess is how I look at it. I see these ads for assistant medical directors, medical directors, associate medical directors, executive medical directors. It's kind of nebulous terms. So is it they just have more responsibility in a bigger scope of people reporting to them? Is that basically what that means? Or is there some other key that we should be aware of?

Dr. Savi Chadha: I think you sort of touched on it. An associate director usually will be joining, maybe that's their first directorial level position. They'll be labeled as associate and maybe not have full director type responsibilities. As they gain more experience, then maybe they become a director and then maybe eventually senior director. I think you touched on it, it's really just the volume and intensity of the types of projects that they're given and trying to manage.

John: All right. I'll put you on the spot now a little bit, even more than I already have. I'm just trying to think of other advice you can give to physicians or even other clinicians because I do have some nurses and pharmacists and dentists that listen.

But in terms of preparing for that first MSL job, but then maybe even learning some things prior to be getting your first MSL job that might help you later on, move up the ranks. Any thoughts or suggestions on that?

Dr. Savi Chadha: Yeah, I would say a couple of things. I would say to really talk to their drug reps that come to their offices or their hospitals. They are an excellent, excellent resource in terms of information and in terms of just networking a segue in. They can ask their reps, if they have a medical liaison that they work with. If so, ask to speak to them, get to know them. It wouldn't hurt to maybe give them a copy of your resume if they're hiring. Who knows, maybe they're hiring. That is an easy segue that's kind of laid out right there. So, I think that's a resource that people have that's often overlooked.

John: Yeah. I've at least spoken with one person whose job came directly from talking to the drug rep when they were still clinically practicing. And then actually just within a year she became an MSL and it's like, "Okay, that worked out well, but it's not always that simple."

Dr. Savi Chadha: You're right, it certainly is not that simple. That being said, it is an avenue that's available. There are other avenues. I think that if that's an avenue that's right there, that's proverbially sitting right under the bed, if you will, you might as well take advantage of it.

John: I think part of the issue was for her, it was that some of her colleagues ended up being KOLs. So, it was built in, she became an MSL and she was calling on those very people that she used to interact with. I think the company thought this would be a good hire, but it doesn't work like that very often from what I've heard.

Dr. Savi Chadha: Yes and no. I would say it can be an asset in terms of our professional network. I can pretty confidently say that will not be the only network that she will talk to. It will certainly have to expand.

John: Yeah, and what are the odds that you're going to just happen to live in an area that happens to need an MSL who's not already working there and for that company. Still, it's worth it. Definitely you can learn a lot from your rep from what I've heard. So I'm glad you definitely second that.

Anything else that we're missing in terms of the job, applying for the job? Do you see a lot of your colleagues doing lateral moves to other companies? Or do most people try to work their way up in one company and then later on do a switch?

Dr. Savi Chadha: I would say generally I see a lot of lateral moves, primarily for a few different reasons. One, when they become an MSL, a lot of people are simply satisfied with the MSL itself. They don't have an intention or any interest in going into management, which is perfectly fine. In that case lateral moves happen more often.

Generally what I've noticed is that if somebody moves vertically, they do generally move vertically within their own company and then move laterally. So, it's not too common where I've seen somebody do both a lateral and a vertical at the same time.

John: Well, I think I've picked your brain pretty darn well here for the last half hour. Any words of encouragement you want to give to the listeners too? Because most of my listeners are a big percentage. They've been trying for a while to get a nonclinical job, or they're just getting started. They're kind of frustrated working in the hospital situation or even a clinic situation with long hours and working with EMRs and the risk of being sued. Any advice for those people who are still maybe in that early phase?

Dr. Savi Chadha: I would say don't lose heart. If you're persistent, I know it's hard because people oftentimes want to transition during very stressful times in their career, and they want out pretty quickly. The transition does take time. Most people I've talked to, it didn't happen right away. It takes them months, sometimes years. It's just patience, persistence, and fortitude. Don't personalize rejection, have thick skin to work through it I would say. I know it's hard. I know it's not easy. I know that the very reason they want to transition is because they're stressed out at their current job but it does take some time regardless.

John: I think that's good advice because when we're in a big hurry sometimes we make mistakes that end up being worse than the solution that we would've gathered if we just gave it some time and really figured out what we wanted to do instead of run away from something. So, that is definitely excellent advice.

All right, Savi, this has been really good. It's been great to catch up with you and we'll put it on the books to get back together in five years.

Dr. Savi Chadha: Thank you for having me.

John: I really appreciate the time you've taken to come in and share all that. Best of luck, continued luck and success in your work in pharma. It sounds really good. So with that, I'll say goodbye.

Dr. Savi Chadha: Thank you so much. I appreciate it, John. Thank you again for having me.

John: You're welcome. Bye-bye.

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Making Your Way to a Rewarding Career in Clinical Development – 308

John Jurica — Tue, 11 Jul 2023 12:40:41 +0000

Interview with Dr. Linda Ho

In today's episode, Dr. Linda Ho returns to the podcast to discuss working in pharma in clinical development. And she explains how she moved into this role after starting as a medical science liaison.

During our interview in September 2018, Dr. Ho described her shift from clinical medicine to work as a Medical Science Liaison. In today's interview, she stands out as the first physician on the podcast to describe her transition from Medical Affairs to Research and Development.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete.

Exploring Clinical Development

Dr. Ho describes her professional journey, transitioning from MSL to a position in clinical development (CD). With enthusiasm, she explains these two areas within the pharmaceutical industry.

Drawing from her own experiences, Dr. Ho highlights transitioning to CD:

She began learning about clinical trials at her company, even as she worked as an MSL.
Networking is crucial, including making connections with local MSLs and sales representatives to find out about opportunities and express interest in transitioning.
Joining a contract research organization (CRO) as a starting point to enter the pharmaceutical industry can be an option, but it may not guarantee a direct path into clinical development.
Physician Development Programs offered by big pharmaceutical companies are an excellent way for young physicians to enter the industry. These programs provide rotational experiences in various departments, allowing physicians to explore different functions and decide on their preferred career paths. These programs are also known as Physician Fellowships, Physician Leadership Development Programs, or Pharmaceutical Leadership Development Programs.

Transitioning in the Pharmaceutical Industry

For an MD, it's a natural transition to do something that is more MD related. I use my medical background every day, assisting physicians with managing adverse events and providing insight into patient cases. While the ultimate management is up to the Principal Investigator, I can advise them on available resources and discuss the case given my knowledge about the drug and the program.

She also highlights the importance of networking and showcasing experience in team management during job interviews. Having experience in managing timelines and resolving conflicts within a team, even if it's not an official managerial position, can be highly valuable.

Summary

Dr. Linda Ho's remarkable career journey exemplifies the possibilities and opportunities that exist within the medical field. Her successful transition from Medical Affairs to Research and Development serves as an inspiration to aspiring professionals seeking growth and fulfillment.

Special Announcement

The 2023 Licensed to Live Conference, presented by Dr. Jarret Patton, takes place in just 4 days on Saturday and Sunday, July 15 and 16, 2023.

This conference will feature a lineup of esteemed speakers, including Dr. Nii Darko from Docs Outside the Box Podcast, Dr. Dana Corriel from SomeDocs, Dr. Stephanie Freeman, and many others.

Check it out here, and use the exclusive Coupon Code NewScript for a $200.00 credit off your registration fee.

NOTE: Look below for a transcript of today's episode.

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Transcription PNC Podcast Episode 308

Making Your Way to a Rewarding Career in Clinical Development

- Interview with Dr. Linda Ho.

John: Today's guest, in my opinion, has gone through at least two major career transitions. The first was when she went from clinical work to being an MSL in pharma. But I saw recently that she is now working in clinical development, which is to me a big switch from the MSL work. So, with that, I want to welcome Dr. Linda Ho back to the show. Hi, Linda.

Dr. Linda Ho: Hello. Hi.

John: It's good to have you back. I can't believe it. I was looking at the dates and it's been really like five years since we spoke. I always refer to your episode quite a bit because it's really a good one for people getting an introduction and thinking about moving into an MSL role because you had a lot of great advice back then.

Dr. Linda Ho: Thanks. Yeah, that was super fun. I think that was sort of at the end of my MSL gig, moving on to clinical development.

John: All right. Yeah, I think it was. And so I really am interested in hearing about what's been going on since then, but maybe you want to give us a short thumbnail, kind of explanation of why you switched from clinical to nonclinical. Just briefly, because I can refer people back to the old podcast. And then what attracted you to move from the MSL role to the clinical development role?

Dr. Linda Ho: Geez. I was working at a vein clinic for a while. I'm a pathologist by trade, but I never loved pathology. And I worked at a vein clinic for a while, and then one of my patients while I was at the clinic said that, "Oh, you would make a great MSL." And I was like, "Why? I don't, I don't know what that is." And she explained that she was a sales rep for a pharma company and explained to me what an MSL was. And I was already at that time thinking of a career transition. So, it seemed like a perfect fit.

It did take me a while to find an opening that would take a chance on someone who wasn't already an MSL. I think that a lot of people probably find that challenge when they're looking to transition. But eventually I did, and I was an MSL I think for five, six years maybe, at a few different companies. And then in the fall or late summer of 2018, I moved into clinical development.

I developed an interest in clinical trials, while I was an MSL. And also the travel of an MSL really started to wear me down. At first it was super fun. I loved racking up the miles. I loved flying here and there, but the amount of time spent in an airport was really starting to wear on me. So, that was one of the main reasons for looking for a new role.

John: That makes a lot of sense. And we talked about that last time, and that is one of the things that comes up quite a bit. And depending on the size of your territory, and I remember you had maybe at least at one point a pretty large territory.

Dr. Linda Ho: Yeah.

John: Now that was pre pandemic.

Dr. Linda Ho: Yes.

John: I'm kind of hearing now that post pandemic with everyone trying to be as remote as possible, that some of the MSLs are actually doing more of their work remotely than they were before. But that wasn't going to help you out.

Dr. Linda Ho: Yes, correct. That was a few years too late for me.

John: Yeah. Yeah. Now, what was interesting about clinical development and what does clinical development mean? I hear terms like clinical research, I hear primary investigators. I hear different things thrown out. And so, would it be right to say just clinical development means working on new drugs or new medical devices if it happens to be in the medical device company? What does that mean exactly?

Dr. Linda Ho: Clinical development falls under the research and development umbrella, the R&D umbrella. And it's really the department that generates trial data. Whether it's phase 1, 2, 3, or preclinical data, that generally falls under the clinical development umbrella.

Now, we work very, very closely with our colleagues in clinical operations, which is different. And the subtlety of that is clinical operations, they work on trials as well. However, they're generally not as involved in the data generation or clinical trial design or strategy behind it. They execute the clinical trial strategy that development creates. They have not just in-house staff, but also field staff that go to the sites where we're conducting the trials. And they go through the data and make connections with people at the site level, make sure that the data is looking good on that end.

So, it's a distinction. It's a fine distinction, but it is there nonetheless. And it can be very confusing like what's the difference between development and operations? What are these two different terms? So, hopefully that clears that up.

John: Yeah, that helps. The other thing that I think not all companies necessarily use all the same terms too, that we see from company to company, it seems like they have sometimes slightly different terminology.

Dr. Linda Ho: Yes.

John: And I spoke to someone recently who is working as a principal investigator, but she's working as I guess I could say a PI. But I think from talking to her, she's actually working for a CRO or a third party, and she's responsible for one site where the research is done. But I'm assuming in a pharmaceutical company in the R&D area, where they have a study, it could involve dozens if not hundreds of locations. And that's kind of a different level.

Dr. Linda Ho: A principal investigator to my understanding are generally the investigators at specific sites. So, for example, if we have a site, I don't know, I was just going to make up one, say University of Illinois. The physician who is at that site is the primary investigator. And you have different sites with different primary investigators, PIs, we call them. And they are responsible for ensuring the safety of the patient, appropriate management of the patient, appropriate reporting of that patient's data, managing any adverse events, that kind of thing.

John: All right. And so, in that situation, would that be considered the part of clinical operations in most companies or part of research and development?

Dr. Linda Ho: They are not hired by the company. They are a physician at that particular hospital or institution. So, doctor so-and-so who is going to be named in the study as an author, that is our principal investigator at that particular site.

John: Got it. Okay. Yeah. So you can understand why someone who's never been involved working around pharma can get super confused. So tell me a little bit more about what interested you instead of maybe going into something that was in clinical operations or medical affairs, which like I said, I kind of get the idea that most MSLs are in the medical affairs division. What was it about the clinical development that really appealed the most to you?

Dr. Linda Ho: I think you're right that most MSLs move up into either an MSL manager role where they're in the field and they're managing other MSLs in the field, or they move into a medical affairs role. Now, medical affairs is responsible for the strategy and the management of the asset or drug as a whole, as opposed to clinical development, which manages the data and the trial subjects.

Now, I did not have a lot of exposure to clinical development as an MSL. I sort of had to seek that out on my own. But I became interested when I was in my last MSL role because I took it upon myself basically to provide a tool for the MSL team to use in the field collating all of the studies that were being conducted with the asset that we had at the time.

The team was new, the department was new, so that kind of tool did not exist. But it was super helpful to have, because investigators will ask you, or KOLs will ask you, "Well, what trials do you have going on in this area? Well, what studies do you have that are looking for subjects?" These are very basic questions that an MSL gets. And it's hard to be like, "Well, I don't know." Or to be like, "I'll get back to you on that." You kind of want to have something right then and there that you can pull out and reference.

And so, I created quite a large spreadsheet to help with that. And I became interested like, "What does CTM mean? What is CPM? What is the difference? Oh, look, they're conducting this with this, they're conducting this combination in this population." And that's sort of how I became interested in development.

John: All right. So now you've been doing the clinical development for how long?

Dr. Linda Ho: Five years now.

John: Five years. Okay. Now looking back, and if you were to give advice, let's say to others who either are MSLs or maybe they're doing something else in medical affairs and they wanted to switch into what you're doing, what kind of advice do you have for them to try and get more experience or exposure to something that might help them actually make that transition?

Dr. Linda Ho: For an MD it's a natural sort of transition to do something that is more MD related. I use my medical background every day. Whether it's managing adverse events, assisting physicians, they'll send me an email like, "Oh, such and such patient had febrile neutropenia or had a grade three rash. What should I do? How should I manage that?" And so, I can give them some insight into that.

Now, ultimately, the management is up to the PI. It's not up to me. I'm not putting in orders or seeing the patient, but I can advise them on what kind of resources exist and basically talk through the case with them, given my knowledge about the drug and the program.

John: Yeah. If I think back to when we spoke and with others I've spoken in, of course, there are positions for PAs and NPs and PharmDs and PhDs in the MSL role. But like you said, for those that are MDs, DOs, that have the actual patient care background, there are certain advantages I could see based on what you just said.

Dr. Linda Ho: Definitely. There are a few PharmDs. I have known a few PharmDs. It is rare though. It is relatively rare. You have to have a very strong clinical background. I do know a few PharmDs, but yes, mostly it is MDs and a few MD PhDs that do this kind of work. Because it is very clinical.

Now as far as your previous question, your original question about the transition, it was pretty challenging for me. My prior company, they tried to get, because med affairs and clinical development are like two different departments technically. Yes, they're over the overarching umbrella of R&D but especially in a large pharma, there's definitely a separation. You kind of have to make your own opportunities. And my last company, they tried, they did try to get me there, but at the same time, they want you to do your regular MSL job, which is 40 plus hour week job.

For me, going back to the original job hunting tips that I gave before, it's really about networking and finding another person who's in development who's willing to take a chance on you. Showing your interest in development, showing what kind of experience you have with managing a team. It doesn't have to be a study team, any kind of small team, to get to achieve your goal is helpful.

And they will ask you about that during an interview. "When have you managed a team? What was your role? How did you resolve conflicts in that team? How did you make sure that everything stayed on time with the timelines?" That's very important, timelines. To have that as much experience, managing, it doesn't have to be an official managing. You don't have to have the title of manager, but to show that you've worked on a study team in some capacity before is really helpful.

John: Okay. Now you talk about networking. Would one focus, depending on the size of the company, on internal networking, in other words, working with or networking with those in the company, maybe in other divisions, in other locations, let's say, or try to network more with those outside of your current company? Does LinkedIn help with that? How do you do that networking?

Dr. Linda Ho: You want to start with internal. You have a good reputation within the company. People can speak for you within the company. So, it's always easier to start internally. Now, there may or may not be positions available depending on the company and where the assets are at. They may not have the ability to take you on. And in that case, that's when you really turn to LinkedIn as well as networking at conferences. That is really key, I found more so than LinkedIn.

Yeah. You can reach out to them on LinkedIn, make a connection, but then say, do you have time to meet up at ASCO, meet up at ASH, meet up at whatever college of whatever? That's really where a lot of networking occurs in person networking.

John: And these would be conferences that you would normally be going to anyway as part of your role at the time. And they're more general though, because they involve different members of the overall team.

Dr. Linda Ho: Correct. Assuming that you want to go into development in the area that you are currently in. Gynecology or whatever. Gastroenterology. And most likely the company that you're looking at, the development leads will also be attending, I don't know, gastroenterology meeting. And so, you can say, "Do you have time to meet up at DDW? Do you have time to meet up?" And everyone's got a little bit of time. There's downtime in between sessions, and also at lunch, where you can meet someone really quick for coffee or to grab a sandwich, find a corner and talk.

John: Yeah. No, that makes perfect sense. And particularly if you can piggyback on something that already is on the schedule, just have to make sure to verify that both of you are going to be there. That could be quite useful. Yeah, it really does build on what you said in our previous interview about not relying on some kind of electronic format of communication, which can go nowhere.

Dr. Linda Ho: Correct. Most likely go nowhere.

John: Yeah.

Dr. Linda Ho: That frustrate you and make you very depressed.

John: Any other just off the top of your head or on your list there of anything in particular that one might want to do to help facilitate that transition?

Dr. Linda Ho: Do you mean as an MSL or as a physician looking to get into industry?

John: Either one. I was thinking more as if you're already the MSL, but if there's something different from what we had discussed before, because things have changed. It's been five years.

Dr. Linda Ho: Yeah. There's just been minor things like global pandemics and things like that.

John: Yeah.

Dr. Linda Ho: If you're a physician looking to get into industry, I think the best way to move into clinical development is to A) have experience in clinical trials and B) the lead in clinical trials. The more papers and trials you have under your belt, the better candidate you are. And then again, networking. So, making connections with your local MSL, with your local sales rep, and through them finding out who the people are in the company to talk to and meeting them at conferences to express your interest in the transition.

I personally have known and helped multiple physicians get into industry through this method alone. Meeting them at meetings, talking with them, making that connection. And then when someone says, "Hey, we have an opening for a medical monitor for this particular trial", then I can say, "Oh yeah, I talked to person X, Y, and Z and they have expertise in that and I think they'd be a good fit." And that, to be honest, is more valuable if you're a hiring manager than anything else. To have someone that you know vouch for their work is far more valuable than anything else.

John: Okay. One of the things that's come up, we are kind of shifting gears a little bit, and some of the people that are trying to break into pharma are contract research organizations. I think maybe they're CROs because they seem to have a lower barrier to hiring certain types of positions, although they're not as secure because they fill in gaps like an MSL.

Dr. Linda Ho: Yes.

John: Someone I think that got in that way. They were hired by a CRO as a writer, a medical writer, and then ended up getting into pharma. So, any thoughts on that whole approach to if you've struggled to get in in other ways, whether that would be useful or not?

Dr. Linda Ho: To get into development, you mean?

John: Well, to get your foot in the door in pharma through a CRO to begin with. And then maybe from there, try and use the steps that you're talking about to move into directly working for the pharmaceutical company. Maybe as an MSL and the CRO, and then move into the MSL position in the company. And then next step is to then network and build, get into clinical development that way.

Dr. Linda Ho: That's a long road. That's a long road and not necessarily a guaranteed road.

John: Yeah.

Dr. Linda Ho: For young physicians, if you are fresh out of residency or fellowship, or maybe just been an attending for a few years, and you're like, "No, this is for the birds, this isn't for me." The best way, the very best way to get into pharma in any capacity is to do a physician's development program. The very, very best way.

The PDP program is available at many different big pharmas. I don't think any biotechs or small pharmas have these programs, but I could be wrong. I could be wrong. But the PDP is tailored and developed for physicians to kind of get their feet wet in many different functions in a pharmaceutical company. I think it's a two-year program, and basically you rotate through different departments. You'll rotate through affairs, clinical development, safety, manufacturing I think. All sorts of different capacities where a physician might belong in a pharmaceutical company. It's like residency all over again. You'll have three months here, six months there, and you'll have projects to work on and different things to work on.

And then when you finish, when you graduate at the end of your two years, you have had your toes in multiple different capacities and can say, "Oh yeah, I really loved safety. I really hated medical affairs." And you can decide where you want to go into. And the company will help you. They'll either hire you outright after you finish the program or help you get jobs at other companies. It is the very, very best program.

I honestly wish that I had known about this program when I was looking. I would've applied in a heartbeat. They are fairly competitive. When I was an MSL and trying to get into development, I learned that my company had this program and a lot of the development physicians had come from this program and I wanted to apply and they told me I was too old.

John: Yeah. I don't know that much about these, but I've heard some people have talked about so-called residency or a fellowship with a pharma company. I think it's the same thing. The terminology might be different, but they're kind of competitive, like you said. And I'm assuming because it's a full-time thing, correct?

Dr. Linda Ho: Correct. It's a full-time thing.

John: So they pay you, but it's again, not going to be like you get paid if you were actually working for the company. Is that true?

Dr. Linda Ho: This, I don't know. I'd have to look more into it. I think it is fairly competitive. Maybe not if you were in full-time in that capacity. But I don't know. Certainly they pay you enough to live and to relocate to wherever the home office is and that kind of thing.

John: Okay. All right. Before we go, I wanted to get back to the lifestyle and the other things you like about what you're doing now. I'm trying to get a sense. I usually like to ask about whether people can work remotely in the job that they're doing. Is it everything face to face? Is it 09:00 to 05:00? There is the traveling, obviously, of an MSL. So why don't you just tell me what your experience has been in terms of the lifestyle and quality of life and working in this position?

Dr. Linda Ho: Prior to the pandemic, we were in the office four days a week. You could take one day to work remote. And so, I think I chose Wednesdays or something to work remotely, and that was great. But for the most part, you were in the office. And it was pretty much 09:00 to 05:00.

Sometimes there were early days if you're talking to the EU, and sometimes there were late nights if you were getting ready for a publication or for a data cutoff or something. And those happened fairly regularly. Data cutoffs were every quarter. So at least for a week or two, every quarter it was 12 hour days.

And like you said, there was not the traveling commitment that there was as an MSL. I very much enjoyed the more regular schedule. I think in my younger days maybe I liked being out there and traveling so much. But I think as I got older that started to get more and more difficult.

John: Did that change at all after the pandemic in terms of the amount of time that you could be working remotely?

Dr. Linda Ho: I think it took them a while to figure things out. My particular company, currently, if you decided during the pandemic that you're going to be remote, you could maintain your remote status. However, they are not hiring any more remote people.

John: I don't know. I've heard things, it could be a double-edged sword too, in terms of you can kind of go crazy sometimes if you're just home all the time and not interacting with people.

Dr. Linda Ho: That's true. But you can also get a lot of work done.

John: Yeah. And not be on the road and driving back and forth or whatever it is. That's just a waste of time to some extent, plus the expense.

Dr. Linda Ho: Yes, I knew someone who was working at a pharmaceutical company in San Francisco, but during the pandemic moved back home with his parents in LA. And given the housing prices in San Francisco, it actually made more sense for him to fly back and forth weekly. It's a short trip. It's an hour and a half flight maybe. And to go fly back and forth, and pay for a hotel then to try to buy something in San Francisco.

John: Yeah, that makes sense. Heck, I was doing a 90 minute one way round trip to a job I had in the Chicago area for a while there when I was a medical director. So, that's an hour and a half on a plane and you're not even driving. You can get other work done.

Dr. Linda Ho: Yeah.

John: All right. Well, I've taken up enough of your time today, Linda. This has been very interesting. It's been really good. You give us a little more insight into clinical development and the interaction and the ways to move between these jobs. I still have a lot of people that listen to this podcast that are just burned out and frustrated. And now you've been out of clinical for quite a while, but any last bits of advice for someone who's looking at "Why do I have to go into this clinic every day?" before we let you go?

Dr. Linda Ho: I think more and more people are feeling similarly. People reach out to me on LinkedIn or wherever, and actually there's quite an active group on Reddit I found.

John: Oh, really?

Dr. Linda Ho: Yes, yes.

John: Oh, I'll have to look for that.

Dr. Linda Ho: Yeah. Reddit is pretty much totally anonymous. So, people feel safer asking questions and trying to get advice. They burn you out in residency, and you think it's going to get better after that, but it doesn't really. And yeah, you get paid a lot more money than you do when you're a resident, but the money isn't everything. It isn't everything.

I think that a lot of people are feeling more and more similarly in that the way that the hospitals are going these days, where they're run by administrators and MBAs, where they're really pushing for productivity, it's just counterproductive as far as physicians are concerned. I personally think that the PDP is a great way to go if you are trying to find out where you fit, if you fit in a pharmaceutical company sort of environment. There's a lot of other options out there.

I found out that a lot of people, they work in the legal system as an expert witness. They can make quite a bit of money doing that. And that is also a good route to go. I know that there's a conference, I spoke at it once. What's it called?

John: The annual conference for SEEK.

Dr. Linda Ho: For SEEK, yes. SEEK. Yes. And there are a lot of speakers there who have different experiences in different areas outside of regular old medicine that are also good options.

John: Yeah, absolutely. I guess a question I would have, it seems to me that the positions that are available for physicians in pharma and other industries, there's still plenty of positions out there. There's lots of job posting. So, there are options that you can do that are much more easy to do in terms of your lifestyle and not putting in 80 hour weeks and being on call every third day, all night and that sort of thing.

Dr. Linda Ho: Yeah, I agree. Hiring has slowed down though a little bit. I've heard a lot of people sort of complaining about that the hiring has slowed down as the economy slows down.

John: Right.

Dr. Linda Ho: Hopefully, that will turn around soon.

John: All right. Well, again, thank you for being with me today, Linda. This has been a good update and maybe we'll swing back around about five years from now but we'll talk before then. But I really appreciate it, this has been fun. And so, with that, I'll just say goodbye.

Dr. Linda Ho: Sounds good. Thanks for having me.

John: You're welcome.

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The post Making Your Way to a Rewarding Career in Clinical Development – 308 appeared first on NonClinical Physicians.

How to Navigate the Challenging Pivot from Family Medicine to Clinical Research – 306

John Jurica — Tue, 27 Jun 2023 19:30:00 +0000

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.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete.

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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Today's PNC Podcast Transcript

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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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The post How to Navigate the Challenging Pivot from Family Medicine to Clinical Research – 306 appeared first on NonClinical Physicians.

Why Your Nonclinical Job Search Is So Frustrating and Unproductive – 290

John Jurica — Tue, 07 Mar 2023 13:30:44 +0000

Address These Potential Errors

In today's show, John describes why a nonclinical job search is so frustrating and unproductive at times. And he suggests ways to overcome those frustrations.

It can feel like we’re bogged down and not making any progress once we’ve decided to pursue that first nonclinical position.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete.

Why Your Job Search Is So Frustrating

Part of the explanation is that we may be expecting too much. When making such a drastic move the path is often not as straightforward as we’re expecting. And we must learn a whole new set of skills.

Common frustrations result from NOT doing the following:

Fully committing to the process,
Addressing your self-limiting beliefs,
Devoting insufficient time to the process,
Narrowing our search to one specific job,
Obtaining new skills to demonstrate your commitment,
Finding and engaging a mentor or two,
Growing your network and finding a sponsor at each company,
Optimizing your LinkedIn profile, and,
Converting your CV to a winning resumé.

Reflect on These Possible Barriers

If you're months into your job search and have submitted hundreds of resumés online with no response, you may have glossed over one of the above steps. And you'll find your job search is so frustrating at times.

Consider each step and determine which one might be undermining your efforts. The ones that I see limiting forward progress most often are not focusing like a laser on one specific job, and failing to identify a sponsor at each company that interests you.

Summary

Pursuing a first nonclinical job requires a number of new skills. Consider each step carefully since a weak link in the process of identifying, pursuing, and landing that first job can undermine the whole process.

NOTE: Look below for a transcript of today's episode.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 290

Why Your Nonclinical Job Search Is So Frustrating and Unproductive

John: Let's talk about the content of today's episode. Let's say you've made a decision to leave clinical practice, and you've taken the steps necessary to identify some possible jobs, narrow them down, search through a variety of job listings, and submitted your resume to accompany your recruiter's website.

But in spite of submitting dozens of resumes, it's just crickets. No response other than an occasional acknowledgement that the resume was received. But no one is offering you an interview, even a screening interview. So, let's talk today about why that might be.

But I want to set the stage a little bit more tightly here in the sense that we're talking about leaving clinical medicine or nursing or another clinical field for a job that does not include direct patient care. That's what we're talking about in terms of a nonclinical or non-traditional job. But we're not talking about those of you who are starting your own freelance consulting, medical writing, or coaching business. I'm talking about the situation where you're looking for a nonclinical position in which you're employed by usually a medium to large size corporation, such as an insurance company, hospital or hospital system, a pharma company, a contract research organization, or even a consulting firm, or a large publishing company.

This is the formal process of finding a job and trying to apply and then get your first interview. That's the timeframe we're talking about. And I have talked to several people, many people who have gone through that process for month after month, have submitted dozens if not hundreds of resumes, and have received no kind of follow up other than an acknowledgement. So, what the heck could be going wrong in that situation? Because it just sounds like you're just spinning your wheels.

So, let's start at the very beginning. Things that might be going on that are keeping you from moving forward. Now, there's this whole category of mindset. Do you have the commitment? Have you already addressed the self-limiting beliefs? Have you gone through and convinced yourself that some of the myths around nonclinical jobs are false?

I'll talk about the myths related to physicians, which we've done an entire episode on before. But again, just quickly, it's things like the fact that there's no jobs out there. I don't have enough education. I need another degree. I'm going to be abandoning my patients. I can't make enough to pay my bills in a nonclinical job, or my gravitas or my reputation will be adversely affected. I won't be a doctor anymore.

Well, we've already dispelled all of those in past episodes. There are plenty of jobs. You have 70 to 80% of the necessary skills you need to become a medical director or physician advisor, or a chief medical officer or chief medical information officer or chief quality officer. You have to get past these mindset issues, and we've talked about that before.

And the other thing is, you really have to make that commitment. There's a difference between being upset, being burnt out, being dissatisfied, but at some point, you've got to say, "Okay, I've had enough and I'm going to keep working. I'm not going to burn my bridges, but I'm going to set time aside to really work on this problem." You can't do this spending a few minutes a week or an hour every two weeks trying to do some research, pick a job, do your application. It takes more time than that.

That's what I mean by commitments. It's the mental commitment and it's the actual time commitment. So you have to block time out. It could be two hours a week, it could be 30 minutes a day, but there's a lot of steps you have to go through before you can really make this process move forward. Otherwise you're just spinning your wheels.

So, how much time can you set aside and can you put that on your calendar? Now, if you're working a full-time job and you're working 40, 50, 60 hours a week, it's going to be difficult. But you might have to just take part of Saturday or Sunday when you're hopefully not on call or whatever day during the week that you have off and not really be doing your charts and things like that. And really set this time aside to do some of the other things I'm going to be talking about in the next 15 minutes.

The other part of that commitment is if you're really committed. You have to see if maybe you can carve out some time in your current job. Go to your boss, go to your manager and say, "Look, I signed up to work 40, 50 hours a week. I am spending 65, 70 hours a week with all the charting I have to do and the meetings and other things that are going on. That's not really fair. So, I need to pull back, but still within my contract so that I can free up time to do other things that I need to do, that I want to do."

And so, you just need to have a, a, a conversation with that person that's responsible for your schedule, if it's not you and carve out some extra time. Full-time job should not take 80 hours or 70 hours a week. It just shouldn't. Now, if you're in private practice and you run the practice and you're the owner of the practice, that's going to be tough, but I think you're going to have to say, "Look it, we're closing on Friday afternoons. We're not going to be open every week."

Now, what are you going to do at that time once you've made the commitment and you've convinced yourself it's doable and it can happen, and that you have the requisite skills? Well, there's some things you need to look at. You need to do some research early on, and this is not to just find the jobs that you are going to apply to. In other words, you're not just looking "Okay, I'm going to find them. That sounds really good, and I'm going to apply." No, you need to do significant research during that time that you've blocked out.

That research needs to be, "What do these jobs entail?" You have to get it called down to a small number of possible jobs. You have to read about these jobs online. Go to Facebook groups, get a book on nonclinical career careers, or at least five or six really good books. Talk to your friends and find out what the jobs entail, and then narrow it down to two or three.

And before you get real serious for applying this one job we're talking about, you got to get it down to one. So, let's say you want to try medical science liaison or another pharma job, or maybe a job in the hospital setting. What jobs are available? You look up physician advisor in a hospital, you look up medical director, you look up a medical director and pharma, and try and look at those job descriptions, not because you're looking for the one you want to apply for now, it's because you want to see what the keywords in those jobs are and what does the job entail. Can I work four days a week? Can I do it from home, or do I have to travel? And that kind of thing.

And so, get a sense of what's out there, and then try and narrow it down. And then once you narrow it down, do some other things. If you've got to narrow it down to one job, let's say you want to become an MSL. I'll use it as an example, because we talk about that all the time. We've done several podcasts on that. Then you need to find an MSL or two to be a mentor. And then you might consider looking at a professional organization that serves MSLs. And there's a good one that actually will teach you how to become an MSL. And there are books on becoming an MSL.

And this is true as a medical writer for a CRO or a pharma company. This is true if you're a medical director for a hospital. There are resources to learn what the job entails. And once you've got a sense that, okay, it's in person and it's 09:00 to 05:00 five days a week, that's one thing. If it's remote, it's at home on my own time, that's another thing. If I'm going to be traveling, that's another thing. How much travel is required? Try to get those things down path and your understanding and really pick the one to go for.

Now, it may not be the one you ultimately choose to take, and maybe once you get into the process, you're going to have to reassess and then shift gears and go to another job. But you only want to go after one at a time. So, now while you're in the process of doing that, you need to find that mentor that's going to tell you more about the job, how they got their job, pitfalls to avoid and so forth.

If you haven't done that and you don't have a mentor, then you're really going to be going into it blind. So, definitely you need a mentor. Maybe you found out that you need a certificate or some additional training. It can just be classes, it can be courses through the AAPL, it can be courses through a professional society, or it can actually be a bona fide, let's say 10 hour course with a certificate exam at the end, something like that. And this all can add to your resume. So you got to think about that.

And then get that additional experience and training while you're going through this process by either volunteering on a nonprofit or volunteering on committees so that you can get some experience, whether it's with quality on a quality committee, whether it's about policies and procedures, whether it is something about project planning on a committee that's putting in a new service line or something like that in the hospital. Or even on a nonprofit they'll have some project planning committees that you may be able to function on and learn from. You're doing all these things simultaneously. And that's where you're saying aside the five hours every two weeks or two or three hours a week to really do your research, find out what's out there, and then narrow in.

Now while you're doing all that and you're working with your mentor, once it's down to one area, now you need to go back and look at those job descriptions again, only this time for the specific position you want to apply for. If it's a remote position, it could be anywhere in the country. If it's in person, then you're going to need to find something either close to where you live or you're going to have to think about relocating if it's worth doing.

Most medical communication companies, for example, are in larger metropolitan areas. So if you're out in the country, you might have to move closer to city like New York, LA, Chicago, or even any big city. It doesn't have to be a multi-million-person city, but a metropolitan area. It could be Austin, it could be anything. The capital of most states are pretty big, but you want to see if they have one of those companies located there because you got to make some plans about actually moving.

Once you've resolved that issue, you should already be working on setting up your LinkedIn profile.

And you want a profile that's complete. And if it's not, and if it doesn't include some kind of description of what you're looking for, that's the first place someone is going to go to look if they're serious about hiring you. They may not look up every applicant on LinkedIn, but at some point they're going to actually probably look you up on lots of social media to see if you've done anything stupid, to see if maybe there's something out there that's embarrassing or shows something that might be alarming to an employer.

I won't get into the details of that, but look at all those sites and then make sure that your LinkedIn profile is 100% complete, has some of those keywords and a good description of what you're looking for. Unless your current employer might see that, in which case you might have to be a little bit more subtle about your profile on LinkedIn.

Then the next thing. Now you're looking for jobs, you've identified the type of job that you want and you've identified the region of the country you might need to work in. And then you're looking at the specific job listings, and you're really going to look to see if this is a job that you want to pursue. And when you do that, figure out the company.

And now you have to do more networking, your own network, the networks of your network contacts, first degree, secondary, third degree. It's just like in LinkedIn. You've got your first degree, and your second degree, and that's how you extend your network. You want to meet new people doing that job or having something to do with that job and whatever industry you're looking for. And then you have to reach out to some of them to see, "Okay, what's going on at that company? I've looked at this job description, I'm kind of interested. I see that you work there. I wonder if we could get on the phone or even just chat by email for a few minutes so I can get a little more information."

And somehow what you want to do ideally is to find a sponsor. I use that word for different things. If you're employed, let's say in a hospital and you want to move up the ranks into management, then you need a sponsor within that hospital or any other company that will help get the word out inside the organization that you're available, that you're interested, that you're capable, and those sorts of things. That's what we call a sponsor within a company.

But a sponsor when you're trying to break into a company is someone in that company who is either involved directly with the HR department, the hiring manager, or something like that, or even another person who's currently working in that company that can help be your sponsor, say, "Hey, I've got this colleague, I've got this friend, I've got this, cousin. I've got this associate that I know is really good at what they do. They're thinking of moving into this. In fact, they've committed themselves to moving into this particular industry. They've looked at a couple of our jobs, and I wonder, can I make sure that you get this colleague of mine, their resume? Can I make sure that you've at least looked at it? Is there something I need to do? Is there someone else I can send my friend or my colleague to learn more about this job?" And that's your internal company sponsor in that firm where you are now actively applying.

So, you definitely don't want to just start shoveling resumes into 5, 10, 20 companies, even a hundred companies. That's happened. I've talked to people that have done that and expect that somehow you're going to float to the top because your resume is probably going to look like a lot of other resumes. You want to follow a proper way of doing a resume no longer than two pages.

You want to make sure that you put in your resume the skills that you have as evidenced by things that you have accomplished, preferably those that are measurable. So, it could be something as simple as "I led a team that put together this service line in this hospital. Or in my clinic of 30 physicians, I led a team that created this new product, or this new initiative." That doesn't have a measurement, but it's a plus minus, it's an all or none. So, you went from not having that service to having it. Or I was working on the committee and became the chair of the committee that oversaw the quality for such and such, and we improved the number of complications in the surgery department by 10% or 30%. We eliminated never events. We did these measurable outcomes. That should all be on the front page.

And then after that, you'll have your listing of where you did your residency, your fellowship, your education, college. Other experiences that will demonstrate your transferable skills such as chairing a committee at a hospital, chairing a committee at a nonprofit, and being the president of the board of a nonprofit, things like that. Volunteering for something, and then the fact that there was something accomplished.

If you're not doing all of those things, there's a pretty good chance that your resume will not make it through the first or second screening where someone's actually looking at it, assessing it, trying to decide whether you can do the job that they're looking for. Now, remember, what is it that is going on here when you're looking for these kinds of jobs? You're back in the regular job market now. It's not like in medical school and residency where you're looking at grades and GPA and scores on certain exams and just checking off all those boxes.

The person who's hiring you for a nonclinical job, whether it's a utilization management, physician advisor or a medical director is "Can that person deliver to me what I need?" And in many of these jobs, you have to have a lot of initiative and leadership because as you get into more management jobs, they're going to need to see evidence that you were able to accomplish things on a team. But again, measurable outcomes.

My examples. Let's say for my time as a CMO, if I was applying for another job as a CMO, I would say, "Look, we put in a brand new comprehensive case management system, with different staffing and formal protocols, and we were able to get the length of stay down for the medical patients on any given unit or what have you, or even for the whole hospital by half a day or a full day. Or we reduce the mortality rate for heart disease or let's say acute MI or heart failure by such and such percent." What they want to see is that you can accomplish the goals of their department or the organization that they're hiring you too. And if you can't demonstrate on your resume and you can't verbalize it when you do get the interview, it's going to be hard to get that job.

I guess I would stop there because the other things I would mention that might be interfering might be things that have to do with the interview itself or the things that happen after the interview. Maybe I'll spend a little more time on that on another episode. But for now, those are the things that I would focus on. You need to be committed. You need to carve out time every week or every other week to focus on this. Some of that time needs to be spent doing your research to find out what you really want to do.

You have to spend some time narrowing it down to one particular type of job, customizing your resume, and customizing your LinkedIn profile. Find a mentor or two to help you and do your networking, and grow your network. Make as many contacts as you can that might help you get into one of those jobs. You might need a contact at multiple different companies if you're applying at multiple different companies. That's where your sponsor comes in and gets someone to look at that resume.

And then by doing that, you'll be in a much better position to have someone actually send you an email, pick up the phone and say, "Hey, we've looked things over. I have a few questions for you, but if this goes well, then we're going to set up an interview, a series of interviews, really. Maybe the first one will be a remote online interview, and then hopefully after that, potentially even a live interview face-to-face."

All right. Well, that's all that I wanted to say today about why your job search is so frustrating and unproductive. And by addressing these things that maybe have not been addressed in a really consistent way, you can overcome some of that frustration and the lack of progress.

One other thing to consider that might be adding to the frustration that doesn't really have to do directly with the process is having the right expectations. Sometimes in these job searches, it's going to take a while. It's something new, you haven't done it before, and you're going to need to learn the whole process. You're going to get better at the process. Every step of the process takes practice. And the other thing is that you're going to have to send in a lot of resumes and do a lot of digging before you're going to get that first interview. That's normal. And also chances are you're going to have to do multiple interviews before you get that first job offer. Because doing an interview is a skill that takes a little bit of practice. You can do role-playing. Other things that we'll talk about another time.

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The post Why Your Nonclinical Job Search Is So Frustrating and Unproductive – 290 appeared first on NonClinical Physicians.