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Recent data suggests that the average tenure for medical science liaisons (MSLs) at a given company is a little over 2 years. Which is lower than the average tenure of almost 4 years for private sector employees across all industries. Although there are several factors for why employees decide to move on, among MSLs we gathered the top 10 reasons based on experience, data, and interviews with MSLs. Here are the results:

1. Their MSL Manager is really a micro-manager.
2. They aren’t always kept “in the loop.”
3. The company has little understanding of what MSLs actually do.
4. The company uses them more like a sales force.
5. Outside of new hire training, there is no investment in ongoing professional development.
6. They aren’t trained effectively on how to use digital tools & technology to properly do their job.
7. Their Key Performance Indicators (KPIs) are driven more by quantity vs. quality.
8. There isn’t much room to grow.
9. They feel undervalued.
10. They don’t feel integrated into the organization.

The ACMA talks to countless medical affairs and MSL professionals and the need to invest in people is by far the single most important factor to building and maintaining a successful medical affairs organization. Providing ongoing coaching, feedback and professional development opportunities that help your team grow and expand their skill set is a win-win for both company and employee.

Looking for innovative ways to offer professional development and raise the bar?

Contact us to learn more or schedule a demo of ACMA professional development programs for MSL teams and medical affairs organizations.

By Hien Nguyen, MD, Judy Walker, MD

Pharma is at a crossroads. 2018 has been a seminal year with multiple events coming to a head and leading many of us to reconsider how we operate. Establishing a professional benchmark of excellence for Medical Science Liaisons (MSLs) as we will see needs to be the future for the industry to maintain the highest standards of excellence for professional development and training of MSLs.

In this paper we examine some of these critical trends in 2018 and offer a way forward.

Industry payments to Journal Editors

If the opioid crisis of 2018 wasn’t enough to raise concerns about pharmaceutical industry practices and that some major change was needed, then consider the amount of money given to peer reviewed journals which report the results of some of the most important clinical trials in medicine. Medical guidelines and physician decisions on how to treat patients are often based on data that is presented in these journals. The notion of ‘evidence based medicine’ has become the buzz word in recent years. However, a recent study by Liu et. al, (2018) cites the amount of money paid by pharma companies to some major medical journals is highly suspect and may possibly taint the ‘evidence’ (see Table 1).  

Table 1

(Liu et al., BMJ, 2017)

Insufficient data supporting Institutional Review Board submissions

What’s more shocking are the results from bioethicists at Hannover Medical School and McGill University in Montreal which analyzed 109 applications from three institutional review board chairpersons.  As McRae (2018) points out,

“These documents were used to approve trials between 2010 and 2016. The applications – called investigator brochures – provide the review board with all of the evidence that they should require to make a sound judgment on whether a clinical trial can safely proceed. Such pre-clinical data tends to include the results of animal trials that demonstrate the potential efficacy and risks of a potential medical treatment. Among the 109 investigator brochures there were 708 efficacy studies that used animal models. Surprisingly, nearly 9 out of 10 studies had no reference to a published report, making it hard to know whether the study would even pass peer review. What was particularly alarming was the relative absence of details on methodology – 95 percent of the studies contained no mention of processes used to avoid the pitfalls of bias.”

The Opioid Crisis and Purdue Pharma’s response

Earlier this year, Purdue Pharma, the OxyContin maker, eliminated its sales force and claimed it was going to use medical science liaisons (MSLs) to educate healthcare providers (HCPs).  The role of medical affairs (the function under which MSLs sit) is supposed to be (1) Data Generation and (2) Data Dissemination. That is, to objectively, ethically and properly educate HCPs on the latest information and data within a particular therapeutic area.

These are just 3 examples of events in the last year that shape our views and highlight the growing importance of standards in medical affairs.

Who are medical affairs professionals?

If we look at who actually makes up medical affairs professionals, they are an interdisciplinary group of professionals (MD, PharmD, & PhD professionals). Most medical, pharmacy and PhD programs do not train graduates to work in the pharmaceutical industry. Rather, they are prepared to work in traditional roles such as clinical practice, retail pharmacy or a bench scientist (R&D) for PhDs. This leaves a significant gap where most have to learn on the job-through experience. Therein lies the issue. The Accreditation Council for Medical Affairs (ACMA), in conjunction with St. John’s University College of Pharmacy and Philadelphia College of Pharmacy, recently presented data at the American Association of Colleges of Pharmacy (AACP) which surveyed pharmacists in the pharmaceutical industry about whether or not their training prepared them to work in the pharma. Unfortunately, the overwhelming majority (72%) indicated they did not receive adequate training and preparation for their roles in medical affairs.

Standardization & Board Certification for MSLs- the Future in Pharma

The role that medical affairs plays is critical to the education of HCPs.  Moreover, pharma uses a collaborative model for the development of new products, data and technologies.  Oftentimes, medical affairs is involved in facilitating these discussions and identifying the opportunities via key thought leaders (KTLs) in the medical world.  Pharmaceutical industry medical affairs professionals need to be trained on the core competencies necessary to be a competent and well-rounded medical affairs professional.  This is critical given the evolving role of stakeholders that they interact with as well as the rapidly changing healthcare landscape.

Indeed, it is the ethical responsibility of every pharmaceutical industry CEO to ensure that there is (1) a minimum standard of competencies that all medical affairs professionals demonstrate and (2) that they are consistent across the industry.  This will help to raise standards around the world and ultimately improve patient care. Moreover, this training or credentialing should in fact come from a third party accrediting body to ensure that there is no bias. But most importantly to ensure a common standard across the field. 

References

Liu et. al., (2017). Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study. British Medical Journal BMJ; 359:j4619.

Yasinski, E. (2018) Study questions animal efficacy data behind trials. Science, Vol 360, 6385. 142.

Piller, C., You J., [July 5, 2018] Hidden Conflicts? Pharma payments to FDA advisers after drug approvals spark ethical concerns. [Internet]. [cited 2018 Dec 10]. Available: https://www.sciencemag.org/news/2018/07/hidden-conflicts-pharma-payments-fda-advisers-after-drug-approvals-spark-ethical

McRae, M (April 6, 2018) An Alarming Number of Clinical Trials Are Greenlit Based on Shockingly Poor Data [Internet]. [cited 2018 Dec 10]. Available: https://www.sciencealert.com/limited-data-included-pre-clinical-investigator-brochures-german-review-boards

Paavola, A., June 20, 2018]. Purdue Pharma Cuts Remaining Sales Force [Internet]. [cited 2018 Dec 10]. Available: https://www.beckershospitalreview.com/pharmacy/purdue-pharma-lays-off-remaining-sales-force.html

Kanmaz et. al, (2018). Are Pharmacy Schools Adequately Preparing Graduates for Roles in Industry? Poster #90 American Association of Colleges of Pharmacy Annual Meeting, Boston, MA.

Anyone working in medical affairs understands that it’s a highly specialized area. And often, medical affairs executives get so engrossed in their day to day activities that it’s challenging to gain a deep understanding of how other departments and functions operate, let alone train another colleague on these functions. But as medical affairs’ strategic value continues to increase, executives need to be conversant about other vital aspects of the life sciences industry, such as pharmacovigilance, digital technology, or compliance and regulatory implications.
But comprehensive, accredited, educational programs for medical affairs professionals are few and far between. And there’s certainly no programs offering board certification. The Accreditation Council for Medical Affairs’ (ACMA), however, offers a Board Certified Medical Affairs Specialist (BCMAS) program for medical affairs professionals across the career spectrum. The BCMAS curriculum is comprehensive spanning 20 modules covering all areas of medical affairs. The BCMAS program is the most comprehensive educational program for medical affairs professionals and unlike other training programs that may be available; it is the only one that is accredited.
Structured Learning and a Deeper Understanding of Industry Functions-
Beyond internal training within their companies, medical affairs executives simply don’t have structured options for learning how the different functions within the life science industry interact with each other. The ACMA’s goal is to establish a common language – a standard – that medical affairs executives can converse in. With a curriculum that includes best practices across the organization, the ACMA’s aim is to reinforce an integrated, cross-functional approach to medical affairs that makes medical affairs to be viewed as a true partner by other departments. And this has proven to be valuable to many who are now board certified thanks to the ACMA.

“I can’t think of a better way, through a very tightly structured format, to learn a lot about field medical and medical affairs. I’m always in this mind set of learning more. The challenge to learn more about other areas of medical affairs without having to travel back to the home office and doing an internship was one of the reasons I opted to go through the program. And I thought a home-based, self-paced program would be great. What a nice and subtle way to differentiate yourself amongst other peer groups either within or across different companies.
“At some point, someone puts information in a whole new context and now it changes its meaning. And that’s what I saw in the ACMA’s 20 modules, with several subject areas that I am very familiar with and several that I am not. I really felt that I wanted to learn a whole lot more about the very broad topics. So I took it partly for self-improvement.
“I learned a lot more about regulatory affairs. We talk about REMs and we support REMs in medical affairs. But I learned a lot about REMs and safety and pharmacovigilance. There are certain elements of the program that really expanded my understanding.
“It seems like the 20 topics were very separate enough from each other that there was minimal redundancy. One of the best benefits is the byproduct. I’ve been in medical affairs since 2000, working alongside of regulatory, legal and drug info. I think what’s good about the BCMAS is it expands your horizons to see these other major areas and the roles and responsibilities within them. I think that’s a nice benefit from going through the certification process.
“I think that what helps me is just better understanding all of the nuts and bolts of the various areas that we work with in medical affairs. And it’s hard to have that appreciation without thoroughly diving into some of this content. So I think it just makes me more appreciative and gives me more context with the other departments and their roles and responsibilities.
“As we differentiate and look at different titles, then I think I will have a nice segue into other roles because of the board certification. I think it was a very good growth platform and a great way to differentiate yourself amongst peers where there isn’t a ton of latitude for growth. The people who go through this process and pass it, that’s a whole different level of commitment that they showed to the organization.” –Robert F.
Senior Medical Science Liaison

DIFFERENTIATION AMONG PEERS AND GRABBING RECRUITERS’ ATTENTION
Everyone approaches the board certification process for different reasons. Some are looking to add to their personal understanding of medical affairs’ role in the life sciences industry. Others seek to differentiate themselves from their peers. Still others are looking for a challenge to learn what they don’t know. According to individuals who have gone through the curriculum and earned their BCMAS, the program meets all of those goals.
But the BCMAS program appeals to younger professionals for very concrete reasons. They feel that having the board certification attached to their names gives them a leg up in both hiring and career development. Anecdotally, BCMAS graduates have noticed more momentum in their recruiting activities. That’s not their only reason for getting a BCMAS certification, however.
“I’m a recent PharmD graduate. So my current goal is to break into the pharmaceutical industry. With the BCMAS program, the main goal for me was to get more experience and make myself more competitive for fellowships and jobs and other career opportunities.”
“There are a few forces at play that any other fourth year pharmacy student or PharmD graduate who’s looking to break into the industry faces. In terms of pharmacy, if we’re not at an over-supply of pharmacists yet, we’re pretty much right there. So as a candidate, you’re looking for something to differentiate yourself, something that’s going to give you some sort of valuable experience that you can talk about in an interview.
“The ACMA was a very comprehensive curriculum. I now have better knowledge of some of the day-to-day activities and some of the more granular details; like the ins and outs of an advisory board, for example. It went into a lot of details for those medical affairs activities. That really was valuable and gave me a better understanding. I think it really made a big difference just in terms of response from recruiters and hiring managers.
“In my time since completing the curriculum, just my overall understanding of medical affairs has really increased. I’ve been getting a lot more traction in my job search opportunities. I think overall it does give me a lot more confidence in my job search. I really think the BCMAS helped me to tie together my story as a candidate. It demonstrates my commitment to medical affairs. Anyone interested in medical affairs or a medical information role, those individuals would be well served to take the BCMAS program.
“In my particular instance the certification made sense. I think there’s definitely a big need for some sort of standardization or certification of medical affairs professionals. To me we’re the extension of the healthcare professional in the pharmaceutical setting. We have a responsibility for patient care when making those decisions. If we have medical professionals in these roles who could affect tens of thousands of patients, if not more, I think we’d be doing ourselves a disservice if we didn’t have some sort of certification or credentialing just to make sure that everyone is at a certain standard. The ACMA is a great organization and I really believe in their mission.”-Bolu O. PharmD Graduate

“I came across the BCMAS through a few articles shared to me on LinkedIn. I’m relatively young in my industry career still and I thought it might be something to 1) set me apart from other candidates when I started applying and then 2) for my own learning purposes, just to learn a little bit more. Other programs are more specific to individual departments. And I wanted to learn a little bit across departments. The BCMAS offers that.
“I came into medical information right out of school. I felt I was lacking that global knowledge of the industry. So I thought that this type of course would be able to offset the fact that I didn’t do a fellowship. It shows that I’m still dedicated and at this point I’m very interested in having an industry career for life. It might put me on more of a level playing field with someone who had completed a fellowship.
“When I had initiated the program, I had started a new job within the last six months. I wasn’t looking to get a new job at that point. But I thought the knowledge would be helpful and I thought that, at some point, when I am ready to go to a new position, that would be attractive to go on my CV.
“I also liked that it had a proctored exam at the end. And it had the ability to have that certification that you could share, that you could have those letters after your name. I think that it just added another layer to not just having completed modules but having shown that you learned something, that you were able to pass this accredited exam, I think it gives you another leg up. The testing portion really motivates the individual to know the material and be able to speak to it. Not only is it beneficial for you because it forces you to know everything, but then it’s also that test to make sure you did learn what you needed to know.
“I found the most value in those modules that were outside of what I do on a daily basis. I definitely think it was a good fit. I would recommend it and encourage people who were new or trying to break into industry to do it. The BCMAS was a great fundamental knowledge about a lot of departments and basic responsibilities. Before going through the certification process, I could function well. But now I have that background understanding to really make me understand what I’m doing, why I’m doing it and how it fits into the whole drug development process.”-Chelsea A. Senior Medical Information Specialist

“I was looking for more resources to just expand my own knowledge base and understand what additional information was out there related to this field. I saw the ACMA’s web site and that’s how I initially engaged. I think the ability to obtain a credential in this space that’s based on a level of knowledge of key elements seemed important to me.
“The fact that there was a basic curriculum that established a basic level of knowledge for all of these areas definitely made my approach more comprehensive. It made me a more well-rounded practitioner in what I do on a daily basis. There are reference materials that you can continue to access through the web site after you’re done. I have done that for sure, maybe for specific areas that I don’t see every day.
“My company has made this available to team members in our medical affairs group to also undergo certification. And several members of the team have actually done that. So this is now, in our company, second generation. We found it useful for the entire group. Without a huge number of additional options in this area, I think this really does serve an important role.
For our company, getting everyone on the same page through the curriculum gives everyone a common starting point, a common language about how all of this is discussed. Because sometimes people in medical affairs come from various backgrounds, I think it is worthwhile for a company. It’s something that my area has found important to support our team members in their own professional development to get this credential.
“It serves a relatively unique function. There aren’t all that many knowledge resources in medical affairs. The fact that you can pursue this and go through, get this information and then receive certification based on that, I just think it’s a really important resource. It’s relatively unique in this field. It’s certainly something that, for my group, we ended up providing and urging people to do. And I absolutely would say the same for anyone who’s in the field who’s looking to expand their knowledge base in this area. Anyone in the field of medical affairs would benefit from it.”
Brian D. Vice President of Medical Affairs

CONCLUSION
The Accreditation Council for Medical Affairs is meeting the daily challenge of expanding and level-setting the knowledge base of medical affairs professionals throughout the industry. The Board Certified Medical Affairs Specialist is quickly becoming the industry standard for medical affairs professionals to attain.
In its nearly four years, the ACMA has laid many in-roads into the industry and continues to do so. But the trend has unmistakably been a steady increase in moving the BCMAS toward the industry standard. With increased scrutiny on pharmaceutical industry practices, ensuring that pharmaceutical companies are validating the knowledge of their field teams in medical affairs and sales is imperative. More and more medical affairs professionals sign up to undergo the certification process each month. And as that trend continues, medical affairs professionals throughout the life sciences industry will no doubt be better prepared, more confident and, most importantly, more knowledgeable as they approach their roles.