Hey, guys. Welcome to the podcast. My guest today is Jim Morgan. He's director of MSLs, and we talk about keys to success working in small pharma versus large pharma. Really interesting conversation. Hope you guys enjoy it. Don't forget to follow us on Instagram, LinkedIn, and YouTube, and now MSL talk live on Clubhouse. Check it out. Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Hey, Jim. How's it going today?
Thanks for joining me. Hey, Tom. Thank you for inviting me. Awesome, man. Well, listen. I'm excited to have you on. You know, we had we had a conversation. We talked about, your background, which is really predominantly in smaller companies. Correct. So thought you'd be perfect. A lot of people have asked me about, you know, maybe getting into the conversation of what it's like and how you can be successful working in small companies versus large pharma.
So before we get into that, why don't you do a quick introduction, let everybody know who you are and and what you're up to these days? Sure. Okay. My name is Jim Morgan. I am a Pharm b by education, and I received, my Pharm b from University of Florida. I've got my start in pharmacy and oncology for the first part of my career. And then about 11 years ago, I made the jump to industry. I worked at a couple of medium to large size companies in the beginning.
And then as you mentioned, my last three companies have been with small start ups. So, I've had I've held a national director and then global director of the last three companies, and, it's something that I'm very passionate about. It's something that I, I really enjoy doing. So yeah. I mean and and I I I I thought you'd be the perfect person to have this conversation with.
So do you have any exposure into into large pharma, or is just most of your experience on you know, the the start up or small pharma side? So when I, when I got into industry, I joined with Genzyme Pharmaceuticals Oh, yeah. Yeah. Which was a bit of a medium to large size, company at the time. And, unfortunately, I came in right before the Sanofi acquisition. So, a few of us from Genzyme left and joined Onyx Pharmaceuticals Mhmm.
Which at the time was, again, sort of a medium, size, company that I was able to, really sort of hone my skills in MSL. I made the jump to regional director pretty quickly. But then, again, with the Amgen acquisition, I I left and I took a small detour with Alexion Pharmaceuticals. And that was much larger Sure. Larger company. And I realized that, you know, it wasn't what I was used to when I was working with the other kind of medium sized companies.
So, I left there and, like, you know, I've been started with a very small startup in San Francisco called Sunesis Pharmaceuticals. Yep. I stayed with Sunesis for a couple of years, but unfortunately, their phase 3 trial, missed primary end point. So the team that we had built had to downsize. Then I left, Sunesis and went to Karyopharm for the students. And again, it was, small start up. There was nobody in medical affairs at the time. So we built out a team there.
But again, you know, things kind of slowed down a little bit. And I got an opportunity to join Immunomeds, which was my most recent company, and that's, where I was able to develop a full team, get a drug through complete through FDA submission and approval and through launch. And, earlier last year, we had a very successful launch of Tridelby, and, we really made a go of it. And we were acquired, late last year, as you may know, by Gilead Yep. Sciences.
So, that's where, you know, it became sort of we made the shift, right, from small start ups, small biotech to a much larger company with a global footprint. So, yeah, I've had, I've had experience in both, but primary, most of my, my significant, input into the MSO role has been in in small start up. Yeah. But, obviously, Genzyme at that time was a good sized company. Lexan, good sized company. So you clearly have experience on both sides of the equation. Exactly.
Yeah. Which which is gonna be helpful for this conversation because I think that a lot of people kinda wanna know, you know, some of those nuances. So let's talk about, like, what to start, like, what are the pros and cons of working in a small company versus large? Let's let's say we start with the pros. Okay. So, you you know, Tom, I get I get asked this question all the time. Right? So, you know, larger companies, big pharma, they're very stable. Right? They've been around a long time.
They have established pipelines. Mhmm. They have marketed products. They they generate revenues, so they have, you know, very strong and established budgets. And they are able to set sort of very, very solid MSL plans for, you know, tactics and and field execution. So, you know, a lot of people that join Big Pharma stayed there for a long time. They developed tenure. You know, they're they're there for for many, many years. And they have a very, you know, established infrastructure.
They have training departments. They have regulatory departments. They have compliance departments. You know, sort of the full suite that you are used to when when you join a large company. Yep. You know, it's very low risk. Right? There's there's low risk of of turnover. You know? No one's gonna come in and acquire a large company very often or, you know, the joint's not gonna fail and, you know, there's gonna you know, you're not gonna be looking for a job in, you know, in a year or so.
So, you know, those are the pros for the large, for the big pharma. Yep. But for for small companies, you know, it's it's a little bit of a different a different strategy. You have to have sort of an appetite for risk, if you will, because, you know, most if you're joining a start up, especially on medical affairs, you're usually joining before the approval. Right. So you're you you know, in phase 2, phase 3, and, you know, there's there's very little infrastructure. So there's a bit of a risk.
You know, we're developing a team, we're developing a lot of the resources as we go along, but, you know, there's no guarantee that the drug will will get approved by the FDA or or even pass, like, the phase 3. I mean, I've I've been in that situation a couple of times. And, you know, if if it's a small company with with very little budgets, you know, typically, these guys are relying on investor capital, right, because they have no revenue generation.
If they don't get approved by the FDA or they miss their phase 3, then typically, they'll downsize the MSL team, and, you know, the the team will have to, you know, start looking for jobs to go go elsewhere. Or if they do happen to get approved, like what just happened with with Mediate Immunomedics, you know, they become acquisition targets. And, you know, they've got a drug. They've just approved it. They've launched it.
And, you know, it becomes very easy for a larger company to come in and buy them up. And that's when, you know, those teams can get off and get internalized. Right. And physicians can unfortunately get eliminated. Right. And, you know, so there is that risk. But along with that risk, right, you know, we say high risk, high reward. Right. Smaller companies tend to offer very attractive equity packages. You know, they offer very, very nice, packages of stock options, of general stock such as RSUs.
And so when you're coming on early on, typically the stock is very low. But if you do make approval and the drug does hit the market, then typically the stock price goes up quite a bit. So that's where, you know, the the fun part of it comes in. Right? You've made your money. Right. And, you know, it's then you get that that excitement of launching the product as well.
Yeah. The other part of it too with small cell reps is they're generally, you know, they they might have a novel drug or they they have a novel mechanism. You know, it's not something that's established, you know, by other companies or anything like that. So the science is a little more exciting. You know, the the KOLs and the top investigators, they wanna talk to you about their drugs. Right? Yeah. And they want to get their hands on and study it. And that's where MSL is really broad. Right?
They wanna go in and talk to these guys. They have something exciting and new to talk about. So, you know, it can be very rewarding Sure. If you're, you know, if you can stomach a miss. Yeah. And that's, you know, that's a big pro for smaller companies is access and the ability to have KOLs that are really eager to see you. Right. And, you know, as opposed to, you know, maybe another organization, whether it's large, small, doesn't matter, but lack of access can be really frustrating.
So that could be a really big draw. But to your point, getting back, I mean, obviously, some of these some of the differences. So large pharma, you have less risk, more stability, more infrastructure. People typically stay for a much longer period of time. But you're not probably not getting that big the big RSU package that you're gonna get. I mean, because their stock price is gonna be stable. Right?
I mean, it's you know, there there's just not gonna be that that brass ring that you would reach for with a smaller company. Yeah. And then what about so we talked about some of the, you know, kind of an overview of the basic pros and cons. But what about the differences in responsibilities when you're working for a smaller company versus a larger company. I would imagine that you get to do more at a smaller company. Right?
Exactly. You know, I mean, again, when, you know, when, a small start up company is developing their medical affairs program, typically, the MSL team will be the first section of their of their medical affairs program that they'll build out because they need people in the field. There's clearly no commercial team. So they're looking for, you know, to start generating awareness. Right?
They're looking for, MSLs to get out and talk about their their clinical trials, help help, you know, encourage enrollment, that kind of thing. But when when they're developing the MS or the medical affairs program, there's typically not much in place. Mhmm. There's no SOPs. You know, there's no internal, content. There's not there's very little training. I mean, typically, when we start with an MSL team and there's very little resources, you know, we have clinical trial protocols.
We have an investigator brochure. Maybe we've had some, you know, materials from previous advisory boards, but that's really about it. Yeah. You know, so for an MSL to come in, you know, they've gotta be willing to wear a lot of hats. They've got to, you know we're talking about developing training materials. We're developing internal content, slide decks. We're developing external facing content that we wanna show our KOLs and investigators.
We're developing standard operating procedures, MSL handbooks and guidelines and things like that. All of that stuff is really incumbent on the incoming team to do it. Right. And so, you know, whereas, you know, large pharma, those are already there. Those are already in place. The MSL comes in. They get big here's your here's your package. You learn it. You read it. And off you go. Where, you know, a small a small start up, you know, the MSLs were all developing this.
And we we kinda have this saying as we're building the plane as we fly it. But I'll I'll tell you, a lot of people as as on the recruiting side, as a recruiter, a lot of people come to me and come to my my team looking for that sort of thing. Right. Whether they've been with large pharma or not, there are people that's that want to to have an opportunity where where they can make an impact, wear a lot of hats, have more responsibilities than just a traditional therapeutic MSL.
They wanna be able to which actually helps them build their resume because they can show that they've done all these things. So I think one of the real advantages to working at a small company is because of the fact that there's less infrastructure, you get more responsibility. You get to do more. Yeah. Would you agree? Oh, absolutely. And and that's you're exactly right.
You put it on your your resume that you've developed SOPs, or you've been a part of developing a clinical trial protocol, or, you know, you launched a product. I mean, it you're right. It is it's it's a lot more rewarding for a lot of MSLs, especially MSLs that are sort of kinda coming into the field and they wanna get that exposure Yeah. That, you know, they have a lot of responsibilities to be able to come and wear a lot of hats.
Yeah. Well, let's talk about So when I when I think about that, I think about infrastructure or lack thereof. So what's what's the downside to that? So what challenges and how difficult is it when you're in that environment, you don't have the infrastructure? I mean, I would think that, you know, there's gotta be a lot of challenges to that. There is. And, you know, we we kinda laugh about it because, you know, one of the one of the fun parts to the job is that there's no infrastructure.
And one of the hardest part of the job is there's no infrastructure. Right. Right. You know, so like I said, you know, we're we're developing content ourselves. I mean, you know, when I was at Immunomedics and we had our team, we had no training materials. So I assigned topics to each MSL to develop training, and the MSL's train each other, you know, on on our on our drug and our clinical trials and our data and so on.
But, you know, moreover than that, there's there's there's like I like I mentioned before, there's no standard operating procedures. So we have to put these things in place. You know, there's there's very little budget. Right? You know, I mean, you know, commercial organizations have very large large budgets, and, you know, large pharma has very large budgets.
But, you know, it's it's very tight when it comes to, you know, we wanna have we wanna hold an advisory board for, you know, for some of our investigators and some of the top tier KOLs. You know, we're we're looking at ways to cut corners and and, you know, use utilize MSLs for medical writing and and things like that. So it becomes a bit of a challenge. You know, I'll be honest with you. I've had I've had MSLs that have come work for me that had come from large pharma.
Mhmm. And they ultimately didn't feel very comfortable because there was very little resources. You know, they didn't they didn't feel comfortable, like, developing all this content and there's no training, Jim. There's nothing training. They're like, well, yeah. We're we're doing it on our own. But so it does require a bit of a different mindset when you come into small pharma is, you know, you gotta be willing to work with with little to no resources and and sort of make do with what we have.
And that that's something that really has to be evaluated during the recruiting process because we see that all the time. You you can't take somebody that's spent their whole career in large pharma, and then all of a sudden, they wanna transition to a small start up, or small pharma.
And not to say that they can't be successful, but they really do need to be vetted out to to make sure that they have an understanding of what they're signing on for and that that's what they want at that stage of their career. You you're exactly right. I mean, it's, like I said, it's it's it's a difference in comfort level of being able to, to thrive in that kind of environment where, you know, there's not a lot to to grab onto.
Yeah. So when you when you spoke before about how medical affairs is being brought in at the very beginning of the process in these small companies, and a lot of times, there is no commercial at that point. So how does that work? What's it like with field medical operating in a system where their commercial isn't in place yet? Well, you know, it's it's it's interesting because you kinda it's a little bit of a dual role.
Mhmm. You know, the the field medical team essentially becomes the face of the company. Right. So, you know, we're out there generating awareness, generating brand recognition. When I say brand recognition, I just mean, you know, the clinical trials that are running the name of the company. I mean, a lot of times, KOL investigators have never even heard of the company. Yeah. You know?
And so, you know, you're getting in their faces, and you're doing a lot of introductory meetings, and it's it's very broad level general introductions and and and generating awareness. But it is preapproval. Right? So there's gonna be no one on the commercial side. So that traditional firewall between commercial and medical isn't there. Right.
So, you know, we're we're kind of taking some liberties to get out and do a lot of, you know, face to face, 1 on 1, interactions, especially at, let's say, large congresses like, you know, like ASCO or something like that. There's gonna be no commercial booth. We're gonna have a little medical booth, and we're we're gonna have the MSLs, you know, front and center, generating awareness.
You know, larger companies have commercial organizations, even departments within the commercial organizations that handle advisory boards or investigate or not investigative meetings, but, you know, KOL meetings and conferences and things like that. That's gonna be a possibility of field medical affairs. Yeah. And we'll be doing all of those things. So it's a little different, you know. And then there's that, again, that compliance question. Right? I mean, you know, it's preapproval.
There's no marketed products, so there's no Sunshine Act. Right. You know, there's no, there's no obligation to report a lot of those things. So, you know, we're we're in there, you know, having dinners with with KOLs and investigators. You know, again, just generating awareness and and being sort of the face of the company. And that has to cause some stress. Right? So you have your field medical teams, the face of the organization. You don't have a compliance department keeping people in line.
You don't have, like, the nor like, it's it's it could be a recipe for disaster. It is. I mean, it is it is tough waters to navigate. And listen, I mean, that's one thing that the MSL team has to be you know, they have to be ready to adapt and change. Yeah. I mean, because, you know, if if we're moving in one direction and leadership team decides we're gonna go in another direction, then, you know, it's stop and do it about face and go go in a different way.
And a lot of it is due to, you know, some FDA regulations that are coming up or some compliance concerns. You know, it's it's a bit of a fire drill sometimes. Yeah. Well and that makes me think about you know, again, getting back to the recruiting piece. Would you say that for a smaller company, it almost becomes mandatory or, desirable to find people with more experience because there's less training and because there's less infrastructure?
Kinda I would think it would be very difficult to hire somebody brand new into the role when they don't have the training capacity and the access to that. You you're you're right. It is it is a bit of a, there's there's a there's a a very kind of a narrow window of sort of that MSL, experience that you're shooting for.
Because as you mentioned, you know, very senior MSLs that have been around for a long time, they're around 20, 30 years that haven't worked in in start up, also don't really thrive in this situation with with limited infrastructure and resources.
Yeah. But brand new MSLs is too you know, you don't wanna be holding or I don't wanna say holding hands, but you you don't wanna be training someone on basic m f MSL 101 type of techniques on how to engage the physician or anything like that when you're in startup mode and everyone is hitting the ground running. Right. You know?
I think what we look for is we look for people that have experience in in getting in the field and talking to investigators that can work autonomously, that don't need a lot of guidance. Yeah. But again, that are willing to adapt, wear a lot of hats roll up their sleeves, and, you know, be willing to maybe take on some roles that are not in the traditional MSL role.
Yeah. So other than experience and some of that stuff that you just mentioned, if there are people out there listening to this that are interested in transitioning their career to a small company, what skills would you look for when you're hiring folks like that? So, you know, when I'm going through the inter interview process, I'm looking for, first and foremost, people skills. Right?
I I'm looking for people that can can speak very clearly and fluently and and don't really have a problem getting in front of a group and speaking because, you know, again, we're we're out there in the field with the face of the company. But I also look for people with with other technical skills too that, you know, can you manipulate a spreadsheet? Can you create a a PowerPoint presentation? Can you get in front of a room of doctors and speak, you know, clearly and and fluently?
You You know, because at this point in the game, you know, one of the one of the big topics with with MSL organizations, right, is metrics. Right? You know, do do you do you follow metrics? But, you know, in a startup organization, there's no room for that because every MSL is gonna be working on a different project. They're gonna be working on different things.
I mean, there there's no way to establish, you know, a performance indicator or a metric that can be, you know, sort of spread across the whole team because we're just not in that mode. You know, we're we're we're as I mentioned, we're building the plane as we fly it. So I've got a couple of MSLs over here that are working on content development.
I've got MSLs over here that are working on advisory board, you know, and then I've got other guys over here that are, you know, working with clinical investigators and and and medical information, things like that. So, you know, it it just it really you have to let the MSLs play to their strengths, and you have to, you know as an MSL, you have to be willing to okay. Let me put down this project that I was in the middle of. Now I've gotta do this because this is not a new hot button.
Well, it sounds like in in a in small environments, you have to be both strategic and tactical at the same time. That's right. That's right. And and how do you navigate that? Is it just like you have to have a really dynamic individual, I guess? It it it it's true. You know, large pharma you know, big pharma companies can sit down, you know, in the beginning of the year and map out strategy for the whole year. Right? Mhmm. And they can develop tactics.
The MSLs have their their roles and responsibilities and, you know, off they go, and they're doing it for the whole year. Small start up, you know, you may have strategy for 60 or 90 days at a time, and that's it. Yeah. You know, and and, again, you may have a strategy that we're gonna get to this level of the FDA submission. Mhmm. However, you know, data may come back that you have to halt right in your tracks. Right? Right.
And switch strategy, switch tactics, and and and move in a completely different direction. And and it is tough. I mean, it's it's you're you're you're a lot of overlap of changing strategy and and, you know, trying to organize your tactics and keeping the MSLs on on a goal that, you know, eventually, they they'll be able to get there because there's a lot of change, and it's very dynamic in within the FDA submission process. Yep. And how do you feel and this is I'm I'm asking you this.
It might be more of a personal question than, you know, business, but would you consider going back to either larger or, like, big pharma now that you've been spent so much time on the side of the small and start up company? You know, it would be it would be tough. You know, I really like the small biotech. I mean, you know, I think it would be my preference would be the small to midsize.
You know, because, again, you know, some of the some of the fun the fun part about or the more rewarding parts about, you know, working in in this type of environment is, you know, if there are decisions that need to be made, you know, you can sit down with the leadership team, make a decision, and it's done. I mean Yep. You go.
Yeah. You know, in in large organizations, there's probably 2 or 3 more committees and more meetings that, you know, decisions have to be vetted through before changes are made. You know? So that's kind of the part that I I like the most. So if, Tom, if I were to go to a large, you know, a large farm again, it would have to be sort of a very unique position and unique situation that maybe they're they're about to launch a new product and developing a new team. You know? I I could do that.
But you know? I'm not surprised that you say that. I I I feel like most times when I'm talking to folks, when they make that transition and spent a lot of time at small in, you know, small pharma biotech, they get used to that type of lifestyle and and, you know, being in more of a fast paced dynamic, wear a lot of hats, and get used to the lack of of infrastructure. And then it becomes difficult for them to make that transition over or back over to large pharma. So it it does make sense.
And I'll say this from a recruiting standpoint and just looking at the industry as a whole, there have been and there will continue to be more and more opportunities in small pharma because more and more drugs are getting approved each year by the FDA, which is creating more and more opportunities. More and more MSL teams are being built than ever before. As you said, MSL teams are coming in before commercial and, you know, to prep the market and do all the heavy lifting.
So it's it's a it's really a great time for field medical affairs as far as opportunity. And I think that anybody that's listening to this that may have a career in large pharma, it might not be a bad idea to consider making that transition at some point. Or if you've had your whole career in small pharma, you might wanna consider continue to stay there because I just think there's gonna be a lot of opportunity, personally. I I agree.
And I and I can tell you that most of the colleagues that I've had in small pharma, we're all still here. Yeah. And, you know, we're we're all in in small small pharma kind of companies and, you know, listen. We we also kind of travel in packs. I mean, you know, my director that hired me in August for you know, hired me to use this and hired me in Carrier Farm. And, you know, teams of MSLs came along with me.
Yeah. And, you know, as I left as I most recently left Immunomedics, you know, I would probably you know, if the opportunity came along, I would probably look to hire, you know, other MSLs that I've worked with in the past to come again, because they like that. They like that opportunity. I I don't know of many that leave small biotech and and go back into large pharma again. It use it's usually once we get here, we kinda like this. Yeah. I kinda feel that that's the same. So last question.
What what would you say I mean, what advice would you give to someone who is whether they've done it before, but someone that's transitioning to small pharma startup, you know, atmosphere? What would what advice would you give them? You know, I think you gotta be my advice would be, you know, be willing to be a little bit, you know, tolerant of risk. Mhmm. You know, there's always gonna be that unknown.
And as long as you're comfortable with that, then, you know, the rest of the job can be very fulfilling and rewarding and and almost even fun. Yeah. But if the inevitable does happen and, you know, the FDA doesn't approve the product or, you know, the company you know, the the trial fails or something like that, you you know, then it's just on to the next it's on to the next opportunity. Yeah. Know? And then you kinda go there and listen.
If you want your resume to be 10, 12 years at one company, then, you know, maybe small start maybe some start ups not what you're looking for because I gotta be honest with you, as I've told you, you know, I've been in industry for 11 years now, and I've been with 4 company 5 companies. So, you know, you have to be willing to, you know, have that that opportunity to go to the next company if it, you know, if it doesn't if it doesn't go well.
But, other than that, I think, you know, it it's very rewarding and fulfilling. And if you like to get in and roll up your sleeves and do a lot of things, then it's it's the perfect opportunity. Awesome, man. I listen. I'm a big fan. I love working with biotechs and small companies, and, we we do a lot in that space. It's actually become a bit of a niche for us. And to your point, and I and I do wanna I do wanna actually just reflect on what you just said.
I do think that it is a byproduct of small biotechs that you may wind up with a couple of jumps on your CV. Yeah. It it you know, you you have a better chance of tenure at in a larger company than you do a smaller company. And that doesn't mean you're necessarily a job hopper. It might just mean that you got caught up in an acquisition or maybe the drug didn't get approved or, you know, all the pitfalls that we hear about in in biotech and and small pharma.
So it is it definitely is a byproduct of being on that side of the equation. It is. It is. And and listen, when you know, I think and and you may be able to tell better than I am, but I think small biotech hiring managers, when they see that and they see that you've gone, you know, from a couple of small companies along, they understand, and they get it. So it's not necessarily a black mark on your CV that you've made a couple of jumps.
It's just because you you've been in this environment and, you know, you've been subject to a buyout or, you know, a failed trial. But that's just the nature of the business. And, you know, it's I don't think it's a huge black mark when you, you know, when you can kind of clarify what is what has happened along the way. Yeah. Good stuff, Jim. Hey. Listen. I appreciate you taking some time. This was really good info. And, you gotta come back again sometime. Absolutely. I'd love to.
And I and, again, I really appreciate the invitation, and, I really enjoyed the conversation. Good stuff, man. Alright, Jim. Take care, buddy. Alright. Thank you. Thank you so much for listening to the show. And if you enjoyed it, please subscribe so that you don't miss an episode in the future and feel free to leave a rating or a review or a comment. Thanks again, and we look forward to seeing you soon.