Welcome to MSL Talk with Tom Caravela, a podcast specifically designed for MSLs and all things field medical. Greg, welcome to the podcast, buddy. Thanks for joining me. Well, thank you so much for having me, Tom. It's a pleasure. I can't tell you how excited I am to bring this guy to this podcast because there's a real story here. So Greg and I worked together at what was originally Ross Laboratories, which became Abbott Laboratories, for almost 10 years.
So go back to the beginning of both of our careers. And he and I spent 10 years together working at the same company, and it's just this is a long time coming. So I'm really excited to have Greg. I'm gonna have him share his amazing, amazing story with you on his career. But before we do that, Greg, why don't you do a quick intro? Sure. Thanks, Tom. My name's Greg Auclair.
I'm a senior director of medical affairs at Cytokinetics, which is a South San Francisco-based biotech company that specializes in the discovery, clinical development, and, fingers crossed, next year, commercialization of small molecules that modulate sarcomeric function or muscle function. In my role there, I help to manage a field-based medical science team, aka MSL team.
And I also sit on a number of internal work streams that are helping to advance the company in preparation for our first drug launch next year. Sweet. And, guys, Greg's being humble. Like, there's so much to unpack here. The dude's just being humble. He's a rock star, and we're gonna get into it. And, actually, let's go back to the beginning. Let's talk about how you started off and got into and transitioned into the medical affairs space. Sure. Yeah. That's, that's an interesting story.
So little-known fact, after I got out of grad school, I started my career practicing clinically. I actually was responsible for taking care of patients in the SICU, MICU, and CCU. Specifically, I was the person who planned and was responsible for all the parenteral and enteral feedings in those critical care units. So I started out my career as a registered dietitian.
After doing that for about a year, I realized that that wasn't going to be the best path for achieving some of the things that I wanted to achieve moving forward. So I interviewed for and transitioned into the Ross Products division of Abbott Labs, where you and I met and worked together for 10 years. And after about a dozen or so years in the field on the commercial side, specifically selling, I got that itch and was starting to feel as though I really wanted to do something different.
Now interestingly, when I was in sales in the field for a small pharma company, my sales manager at that time said to me, you know, you have an unusually high clinical and scientific acumen, and I don't think we're utilizing your skills to the best of your ability and for the benefit of the company. So I want to make you our regional trainer. And I said, sure. That's great. I'd love to do it.
Coincidentally, around the same time, one of the doctors that I was routinely interacting with in the field in sales said, hey. You know, you have a very strong knowledge and command of the data. Have you ever thought about becoming an MSL? And I said, what's an MSL? What's an MSL? Yeah. Right. I have no idea. And he explained it to me, and I thought, well, that seems to align really well with my skill set.
And to make a long story short, I ended up applying to a contract medical organization, which back then was known as Science Oriented Solutions. Mhmm. Since transitioned and morphed into the medical affairs company or as most people know them, TMAC. Mhmm. And I was able to secure a contract MSL role with Science Oriented Solutions working for GSK, helping to support their antiretroviral products in the HIV space.
And after that contract ended, I was moved over to a new contract, which was for a smaller startup biotech out of the Boston area, called NitroMed, and they were getting prepared to launch a new drug. I worked on that contract for about a year, and that ended. And with that two years of MSL experience under my belt, I felt confident that I'd be able to begin searching for a permanent role with a standalone company that wasn't contract.
So long story short, I landed one of those positions with a small private company out of New Jersey, and they ended up getting acquired by a big pharma. And I was able to interview for and obtain an MSL position with Medtronic Cardiovascular, specifically within their coronary business unit. And I did that position for about eight years, unfortunately, as a consequence of some negative trial results for a very high-profile renal denervation study, the team was eliminated.
And I transitioned over to another field medical role, a role with Boston Scientific. And after about three and a half years in that position, I got that itch again and decided I wanted to do something different. So this still kinda surprises me. I actually took a role with a biotech out of Cambridge, an in-house position in their marketing department.
Oddly enough, they wanted someone who had a track record for being able to establish relationships with key opinion leaders and other HCPs because the role that I took with them in the marketing department was associate director, overseeing HCP relationships. Two years doing that, and I just realized how much I missed medical affairs. And I got recruited to come to Cytokinetics in the fall of 2019. And, God willing, this is my last stop. It's a fantastic company, and I'm very happy here.
So it's been quite the journey. That's a journey. Over 35 years in the industry. Yeah. That's a journey. And you are now a senior director of medical affairs. Correct? That's correct. Yeah. So let me unpack that for a second. So here's a guy that—and by the way, I'm gonna spell this out—starts out in sales. Doesn't even know what an MSL is. Same with me. Like, when I got into MSL recruiting, I was recruiting salespeople at the time. I didn't know what an MSL was. This is a million years ago.
So I fell into medical affairs recruitment in the same way that Greg fell into the medical science liaison role. Now makes sense. He's way smarter than me. He's way more clinical than me. So I couldn't have pulled off the MSL role, but I can be a recruiter. So, anyway, he takes on a bunch of different roles, went in-house, did the marketing thing, and landed as a senior director of medical affairs, which is extraordinary. And he did it all without a doctorate-level degree.
So I want to share with all of you listeners that maybe either don't have a degree or are worried that your experience may not be exactly what you think it should be to get to that next stage in your career, listen to Greg's story. So the next question I have is, how challenging was it for you when you're interviewing for positions that maybe typically require a doctorate? That's a great question.
You know, years ago, Tom, 20 years ago, 25 years ago, there definitely was an expectation in industry that to take on a high science role like an MSL, you needed to have a terminal degree, whether it be a Ph.D., an M.D., a Pharm.D., etc. And the reason why is because there was a perception out there that having one of the D degrees, as we like to call them, is necessary for credibility. I don't necessarily feel that way.
And granted, I'm biased because I don't have a terminal degree, and I was able to get into the space and advance my career. But I would say to people who would like to get into medical affairs, but don't have a doctoral-level degree, do not be discouraged. You may get some pushback in the beginning, but keep at it and you will break into the space.
And once that happens, it's all about proving who you are and what you know and what value you can bring, not only to the KOLs, but also the insights and other benefits that you can bring into the company from your relationships with key opinion leaders. And how did you do it? Like, what strategies or advice can you give people to help them because, obviously, I think there's a lot of people that are gonna be really inspired by this. But then how would you recommend they go about doing it?
Well, there's a number of different paths you can take. I chose a path where recognizing back then that I didn't have the doctorate and I didn't yet have experience as an MSL, I needed to find a way to kind of nudge my foot into the door so I could start gaining experience. And for me, I found the best way to do that was to get some experience through a contract MSL role.
I really believe that it's a great opportunity for people who want to break into medical affairs with or without a terminal degree to learn what the MSL role is, to understand all the different responsibilities within the MSL role, especially how to form meaningful deep relationships with key opinion leaders.
And once you get that MSL experience on your resume, even if it's with a contract company, you're in a much, much better position and should be able to, in my opinion, leverage that into an MSL role with a standalone company. So I would encourage people to look into contract roles initially. And there's a lot of different companies out there that do contract MSL work. Yours does, Tom. The Carolan Group does. TMAC or The Medical Affairs Company, Syneos Health, Amplity Health.
There's a number of different companies out there that do contract MSL work with large and small pharma and device companies. So that would be my single best recommendation if you want to break into the MSL role to gather some experience that way. I think it's great advice, and I think that this is a you described a journey. Right. With a lot of different kinds of side steps to get to where you are now. And I think that people need to understand that this is definitely not a sprint.
It's a marathon. So you may need to consider getting a contract position or we have a lot of aspiring MSLs in our coaching program that have transitioned into other positions as stepping-stone positions, whether it's research positions, medical information. We even have somebody who's in a training capacity, a medical education capacity, to get the skills that they need to make them marketable for an MSL position.
So look at it that way as part of your strategy is, yeah, the goal is to get to an MSL job, but it might require a step in between. Now. That's a great point, Tom. Yeah.
You know, securing another position or what I call within a subfunction of medical affairs, whether that's medical education or medical communications or publications in a company, is a great way, especially for someone new trying to break into medical affairs, to understand how a corporate medical affairs department works and the types of things that they do.
Once you're inside in that different type of subfunction role, you can gain tremendous knowledge about what the field MSL team does and better position yourself to put in for something like that if a territory opens up. I completely agree with you there. Yeah. For sure. And so getting back to your experience when you were going through your career, did you face any skepticism from either colleagues or KOLs as it might have related to the degree issue? Did that ever come up?
I mean, you're so smart and you're so clinical, but did that ever come up? Oh, absolutely. You know, especially in the early days of the MSL role 20, 25 years ago. As I said earlier, you know, there was this perception that if you have a terminal degree, you must be eminently smarter and more qualified as an MSL than someone who doesn't. And there was some skepticism among a couple of physicians along the way. I'm not gonna deny that.
But, ultimately, what that told me is I might need to work a little bit harder to demonstrate my value to that key opinion leader, such that in simple terms, I could make them forget that I didn't have a degree. You proved it. You proved it, and people came after you seeing how clinical and how smart you were. You mentioned how people noticed your scientific acumen and your ability to communicate scientific information. Yeah. So you you lived it.
How important is branding and networking for folks that are trying to break in or prove themselves in an industry? Because you clearly branded yourself as a clinical expert. Talk to expert. Talk to talk to that piece of it a little bit. Yeah. It's very, very important, especially for someone in the beginning looking to break into medical affairs to network as much as you can.
Ultimately, it's been my experience that for a lot of MSL positions that are in high demand or that people would really like to have, more often than not, it's because you know someone or you know someone who knows someone that can put you in touch with the company or the hiring manager. And that's directly a function of networking. Absolutely no doubt about that. In terms of the branding, to be very honest, I, I kinda let my resume speak for itself.
I didn't put a ton of effort into quote, unquote branding, for example. I don't spend much time on social media platforms other than LinkedIn, so I'm not tweeting out or sending out other things on social media platforms, highlighting I did this or I did that. That was something that really didn't interest me. Perhaps I could be farther along if I did, but I chose not to do that, and I'm happy with my decision. It's also a different time now. We're, you know, we're old school.
I mean, we've been in this game 35 years. Right? This branding thing is relatively new, kinda sorta. Yeah. Yeah. Think it's more relevant now and more import I mean, networking has always been important. Yeah. The branding thing, I think, is becoming more and more important, especially if you're trying to establish yourself in a career. I'm a you guys know I'm a big advocate of networking. I talk about it all the time. So, Greg's giving you some really good advice.
Getting back to the folks that are out there who may not have the doctorate-level degree and may be looking to either transition in their career or get promoted in their career, have you noticed any shifts in hiring folks that don't have degrees? Has that been something that you've kind of seen over the course of the past few years? Absolutely.
There's definitely been a shift towards hiring more MSLs who don't have terminal or doctorate degrees, and I think that's a function of one primary thing, and that is that companies still need to get their data and their scientific and clinical messages out to HCPs and key opinion leaders. And often, most physicians feel the most credible source for that information is a medical science liaison.
That's not in any way, shape, or form to suggest that there aren't some very talented clinically astute, scientifically astute salespeople out there. But there has been a shift.
And because there's this constant need to get the data and those scientific and clinical messages out to key opinion leaders, I've noticed that the demand for medical science liaisons is outstripping the supply such that most companies, my own company included, and me as a hiring manager, I'm more than happy to consider someone without a doctoral degree if they meet the other criteria for the job.
In fact, when we list open positions at Cytokinetics, we specifically say in the job description, terminal degree or doctoral-level degree preferred. We don't say required or mandated because we don't want to lose the opportunity to hire exceptional talent because they didn't have the degree. Yeah. There's so much to unpack there because, guys, and you've heard me talk about this before, but there are so many new opportunities that now exist in the industry.
Mhmm. There are some opportunities that are better for PAs or NPs. Yeah. Folks that come from a little bit of a more, you know, clinical background. And then there's plenty of opportunities that exist for people that just don't have doctorates but are very well educated, very clinical. So let's just say someone, they do transition, they land a job, but they may be worried about establishing credibility with their HCPs and KOLs. What advice do you have for those people?
How can they quickly establish credibility, without a degree? Two things come to mind. First and foremost, and this is hands down the strongest recommendation I can make, commit better than anyone else to knowing your company's data for the products you support, your competitor's data, and the therapeutic space that your company plays in. If you are seen by your KOLs as someone who is extremely knowledgeable across those three facets of the job, you will build credibility. It may take some time.
Generally, when a new MSL gets established or hired for a job, it can take anywhere from 18 to 36 months for that relationship to form and for a key opinion leader to say, hey. This guy, Tom, really knows his stuff, and I can count on him as a resource. I can go to him when I have questions about the data or what's coming down the pike for his company or what studies someone else might be doing. So that's recommendation number one.
Number two, I've always believed very, very strongly in the following. Say what you gotta say and get out of there. Meaning, tell the KOL what the purpose of the meeting is, how long you think it's gonna take to cover the topic or topics on your agenda, and then when you're done, get out of there.
The one thing I believe that can irritate physicians and key opinion leaders, among others, is when they're sitting in front of an MSL and they feel as though they're just throwing everything against the wall. Mhmm. And they're looking at their watch and the meeting's run, you know, 10 minutes over, and they're late for rounding, and they're starting to get a little bit antsy.
What I have found is if you show tremendous respect for the KOL's calendar, and if you can, even maybe try to end the meeting a couple of minutes early, the one takeaway they're gonna have is this person respects my time, this person respects my calendar, and they're not trying to push me into giving them more time than I'm willing to commit to right now. And the downstream effect of that is the next time that MSL reaches out to that KOL, that KOL is gonna remember. This person respects my time.
They told me what they needed to tell me. They answered my questions, and the meeting ended, and I know they won't abuse my time or my calendar. So those are the two things that I would highly recommend that aspiring MSLs keep in mind. That's great advice. Guys, I told you this was gonna be good. I told you this could be good. I knew it. Awesome advice. So how do you feel about certifications? Where do you stand on these certification programs that are out there?
Sure. I have mixed feelings about those. I think on one hand, for people who don't have prior MSL experience, taking a certification course can give them some understanding of what the MSL role is and what you're supposed to do and how you're supposed to do it and who you're supposed to do it with.
But in the end, to me, nothing trumps the experience of someone who has served in that role and knows exactly what to do and maybe has preexisting KOL relationships that they're bringing with them into their new job with your company. I find those things a little bit more valuable.
So what I would say is even if you want to pursue an MSL certification course, I would still highly recommend that you try to gain some MSL experience initially through a contract medical organization to build your CV. I agree, and I've talked a lot about my feelings on certification programs on this show. There's actually an episode dedicated to it. So if you want my opinion, just go look for it. It's an earlier episode, but I talk all about it. I think there is some value there.
There is some purpose, but I think one of the things I wanna stress is I think a lot of times people think that if they get some type of certification, it's gonna guarantee them a job, and that's just absolutely not the case. And not everybody looks at them the same way. Some people look at them like, yeah. Doesn't matter. I don't care. Some people look at them and say, alright. Well, this person kinda made the commitment to educate themselves, and we'll give them credit for that.
Knowing that and transitioning to your background and your transition was possible because of your skill set and your experience was really a good foundation. It was a good starting point. So what types of prior experience or alternate qualifications do you think are most valuable for someone who's looking to succeed in an MSL role that doesn't have a doctorate? Sure. We touched on a couple of those a little bit earlier.
If an MSL role doesn't appear as though it's gonna be something you can obtain in the short term, give consideration to taking on in it, another role in a subfunction of medical affairs. Right? That's number one. You know, over the last three years, I've hired three people straight out of clinical practice. People who had clinical experience in the therapeutic spaces that Cytokinetics play in.
Now granted during the interview process, we need to dig deep and, you know, assure that they meet a number of the other qualifications. But someone with clinical experience in the therapeutic area for which you want to become an MSL, I think is another feather in your cap. And then, you know, you hit on something earlier, Tom, that I think is very important. It's a journey. It's not a sprint to the tape.
So what I mean by that is give consideration to rounding out your CV with experience across a number of different companies, meaning large, small biotech, pharma, medical device. I even found tremendous benefit from having served on the commercial side of the business initially in the sales role and then the stint I did in marketing.
It gave me a great appreciation for how our commercial colleagues think and the types of things that they need to consider and plan for as you're getting ready, for example, to launch a new product. So I found that incredibly valuable. The more rounded you can be with your experience, I think that makes you eminently more attractive as a candidate. Totally agree. I totally agree.
And I really think there's a lot of patience that's required, not just in breaking into industry, but even when you're in industry. Yeah. Going through your career. I think everybody wants to get to that next step, probably, you know, maybe a little sooner than they should, or they're eager for that next thing, or they're looking at their friend that just got promoted or just got this job. There's this comparisonitis that kind of happens that gets you, you know, it gets you all messed up.
Yeah. So last question I have for you, Greg, and And, like, what would you tell someone who is either on the job market right now and searching or looking for that promotion, but they're discouraged? And maybe they don't have the doctorate or maybe they're just a little below what the qualifications might be. What would you tell those folks? Well, for someone who would like to pursue a career as an MSL, I would say the 3 P's: patience and polite persistence. It's going to take some effort.
You might not do it initially, but if you are patient and you are thoughtful and you are politely persistent in your pursuit of an MSL role, I have no doubt you will break into the field and you will secure one. As far as folks that are currently in an MSL role and would like to be promoted, the best piece of advice I can give is approach your manager and sit down and develop an individual development plan that moves you towards consideration to be promoted.
Different companies have different thoughts about advancing MSLs, but you need to understand in the company you're working for, what is that process and how do I go about doing it? And I believe strongly that it starts with a solid individual development plan, which you as the MSL need to own.
It's your responsibility to develop that plan with your manager, to execute the deliverables within that plan, and keep your eyes and ears to the ground about opportunities to be potentially promoted, even if it's in a different functional area within the company. For example, clinical development might be a good opportunity as well. Awesome. Guys, I told you this was gonna be amazing. Greg, thank you, my friend. You, you, this was something I was really looking forward to.
I want to congratulate you on your tremendous, tremendous career and all your success. It couldn't happen to a better guy. So thank you for coming on. Thank you so much, Tom. Always a pleasure to talk to you. Yeah, man. And guys, thank you as always for your support. If you found value in this, please share it with others. As always, I love you all, and I'll see you next time. Thank you so much for listening to the show.
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