Medical Science Liaison: A Day in the Life
The MSL position comes with great flexibility, work-life balance, compensation, benefits, travel to interesting places, and a sense of expertise in your given field.
Within the pharmaceutical industry, perhaps no role is more competitive or sought after than that of the Medical Science Liaison (MSL). The reasons are easy to understand. The MSL position comes with great flexibility, work-life balance, compensation, benefits, travel to interesting places, and a sense of expertise in your given field. Of course, there are downsides to being an MSL, but I still believe the liaison role is one of the best positions available to pharmacists in the United States.
Let's dive into what a day in the life of an MSL actually looks like!
Since every day looks very different as an MSL, we will split our "day" up into categories: travel, interactions, clinical trial support, and internal meetings. Note, there is a lot more to being an MSL than just these categories, but these are some of the most important aspects of the role.
Travel:
MSLs have to travel to many different locations as part of their job. The amount of travel varies between MSLs because the territories they cover can be drastically different. For instance, an MSL out West might cover 5 or 6 states as part of their territory. Conversely, an MSL on the East Coast might only cover New York City. That means the West MSL will have many more hours of travel and overnights as part of their work life, whereas the NYC MSL may have very little travel at all. Both MSLs will occasionally have to travel to major conferences outside of their respective territories as well, which can add to the time away from home. For example, many MSLs in oncology will attend ASCO in Chicago every year. Territory sizes also vary between companies, with big pharma typically having smaller territories compared to biotech and start-up companies.
The benefit of more travel is mostly accumulating rewards through your favorite airline or hotel chain, which you can take advantage of for personal use later. You also get to see a lot of the country, which can be a huge benefit for those who don't mind being on the road. On the other hand, if you have a family at home, this can definitely be a strain.
Interactions:
The reason MSLs travel is to have face-to-face interactions and build relationships with key opinion leaders (KOLs). KOLs are also referred to as external scientific experts (ESEs), subject matter experts (SMEs), or simply external experts (EEs). As an MSL working in thoracic oncology, I mostly interact with medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, and APPs like pharmacists, NPs, and PAs.
These interactions are meant to educate KOLs on any emerging data that a company has to offer. This is particularly important in the community setting, where oncologists often cannot keep up with the onslaught of data releases happening all the time. The benefit of being an MSL is the ability to have off-label discussions, meaning you aren't limited strictly to what is FDA-approved in your discussions. This is important as the majority of new and emerging data are not FDA indicated. The catch is that any off-label conversations must be reactive, and MSLs cannot discuss off-label topics proactively.
Importantly, these interactions are not unidirectional. In addition to providing education on new data, MSLs collect insights from KOLs, which are used to inform medical strategies. For instance, MSLs might collect insights identifying areas of unmet need in various patient populations or different biomarker testing practices between academic and community sites. They may gain insight into when and why a KOL would use their company's drug vs a competitor (and vice versa), which AEs are difficult to manage, and what the patient journey looks like at each site. It is often said that "insights are an MSL's currency" because companies use these insights to generate strategies around medical narratives and even determine which clinical trials should be run next.
MSLs often have a list of metrics they're supposed to hit. For instance, they may be expected to have 250 ESE interactions in a year with 50% of those meetings occurring face to face. Through these interactions, MSLs maintain relationships with KOLs that are mutually beneficial to both parties. For instance, many of these KOLs will go on to serve on advisory boards, fill study leadership roles with the companies they work with, and get authorship and presenter opportunities at major conferences. They also directly influence the landscape of future clinical trials and help pharma companies decide which areas of unmet need should be prioritized first.
Clinical Trial Support:
One of the best parts of being an MSL is supporting clinical trials in your territory. This includes supporting industry-sponsored clinical trials (especially phase 2 and phase 3 studies) as well as investigator-initiated trials (IITs). MSLs typically present to primary investigators during site initiation visits (SIVs), and support the trial site going forward. Most of the time, MSLs are expected to meet with their trial sites on a regular basis to make sure things are running smoothly and answer any questions. If a site is struggling to enroll patients, MSLs are often the ones who intervene on behalf of the company to assess what's going on. Many of an MSL's interactions come from SIVs and trial support throughout the year. It's also common for MSLs to make recommendations to internal study teams regarding which sites should be considered for clinical trials based on their investigators, patient populations, and capabilities.
Generally speaking, IITs are far less common than industry-sponsored trials, require more work on the part of the MSL, and are often only considered from investigators at academic sites. Still, IITs can be extremely interesting and rewarding opportunities for MSLs and investigators alike.
Internal Meetings:
Although an MSL is considered a field-based position, there are plenty of internal meetings to attend. These can include training meetings to stay up to date on recent data, insight calls where MSLs and HQ teams discuss recent insights collected from the field, congress preparation meetings, and many, many more. Luckily, these meetings are generally done virtually and don't require additional travel by the MSL, though there are normally at least 1-2 internal meetings per year that require in-person attendance.
Oftentimes, there is a minimum of one big internal commercial meeting and medical meeting held annually. MSLs often attend each of these along with the rest of the company.
The number of internal meetings ebbs and flows depending on product/indication launches, upcoming conferences, and competitor positioning. It's a significant part of the job, but still, the MSL's primary responsibility is to interact with the field and collect insights. Most MSLs prioritize ESE meetings over internal meetings when there are conflicting schedules.
The MSL position is an incredible opportunity, and it's worth pursuing for those who are interested! For more information on being an MSL, you can find some of our previous articles below.
Brentsen Wolf, PharmD
Brentsen Wolf, PharmD
If you want to be an MSL or have any questions, drop them in the comments!