This is the second part of an article describing a model for managing and developing new MSLs. Part One provided advice for managers on the key mentoring and management needs of a new MSL, so that they can help the MSL settle into their role as smoothly as possible. Here in Part Two, I’ll cover the second component of the model: a structured Medical Affairs (MAF) training programme, by which the manager steadily introduces the MSL to the key MAF activities with the aim of producing an independent and competent MSL over a period of two years.
The table below lists the core MAF activities that an MSL should be able to perform independently after two years, and suggests a sequence and timeframe for learning them. The principles underlying this approach are that: 1) all MSLs should be well-rounded, with an ability to perform a variety of MAF tasks; and 2) MSL training must be structured, pragmatic and progressive.
As outlined in the table, the core MAF activities that should be developed in a new MSL are:
- Understanding of medical strategy (3-6 months)To operate independently, an MSL must be able to align their in-field decisions with the medical strategy. After a study period of approximately 3 months, the manager can assess the new MSL’s ability to do this by asking the MSL’s opinion on the appropriate course of action in real-world MAF scenarios and observing whether the MSL is using the medical strategy as a reference to guide their decision-making.
- Develop KOL engagement plans (3-6 months) Developing engagement plans is an important exercise in helping MSLs to plan their time and territory management, learn the KOL mapping process, and to demonstrate their understanding of the medical strategy. The MSL’s manager and other field-based colleagues who have familiarity with the relevant KOLs should obviously assist.
- Supervised in-field KOL interactions (3-6 months)New MSLs should be given a 3-month settling in period before going into the field, during which the KOL engagement plans can be completed (among other things, see Part One). During the period of supervised in-field KOL visits that follows, the manager should make introductions, help the MSL to draft introductory emails and other correspondence, help with meeting planning, accompany the MSL to KOL meetings, and teach and demonstrate techniques for scientific exchange, as well as teaching rapport- and relationship-building skills. Then, after 3 months of supervised interactions, the manager can assess the MSL’s readiness for independence.
- Independent in-field KOL interactions (6 months)
Six months in, the MSL is ready for independent in-field interactions with KOLs, provided that they have demonstrated a good understanding of the purpose of their role, as well as an ability to think in line with the medical strategy and to manage their time and territory effectively. At this point, the manager must realistically assess the MSL’s readiness for independence, because an MSL who is not truly ready may find themselves directionless and organising meetings that lack clear purpose.
Assuming that the MSL is ready to go out on their own, the first thing the manager should do is schedule weekly meetings. This is not only good management but is also important for monitoring the well-being of the MSL, who will be under increased stress due to the increased autonomy, increased isolation, and the ever-increasing demands of cross-functional colleagues, particularly if the MSL is working remotely. If necessary or if requested, the manager can also accompany the MSL to additional field meetings. To gain additional insights to help with the MSL’s development, the manager can solicit feedback on the MSL’s conduct from trusted MAF colleagues. Finally, since learning to be an effective MSL cannot possibly happen in 3-6 months, the manager should make sure further training in the field-based elements of the MSL role and in KOL engagement is always available, from experienced internal trainers or (for smaller companies) specialised external sources.
- Training in the core MSL activities (6-18 months)Every MSL should have the opportunity to learn the core MAF activities listed in the accompanying table through supervised hands-on experience. These activities will vary from company to company but should at least include participation in Advisory Board Meetings and Medical Education Events. During this phase, the MSL will be acquiring the fundamental skills and experience needed to progress to more senior MAF roles, so it is incumbent upon the manager to provide suitable opportunities and guidance. I have met MSLs who have never attended an advisory board meeting after two years in the role, let alone organised one, which represents an unacceptable failure of management.
- Independent execution of core MSL activities and introduction to advanced MAF activities (18-24 months)
After 18 months, the MSL should be challenged to perform independently the tasks described above. For example, they should now be expected to run an Advisory Board Meeting independently and then start teaching other MSLs how to do it (“see one, do one, teach one”). The manager can begin to delegate progressively more complex and important tasks to the MSL. Weekly progress meetings with a clear agenda should be scheduled to make sure both the projects and the MSL themselves are on track.
In some companies, advanced MAF tasks (such as reviewing promotional material, assessing compassionate access requests, and establishing investigator-initiated studies) may be assigned to more senior individuals. Nonetheless, the manager should ensure that the MSL is introduced to these activities and given opportunity for continuous learning beyond the immediate scope of their role.
The training model described here can be implemented by managers who wish to develop new hires into well-rounded and independent MSLs who are ready for advancement to more senior roles after 24 months. The model is based on the belief that an MSL must be given opportunity to learn a broad range of MAF activities, as this serves the interests of both the company and the individual MSL. As recognition of the importance of the MSL role increases, interest in training programmes like the one outlined here will continue to grow.
About the author:
Tim Nielsen, PhD
Tim Nielsen is a medical affairs professional based in Melbourne, Australia. He is a former research scientist who entered the pharmaceutical industry in 2016. He is presently employed by Celltrion Healthcare and has previously worked for MSD and Janssen. The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer or former employers.