Why I Became a PA
When I expressed interest in the Physician Associate (PA) profession I was excited, nervous, curious, and had a passion to help better the lives of my future patients. I graduated from The University of North Carolina at Chapel Hill (UNC) and immediately entered The Wake Forest School of Medicine PA Program just three weeks after graduation from UNC. This was the first step of my unique journey as a PA.
It is uncommon for applicants to have the patient contact hours required to be accepted into PA school that quickly. However, I worked for a special needs school during a study abroad program in London, England, and worked for the UNC football team as an Athletic Training student. I graduated from the Wake Forest PA Program in Winston-Salem, NC in 2018, and soon entered clinical practice as an emergency medicine (EM) PA.
Clinical Experience and Going Back to School
In the fall of 2018, I entered the clinical world as a PA in the Emergency Department (ED) in High Point, NC. Here I continued to develop the skills, knowledge, and confidence I needed to provide high-quality care to my patients.
I surpassed the steep learning curve that is textbook education versus clinical practice and began to evaluate what I wanted to do with my career in the long term. I considered PA academia as I did not know anything else would be possible for a PA to do outside of clinical practice. I started as an adjunct instructor at the High Point University (HPU) PA program and really enjoyed my time outside of the clinical setting. I was teaching, which I loved while preparing future PAs to be successful upon graduation.
There were few faculty at HPU at the time who had a doctorate degree, and as a new PA educator, I foresaw the need to learn how to be a PA educator. I also wanted to make my faculty applications more competitive by earning a doctorate degree. In January 2020, just three months before the COVID-19 pandemic hit, I began the Doctor of Medical Science (DMSc) Program at AT Still University concentrating in PA education. In the Fall of 2020, I was promoted to Lead APP within my Emergency Department, two years after beginning clinical practice.
Starting a doctoral PA program while working full-time as a lead APP during the country-wide shutdown had its pros and cons. I had no distractions in life and was able to complete assignments without issues. Although, the stress and fear of working in an environment where exposure to an unknown disease was inevitable were frightening for my family and me.
As we moved throughout the pandemic and the Omicron and Delta waves hit, my fear turned into fatigue. I quickly realized I needed a profession that I felt like I could do for the rest of my life and EM was not it. I loved the people I worked with, however, it was not enough. I would walk into an ED shift with 25-30 people in the lobby and a 15-20 hour wait, seeing patients in any corner of the department because of admission holds backing up the ED.
After a ten-hour shift, you leave with now 30-35 patients in the lobby and feeling completely drained. All the while, working as hard, and safely, as you possibly can. It was disheartening and I felt like I was unable to provide the care for patients that I was taught to do. On top of that, the “Healthcare Hero’s” mantra and pizza delivery daily turn into yelling, and both verbal and physical abuse, to not only the providers but the entire healthcare team (nurses, CNAs, phlebotomy, etc.).
We were tired. I quickly began to realize the impact that hospital administration can have on all healthcare team members. I was able to experience this somewhat with my lead APP role but wanted to keep the career options open for the future.
While completing my DMSc, I enrolled in the Master of Business Administration in healthcare management (MBA) program at The University of North Carolina Pembroke. It was tough getting an MBA, finishing my thesis research for my DMSc, and working full-time, while still on faculty at HPU as an adjunct but I knew that getting out of the ED full-time was the push I needed to get across the finish line. I completed my DMSc degree in December 2021 and my MBA in May 2022.
The Road to the Medical Science Liaison (MSL) Career Change
I officially left the ED full-time in early 2022 and began an assistant professor position at HPU. I loved educating and felt it was the best transition from full clinical practice. My students and their education meant so much to me and felt like I was putting the things I learned in my DMSc program to use.
In the spring of 2022, I learned about the Medical Science Liaison role through social media—a doctorate PA Facebook group. People within the group praised the MSL role. The ability to be challenged by understanding complex diseases and drug landscapes, travel, and working remotely, while still impacting patients but in a different way.
Breaking into the MSL field can be extremely challenging and is no short feat. I talked to multiple PAs throughout my application journey. I specifically targeted MSLs who were also PAs or NPs as I felt like those who were once APPs could best relate and provide the best advice to breaking into the field.
I developed a strong LinkedIn page, sent over 30 applications to MSL jobs, and spoke to multiple MSLs over the phone or on messenger. I am so grateful for the guidance that MSLs provided me when applying.
Within three months of applying, I had made it to final interviews for two different MSL positions, ultimately accepting a position as an MSL within oncology. I specifically focus on lung, thyroid, and head and neck cancers and cover a territory of five states.
People always ask how I got the role of an oncology MSL without having specific oncology experience, and only five years of clinical experience at that. To be honest, I think it was a little bit of luck, the right timing, preparation for interviews, holding both a doctorate and MBA degree, leveraging the oncology experience I do have, and tapping into my network and resources for advice to land the job. After talking to mentors while applying, and mentoring others now that I am in the MSL role, I personally believe my timeline is unique. People landing their first MSL job can take months to years. It all can vary and everyone’s story is different.
Life of an MSL vs. Clinician
All the posts I read on Facebook praising the MSL role were 100% correct. Transitioning from working in a clinic to remote is a huge change in your daily life but is great. You are able to do little things while at home, lessen your commute, and can work from anywhere. My work-life balance is similar in some ways but different in others.
On the one hand, working in the ED I never had to pre-chart or take call; thus, I would arrive at my shift, work my ten hours, and leave (not taking work home with me). However, I would take the stress, frustration, and fatigue home frequently. I have PA colleagues who chart frequently at home, pre-chart for the next day, or take call on the weekends. I would imagine the work-life balance would be significantly improved if coming from that type of PA clinical experience.
I was able to improve my work-life balance all while maintaining a great salary. I rarely work past 5 pm as an MSL as my company values work-life balance. However, with traveling I could work late nights due to flight delays or afternoon meetings. While I leave family more due to travel, the improvement in my mental health is worth it. I am happier and less stressed by working as an MSL. While every job can come with stressful times, it is few and far between as compared to almost every ED shift.
Being a practicing clinician will always be the foundation of who I am as a PA. I continue to work in the ED PRN to remain up to date with research, maintain skills, and get back to my roots of direct patient care occasionally.
Working as an MSL is the best career change I have ever made. I am challenged daily by the ever-evolving landscape that is oncology, all the while still impacting patients positively. I can discuss clinical trial data, updated evidence-based medicine practices, adverse event management, etc. with multiple providers in a single day. These providers then see 15-20 patients in their clinic. The information I provided to those practitioners can alter how they treat those 15-20 patients to improve outcomes. This is how I feel fulfilled daily.
Advice for Aspiring MSLs
While having a doctorate degree is not an absolute requirement for breaking into the MSL role, it is helpful. It also allows you to develop strong research and statistical skills needed to be able to present complex scientific data to your healthcare providers which are vital to being successful as an MSL.
An MBA degree can give you a statistical analysis background that can be useful as an MSL as well. However, if you are only going to do one, I would recommend the doctoral degree. While it is important to note holding a doctorate degree is not an absolute requirement to break into the field and if you asked twenty different MSLs the same question, you could get all different answers.
My biggest piece of advice is to network, network, and do more networking. You quickly learn how much everyone is connected as the MSL world is small. The mentors I had while transitioning into the MSL field were so helpful. Read and do research to ensure you know what an MSL does and their role in the medical affairs and pharmaceutical industry.
It is a big leap, and you want to make sure you’re doing the right career change for you. There are books and podcasts about how to transition into the MSL field, interview advice, etc. that can be helpful.
Applying to an MSL job is different than a clinical job and you want to be prepared and leverage your clinical experience appropriately. That is truly how we, as practicing clinicians, stand out as an applicant.
Going Forward as an MSL
There are so many non-clinical career options for PAs, and it is vital for practicing PAs, and PA students, to be aware of that. While nothing can replace direct patient-care experience, it is essential to know that you can still impact patients positively in different ways.
As I continue to dive into the MSL role I am hopeful and look forward to the vast career growth opportunities within the MSL profession (medical and global affairs, medical director, manager, trainer of MSLs, disease state leads, etc.). I am unsure what my career goal is at this point but look forward to figuring that out in the coming years.
I had reached my peak early. I am thankful for the leadership opportunities given to me during my EM PA career but found myself concerned I had hit the top so early. PAs bring such a unique experience to the MSL profession. With my career change, I continue to remember my clinician roots while still positively impacting patients, just in a different way. I continue to truly feel fulfilled as a PA.