At some point during training, oncology fellows will have to identify the career path they want to follow: private practice, academia, or industry.1 Finding the right fit largely has to do with identifying how they want to spend the bulk of their time, what their strengths and interests are, and how those strengths and interests align with the various career options.

Victor Sandor, MD, group vice president of clinical development for Incyte Corporation, knew in medical school that research was what piqued his interest. “At that point, and throughout my fellowship, the only thing on my mind was to pursue an academic career,” he said.

Although he was aware of industry as an alternative to academia for a research-inclined oncologist, Dr. Sandor did not consider it seriously as a career option. “I was not ready to give up the black bag yet and not see patients,” he said.

After spending 3 years in an academic position, however, with laboratory and clinical responsibilities and teaching duties, he became disillusioned. “In learning how to write grants, it became obvious to me that what was valued was persistence and consistency in pursuing an idea, whether or not that idea was correct,” Dr. Sandor said. “But if the data tells you you’re not right, why would you continue to do the same thing?”

Thinking he might be able to do clinical research in a private practice setting, where research would be supported by pharmaceutical companies and not be dependent on grants, Dr. Sandor took a position with an oncology program that had a large clinical trial program.

“I hated it,” Dr. Sandor said. The volume of patients he needed to see every day inhibited his research, and he was not particularly happy with the type of research he could do in that setting. “I would be putting patients on studies rather than designing studies or doing any actual research myself.”

Having thoroughly tested both academia and private practice, Dr. Sandor reconsidered industry. He began actively looking for an industry job and landed a position at AstraZeneca in 2002.

Over the past 25 to 30 years, things have changed in terms of how people perceive industry positions, and in terms of who wants them. “There has been a change in the type of person who goes into industry. Now it’s someone who is thinking of industry as a viable option early on, as opposed to someone like myself who went through various stages and eventually found industry an intellectually satisfying niche.”

The companies have changed as well, becoming much more selective. “It used to be thought that if you could spell ‘medicine’ you could get an industry job, but that’s absolutely not the case any longer. It’s a competitive environment, and fellows should be prepared for that,” Dr. Sandor said.

He advises fellows interested in industry to obtain research experience before launching a job search. “Being the chair of a study, doing bench work, getting familiar with research and being good at it will be critical for success both once you get the job and in terms of getting the job,” he said.

He recommends that fellows seeking industry careers also get some real-life experience: learn how a clinic works, understand the economic aspects of working in private practice and the pressures faced by academic professionals. “You’ll be working day in and [day] out with those people; if you have some experience with their work, you’ll be better able to relate to and understand their issues.”

Along with being able to show an aptitude for research, it’s important for industry oncologists to be able to fit into a corporate environment. “One of the biggest failings that physicians often have coming into industry is that they’re used to being the lone decision makers,” Dr. Sandor said, allowing that this can be a bigger problem for surgeons than for oncologists, who tend to work in multidisciplinary teams.

Within industry, there are a number of roles physicians play, from preclinical development to the strategic planning of the business (Figure).2 “There’s drug safety, medical affairs, drug development, and some people take a sideways course in the sense that they work in a commercial organization—people who get an MBA to further their career,” Dr. Sandor said. “In industry there is a lot of possibility for movement in terms of the types of roles you can take on; there’s lateral movement and movement upward within a given structure.”

Compared with entry-level academia and private practice, salaries in industry tend to be significantly higher, although possibly not as high as salaries for partner-level private practice physicians. Compensation packages tend to be similar across companies, with employees receiving a base salary, a bonus target, stock options, and a benefits package.

“In most companies, the difference in base salary changes as you move up, but the bonus target changes more depending on how the company does and your own performance within the company,” Dr. Sandor said. “If the company does poorly, you could get zero; if it does very well, you could get multiples of your target.”

Oncologists starting out in industry may want to pursue positions at larger companies rather than smaller ones, which may face greater budget restrictions and uncertainties, and place higher demands on their employees.3 “Smaller companies are generally not great training ground,” Dr. Sandor said. “But even a year or 2 at a big company gives you a solid foundation in terms of learning the ropes and understanding how things are done.”

References

     
  1. Carlson R. Choosing an oncology career—deciding between academia, industry or private practice. Oncology Times. 2005;27(16):12-13.
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  3. Brown R. Career choices in oncology. The Molecular Report 2006;1(1). http://molecularonc.com/mor/mor010161.html. Accessed December 12, 2011.
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  5. Resources for medical students. Life in industry. http://www.asco.org/ascov2/Education+&+Training/Training/Resources+for+Medical+Students?sectionTitle=Life+in+Industry&sectionId=104127. Accessed December 12, 2011.
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