Transitioning into clinical research: the roles of the CTA and CRC

Today I’m going to write about two roles in clinical research that offer a good opportunity to transition into a pharmaceutical career. Clinical Trial Assistants (CTAs) and Clinical Research Coordinators (CRCs) both play important roles in the management of clinical trials. Both can be a good stepping stone for other, more coveted roles, such as clinical research associate or clinical project management jobs. However, they aren’t quite the same, and understanding the distinctions will help you to understand how one of these entry-level clinical research positions can fit into a long-term career in the pharmaceutical industry.

A clinical trial assistant (sometimes also referred to as clinical trials administrators or clinical research assistants) usually work for pharmaceutical companies (trial sponsors) or contract research organizations (CROs). Their role is primarily office-based, and their responsibilities involve providing support to other members of the clinical research team. They track and file documentation (such as trial protocols and case report forms), coordinate meetings and teleconferences, and help to manage timelines and budgets. As with anyone involved in clinical trials, it is essential to understand and follow ICH-GCP guidelines.

At myjobsearch.com, Charlotte Parker, a clinical trials administrator for a pharmaceutical company, describes her job:

I love my job; every day is different. I could be raising purchase orders, scanning documents into our electronic trial master file (electronic filing system for all clinical trial documents) or creating essential documents for the hospital staff working on the clinical trials.

I also regularly attend teleconferences and study-team meetings (I am now a well-practised minute-taker), co-ordinate ethics and research and development (R&D) submissions, and prepare for site initiation visits. This involves creating all the necessary site files and study specific materials. There are always things to be doing. (. . .)

I also work closely with hospitals. Each clinical trial protocol is carried out in a hospital (we call them sites or centres), and each site is managed by a clinical research site manager (CRSM). I currently work with around 15 different CRSMs. Some manage multiple sites over the different trials.

I also work with the co-ordinator of the clinical trial at each site to ensure that the correct essential documents are signed, completed and returned. Sometimes I have to communicate directly with the investigators (doctors), research nurses and pharmacists. I also work with 12 fellow CTAs. We support each other in our workloads and take on some tasks as a group.

In some ways, Clinical Research Coordinators represent the flip side of the CTA coin. Many of a CRC’s responsibilities are similar to those of a CTA, but whereas a CTA helps to manage the sponsor side of a clinical trial, a CRC’s role is to work closely with a principal investigator – a physician who is leading the conduct of a clinical trial at a research site (which may include independent medical practices or clinics as well as academic sites affiliated with a university hospital).

The CRC is usually employed directly by the PI, and is responsible for the coordination, management, and conduct of clinical research at the site. They may be involved with preparation of IRB submissions and informed consent documents, negotiating budgets and processes with the trial sponsor and institutional representatives (e.g. hospital administration), patient recruitment, adverse event reporting, preparing the case report form (CRF) and data management – again, all under strict ICH-GCP guidelines.

This recent article in the journal Nursing provides a good overview of the CRC role:

The CRC handles a diverse range of activities, including administrative, business, medical/nursing, and patient care duties. The CRC, like the clinical nurse, needs self-confidence, flexibility, and the ability to adapt to change. To comply with regulations and policies, the CRC must also pay close attention to details.

Fostering and maintaining good relationships will aid in recruitment and retention of study subjects (patients) and create an atmosphere of professionalism. A CRC also needs good people skills for dealing with representatives of sponsor companies, medical directors, administrators, and others involved in the study.

Eric Lee is a CRC who has an interesting blog about his career transition from academia to clinical research. He recently listed his responsibilities as a CRC at a university hospital:

– collaborating with Principal Investigators regarding new research proposals
– report preparation
– research accounts financial management
– assisting in the development and review of study protocols and preparing protocols for use
– preparing Research Ethics Board (REB) and grant submissions
– acting as a liaison between the REB and Principal Investigators
– developing and maintaining case report forms, data collection forms, questionnaires, parent information handouts, consent/ assent forms and all other research related documents
– performing data collection and entry
– chart requests from Health Records
– overseeing recruitment and patient contact
– monitoring and follow-up on serious adverse events and reporting to Principal Investigator and REB
– booking and coordinating research meetings with study collaborators from other
departments
– working with Biostatistician to develop randomization tables for randomized studies
– specimen shipping (certification for shipping dangerous goods required)

Other Responsibilities:
– designing/overseeing/managing the Medical Student IGT Summer Research Program
-collaborating with the Principal Investigator to apply for medical student funding
-acting as research supervisor for summer medical students and ensuring that students have a structured research experience with measurable learning objectives
-overseeing all REB applications for students and familiarizing students with REB procedures and documentation
-ensuring all students have required Research Ethics Board On-Line Training
-coordinating meetings between students and Principal Investigators
-providing access to data analysis programs or Biostatistician

While both CRC and CTA jobs provide excellent opportunities to transition into a clinical research career, there can still be challenges. CRCs in particular are often frustrated that their experience is often not valued more highly in the search for a clinical research associate job. As Eric notes on his blog,

A CRC helps the PI coordinate a study and protects the investigator’s responsibilities and the CRA monitors it.  At one point in time most CRAs began as a CRC! They gained some experience in monitoring some trials and ended up becoming full time CRAs. The process of becoming a CRA still eludes me! When I see entry level CRA jobs, it’s almost always required that the candidate have at least 1 to 3 years of monitoring experience. I think employers have to wake up and smell the roses. If it’s an entry level job, your target audience should be CRCs – ie. experience in coordinating clinical trials. The real difference as a CRA is this: you protect the sponsor with respect to conforming to international guidelines and regulations and as a CRC, you protect the investigators while conforming to the same guidelines. I think an experienced CRC knows what monitoring is all about after they’ve been monitored for all industry sponsored studies! I honestly have not seen any posts that hire entry CRAs without prior monitoring experience. Where the heck do you get the experience in the first place? Again, if you’re already a CRC or an assistant at a pharmaceutical company, you might have the opportunity to move internally into a CRA position. If you’re external, forget about it – to me, this frustrates me and is pretty stupid!

From my experience as a headhunter, I have some appreciation of the sponsor’s point of view. A CRC typically works closely with one, or possibly a few PIs, developing a strong working relationship and in some ways helping to defend or insulate the PI from sponsor demands. They will typically only handle a limited variet of trial protocols, usually within a single therapeutic area.

In contrast, CRAs work with many sites, and while it’s important for them to develop good relationships, sometimes they have to be the “bad guy” and take sites to task if they’re not measuring up. Add to this the fact that an academic or clinic environment is very different than the “real world” of industry: there are different stakeholders, different pressures, and an almost entirely different view of priorities and timelines.  While it is undeniable that CRCs have an excellent grasp of ICH-GCP and the trial process from the clinc perspective, they will need to prove that they also understand the ‘bigger picture’.

If you do land a job as a CRC, but hope to transition to a CRA role someday, the best way to manage these objections might be to avoid getting too comfortable. Don’t stay with a single PI or therapeutic area for too long — move around if you can, and try to develop a broad perspective. By showing that you can successfully work with a diverse collection of PIs, protocols and therapeutic areas, you’ll be able to build a strong case that you can succeed in a Clinical Research Associate job.

Good luck in your search!


Posted: August 11th, 2011 | Author: | Filed under: Clinical research, Clinical Research Associates, ICH-GCP | Tags: , , , , , | 8 Comments »

Free ICH-GCP Good Clinical Practice training course back online!

Great news! I have been able to find a mirror of the free online ICH-CGP Good Clinical Practice training course developed by MIT. Please see the original post for the updated link.


Posted: March 13th, 2011 | Author: | Filed under: Education, ICH-GCP, Training | 2 Comments »

How to write a clinical research associate resume

This post will help you write a resume for clinical research jobs: entry-level clinical research associate jobs, clinical research coordinator jobs or clinical trial associate jobs would be good targets for this advice.

The hardest step to a successful career in clinical research is the first one. Getting your foot in the door takes patience, preparation, ingenuity and a toolkit of supporting materials and behaviors that will make you stand out above the competition.  A well-crafted resume can help you get your chance to shine as a clinical research associate, medical science liaison or other pharmaceutical professional.

There are a million guides out there that will give you good general advice on writing and formatting your resume, and (with one important exception) I’m not going to waste your time by duplicating that advice here. These tips are specific to the clinical research field. If you’re applying for entry-level clinical research associate jobs, the following suggestions may help your resume get noticed. Read the rest of this entry »


Posted: January 29th, 2009 | Author: | Filed under: Clinical research, Clinical Research Associates, ICH-GCP, Resumes & CVs | Tags: , , , , , | 13 Comments »

Free online training course in ICH-GCP Good Clinical Practice

[Update 2011: Unfortunately the MIT e-learning site appears to be out of service. However I have been able to find these courses hosted at a new location.  Enjoy them here.]

A thorough knowledge of good clinical practice is essential for landing a job as a clinical research associate, assistant, or coordinator.

Instead of paying a lot for an online ICH-GCP training program, you can learn what you need for free from these video seminars.  The site provides a series of lectures covering various aspects of the GCP guidelines.  It was designed to train physicians in South America and it’s affiliated with Pfizer and MIT, so you can trust what they tell you.  The only bad thing about it is that you’ll need to install RealPlayer (or the Real Alternative codec pack).

Read the rest of this entry »


Posted: January 10th, 2009 | Author: | Filed under: Clinical research, Education, ICH-GCP, Resources, Training | Tags: , , , , , , | 83 Comments »

What is a Clinical Research Associate (CRA) job all about?

Many people trying to obtain their first job in the pharmaceutical industry have a particular role in mind: the Clinical Research Associate, or CRA. These positions are seen as desirable because they typically offer relatively high salaries, a lot of independence, and are frequently home-based. In this post, I’m going to discuss the Clinical Research Associate’s role in detail: what do CRAs actually do? How does one obtain a CRA job? And what are the long-term career prospects for a new CRA?

As the name suggests, a Clinical Research Associates’s role in drug development begins at the clinical research stage, which is the point when human testing begins. CRAs may be involved with Phase I, II, III, or IV (post-marketing) clinical trials. A CRA’s main responsibility is to monitor clinical trials (and in fact some companies refer to CRAs as clinical research monitors). A CRA will travel to the clinical sites where trials are being conducted to ensure that all of the activity relating to the trial is in compliance with the protocol and ICH-GCP (Good Clinical Practice) guidelines. This may include reviewing the way patients are enrolled, to ensure that they meet the inclusion criteria; checking that clinical trial supplies are stored and dispensed appropriately; and reviewing Case Report Forms (CRFs) to ensure that they have been filled out correctly. In many ways, the CRA’s job is one of quality control, and many of the best CRAs pride themselves on having an extremely detail-oriented, “checklist mentality”. Of course, sometimes a site visit will reveal problems, and at that point the CRA must work with the staff on site to resolve outstanding issues. This can sometimes require a lot of charm and good negotiation skills!

Clinical Research Associates are frequently home-based, which is one reason that many people see this role as desirable, but this must be balanced against the fact that CRAs spend a great deal of time away from home. A CRA will typically be responsible for 5-10 different clinical sites, and will visit each one several to many times during a trial at a frequency determined by the protocol. This means that many CRAs are constantly on the road, and can expect to be away from home 60-80% of the time. Those working in urban centres may be able to drive to their sites, but regional CRAs must often fly to more distant locations. Many CRAs find the frequent travel exhausting after a few years of experience.

Historically, the major pharmaceutical companies that sponsor drug trials have been the largest employers of Clinical Research Associates, but this is beginning to change. Increasingly, these companies are outsourcing the operational aspects of the clinical trial process. Contract research organizations (CROs) such as Quintiles, Kendle, and ICON carry out trial activities on behalf of the sponsors. As a result, these days there are many more CRA jobs available with CROs than there are directly available with pharmaceutical companies. Many experienced CRAs choose to work independently, as self-employed contractors, working for a sponsor or CRO for the duration of a trial.

Working as a CRA for a Contract Research Organization can be different than working directly for a sponsor. In this position, CRAs often gain experience in many different therapeutic areas and work with many different protocols, which can be valuable for career development. However, they may also be required to monitor several different trials at the same time, which can be stressful. In contrast, CRAs working directly for sponsors sometimes complain because they are asked to monitor sites over much larger geographic areas, which can increase the amount of time they are away from their homes and families.

The Clinical Research Associate marketplace has been very competitive. Because CRAs are very much in demand, and their role is virtually identical in every company, it is easy for them to change jobs. CRAs are frequent targets of headhunters. As a result, companies have offered high salaries and excellent benefits in an attempt to buy employee loyalty. The pharmaceutical companies have typically offered higher salaries than CROs, but the shift in the marketplace towards outsourcing may be changing the dynamics of CRA compensation. Currently, a qualified CRA with less than 2 years of experience might reasonably expect to earn a base salary of about $60,000 and will see their salary potential grow quickly. It is not unusual to see CRAs with 3 years of experience earning in excess of $85,000. CRA compensation frequently also includes a company car and a competitive bonus structure. A CRA’s salary will normally max out at about $95,000. CRAs who go into business for themselves as self-employed contractors typically bill their services at $65-$100 per hour.

Many CRAs greatly enjoy their jobs and are happy to remain as clinical research monitors for their entire careers. Those who are looking for career development will typically move towards project management, becoming responsible for organizing a team of CRAs and managing operational aspects of trials. This in turn can lead towards senior roles in Clinical Operations.

To be hired as a Clinical Research Associate these days, an individual normally must have a degree in health sciences or life sciences. Many companies prefer to hire people with a Nursing background because of their familiarity with clinical settings. A very strong knowledge of ICH-GCP guidelines is essential. In terms of personality, a successful CRA must balance strong people skills with a very detail-oriented checklist mentality. It may be easier to get your foot in the door by starting as a clinical research assistant, or clinical trial associate instead. I’ll talk about this role in more detail in a future article.

Because CRA jobs are in demand, many courses and programs have appeared claiming to offer training that will help new job-seekers to obtain them. A number of colleges now offer post-graduate programs in clinical research that are respected by the industry; these frequently include co-op opportunities that give students real, on-the-job experience in clinical monitoring. In contrast, there are also many online courses and less reputable programs that will take students’ money, offer cursory training in ICH-GCP, and give graduates a certificate that is nearly worthless on the job market. One notorious company bills itself as a CRO, posts jobs online, and then steers applicants towards its expensive ‘training program’.  Unfortunately, having this company’s certificate listed on your resume is evidence of poor judgement, not good clinical training. Before spending any money on training programs, it’s important to do extensive research to ensure that you’re not getting ripped off.


Posted: October 28th, 2008 | Author: | Filed under: Clinical research, Clinical Research Associates, ICH-GCP | Tags: , , , , , , , , | 38 Comments »