Whether to specialise, and along which line
Specialisation can focus a medical-writing practice on a subject, audience, service, document or client sector. Depth can reduce the learning needed for each assignment and make expertise recognisable, while breadth offers variety and more possible clients. Advice differs on whether a niche is essential and when a writer should choose one.
The scope of a specialism
A niche can be a document type, such as clinical study reports or manuscripts, an indication, or a service such as translation. It can also be an audience, client type, writing style or skill, and can evolve over time. Workshops in a specific indication or service can themselves be a niche and a source of income.
Three decisions distinguish the role, subject and document type.
- Whether to write, edit or take responsibility for every aspect of a project.
- Whether to specialise in one disease or work across several.
- Whether to undertake one kind of writing, such as regulatory writing, or several, such as continuing medical education, sales training, patient education, journal supplements and medical advisory boards.
Personal preferences matter: one writing company managed two or three large projects involving hired writers, editors, photographers, typesetters and printers, then decided that it preferred writing to coordinating the whole production. The same company worked across many disease areas, with no ophthalmology experience simply because no client had requested it, and preferred varied project types for their fit with the partners’ personalities and contribution to a diversified client base.
Before applying for work, beginners should consider the lifestyle and deliverables they want, including whether to freelance, write or edit, and pursue medical communications or regulatory writing. These decisions help target roles that offer greater job and personal satisfaction and easier progression.
Whether and when to narrow the practice
Advice differs on whether success requires a niche: one experienced freelancer regards it as optional, while a freelance coach recommends starting with a niche, or at most two or three, because a memorable specialism helps referrals and getting established. A stronger view holds that niching by output or therapy area is the only way to establish a freelance practice. The coach’s approach distinguishes audience, deliverable and therapeutic area, usually recommending one or two of these dimensions, with three considered a lot. Writing for healthcare professionals in respirology combines two dimensions; some breadth within a dimension is acceptable, but a handful of unrelated offerings can obscure the focus.
Starting broadly can help a new freelancer attract clients and discover which work suits them before narrowing with experience. It can reveal preferred writing styles, clients and sectors that fit personal values and the desired life, while building broad knowledge, skills and flexibility. A niche can then be refined from existing skills, talents, interests, enjoyable assignments and deliverables that already generate revenue; it needs focus rather than extreme narrowness.
One medical-marketing writer began with disease descriptions, newsletter and magazine stories, web content and reports for consumers, patients, physicians and varied clients. Enjoyment of consumer and patient writing led to targeting hospitals and disease associations, while continuing to cover many therapeutic areas. Another writer initially edited, wrote, researched and synthesised white papers, reports, needs assessments, slide decks, monographs, manuscripts and book chapters for public-health nonprofits, biotech startups, continuing-education providers, academics and individual clients. That writer’s niches later included white papers and education-outcomes manuscripts, medical specialty societies, and qualitative evaluation of continuing-education programmes.
Depth and variety
Deep knowledge in one therapeutic area can be more useful than superficial knowledge in many. A broad understanding of a medical area can open different career paths: in oncology, opportunities identified in 2012 included trial reports, professional education, journalism, patient web information, lifestyle campaigns and government communication about publicly funded treatment.
A highly specialised domain can support varied services. One translator-writer combined writing, editing, translation, training and multilingual project management, with most work grounded in medicine, particularly oncology and haematology. Focusing on one subject can make the learning curve less steep, allow learning to transfer between similar projects and simplify marketing to a single segment; it can also tie income to that segment, reduce sales opportunities, make the customer base harder to expand and become repetitive.
Varied medical-communications work can require rapid changes of subject under tight deadlines—for example, a competitive antihypertensive brochure, a phase III oncology manuscript and a narrative review for a rheumatoid-arthritis monograph arriving in a cluttered sequence. Working on a suite of documents or one area over time allows knowledge to deepen, whereas frequent changes between disease areas make continuing development harder to accommodate. Keeping up with one specialised area is easier than monitoring many, but remains challenging and requires substantial subject competence and command of its vocabulary; the narrower knowledge base may also restrict work opportunities. The continuing task is to balance the number of accepted projects with competence in their medical areas through sustained professional development.
Different practices retain different kinds of variety. One former researcher narrowed to immunology and oncology, preferring continuing education while retaining publications and grants, after finding that too many unfamiliar subjects were exhausting and prevented deeper expertise. Another found that oncology-focused employment restricted wider therapeutic experience, whereas freelancing enabled more diverse projects and kept client options open. A third preferred a niche in project and client types while keeping therapeutic areas and deliverables varied to avoid boredom. Focusing training on a niche can build authority, help address an ideal client directly and supply value that supports continuing work. Medical writers need both depth and breadth, and a freelance niche can help establish expert standing by therapeutic area, deliverable or client type.
Benefits and costs
Specialisation can bring the following benefits.
- Deep knowledge of the specialty.
- Ability to anticipate trends and discuss them intelligently when pitching.
- Strong contacts.
- Frequent recommendations from colleagues and clients who know the specialism.
It can also bring the following disadvantages.
- Difficulty expanding beyond the existing specialty.
- Fewer opportunities for diversification.
- A perception that the writer does only one thing.
- Heavy competition for limited projects.
- A steep learning curve for a new therapeutic area or kind of writing.
Six further advantages concern the operation of a freelance business.
- Clients seeking specialists expect them to identify what matters in a study, put it in context and summarise it concisely.
- Established clients may offer repeat work and opportunities to extend into another service.
- Subject knowledge and familiarity with terminology, audiences and deliverables can build credibility, demand and referrals.
- Specialisation may improve revenue through higher compensation and less research and preparation; evidence for higher compensation is limited and largely anecdotal.
- A clear niche makes prospect targeting and marketing more consistent.
- Selectivity about clients, projects and experiences can conserve cognitive energy and support work that fits personal priorities.
A niche can exclude appealing clients and assignments, lead to boring repetition, reach a rate ceiling, allow skills to stagnate and make a change of direction difficult; market demand can shift or the niche become obsolete. Generalism also has costs: unfamiliar projects and clients can trigger anxiety and prolonged research, while spreading effort across subjects and formats can bring frustration, inconsistent revenue and cognitive overload. Taking every appealing project can eventually leave a writer scattered and exhausted.
Specialisation by industry or client
An industry specialism can remain broad in subject and format. A pharmaceutical and biotechnology employee who became freelance worked across medical communications, sales training, continuing education, regulatory affairs, marketing communications, patient education and public relations, in many media and therapeutic areas. The advantages of that industry knowledge included the following.
- Familiarity with drug discovery and development from laboratory through clinical work to marketing, promotion and sales.
- Knowledge of US and international industry regulation.
- Understanding of phase I–IV study design and conduct, and FDA reporting and submission requirements.
- Understanding of relationships between regulatory affairs, clinical research, medical affairs, marketing and sales, including where to find resources.
- Ability to take projects from different company departments.
- Connections across many companies.
The costs included becoming too general and repeatedly learning unfamiliar subjects, audiences and media. After the 2008 downturn, that practice expanded into grants, residency personal statements, graduate theses, hospital websites, managed-care and nonprofit policies, textbook editing and nonprofit consulting; despite that flexibility, a narrower focus on one or two diseases or one medium remained an appealing possibility.
A different practice specialised in pharmaceutical companies and their agencies, mainly continuing education for physicians, nurses and pharmacists and domestic and international sales-training modules. Keeping abreast of regulatory changes enabled the writer to help new product managers navigate product requirements and contribute specialist value. Mergers and acquisitions could remove contacts or transfer work to the acquiring company’s staff, although one client relationship continued through five companies. By 2016, that writer doubted whether newcomers could prosper by following the same path, despite supporting specialisation. Strengths, abilities and interests need to be considered alongside market demand; active association membership and education can reveal different career routes.