Choosing an internship and learning from it
An internship is a few months of on-the-job training that gives an entrant work experience and a trial of a field. Internships differ in what they are called, what they pay, how long they last, the training and projects they offer and what they lead to, and an intern learns from the first months of work and from feedback on early work.
Origins of the internship
The term intern comes from the French interne, meaning "assistant doctor", and was supposedly coined during the First World War for someone who had a medical degree but no licence to practise medicine. The intern trained hands-on in medicine under the supervision of a licensed practitioner and eventually became a fully trained, qualified physician. The same qualification pathway exists in many countries today, as doctors go from internship to residency before obtaining a full attending position.
By some accounts, internships trace their roots to the European apprenticeship system of the Middle Ages. In the 1630s apprenticeship meant "to bind to a master for instruction in his craft". Under that system, children as young as 11 started vocational training under a master craftsman, learned the trade by shadowing the master, and should have been fully qualified after about seven years. The apprenticeship system is still practised in Europe, for a shorter period, under strict regulation by labour and education authorities.
One writer, by her own account no historian, thinks internships or apprenticeships go back further still, to the scribes of ancient Egypt. These highly trained professionals were sent to a special school at an early age to learn to read and write hieroglyphs under a master scribe, and after many years of training they took on a highly specialised profession in a predominantly illiterate society. It was always thought that only boys qualified to become scribes, but there are records of female scribes who had to achieve literacy to practise as priests or as physicians. Even in ancient Egypt, doctors, male or female, had to be able to read medical documents.
What the training is called and what it is for
The term internship now covers all forms of professional career that require a high level of qualification. Internship, apprenticeship, traineeship, volunteership, placement and job shadowing are used interchangeably for on-the-job training programmes that last a few months, and the distinctions between them are not very clearly defined and vary from company to company and from country to country. Whatever the term, such training has two main purposes: to get a leg up, by gaining work experience that can pave the way to an entry-level position, and to test-drive, the intern trying out a field when unsure of the career path to take and the company checking the job fit before making a job offer.
Value for a medical communications career
In 2016 medical communications was a rapidly growing industry in which competition for experienced recruits was often fierce, yet getting a foot in the door can be very difficult for those without formal medical writing experience. So for an applicant wishing to start a career in medical communications, prior experience can strengthen the CV and give an invaluable insight into the day-to-day life of a medical writer. Where the applicant has no previous employment in medical writing, a well-structured internship should also let them sharpen their writing and editorial skills while learning more about the healthcare industry in general, ultimately increasing their chances of finding a suitable job in medical communications.
Pay and work experience
In the old European system, apprentices lived with their masters and in many cases worked for their board and keep. Pay for internships now varies a lot, between paid and unpaid internships, and the rules governing compensation depend on the company and on the country's labour legislation. In the UK the government provides guidance on the matter for both interns and institutions.
Work experience generally means a period a person spends in a company, business or institution outside the classroom, and whatever the compensation, an intern is assumed to learn something about working life in general and about specific aspects of a profession, so it is appropriate for an intern to list an internship on a CV as work experience. Internships, especially unpaid ones, do not necessarily qualify as employment, so they may not be listed under employment history.
A medical communications agency's programme
One medical communications agency's scientific internship programme, launched in 2012, offered positions to graduates and postgraduates from a range of disciplines to gain experience in the industry. Its primary goal was to let people interested in healthcare and with a passion for writing make a more informed decision about whether the industry could give them a fulfilling and rewarding career.
The duration of internships may vary greatly from company to company. In 2016 that agency usually offered three months: an intensive two-week induction and training period followed by about ten weeks of project work contributing to a range of ongoing client deliverables. Subject to an internal review, interns could choose to extend their contracts for up to six months, which gave a greater opportunity to take on more project responsibility and potentially to experience work across other divisions. Participants were typically based in one division with an assigned line manager but could gain experience across a variety of project types, including medical writing, evidence development, medical affairs and market access.
The agency defined a set of core objectives to make the experience as rewarding as possible for the intern:
- to experience a variety of projects reflective of a permanent position
- to see at least one project through from start to finish
- to gain an insight into project management
- to gain experience of communication with clients
Beyond these objectives, individual intern programmes were managed flexibly and relatively informally, so that the intern and their manager could match project work with the intern's own interests as new opportunities arose, and client work could be delivered rapidly when needed.
A regulatory writing internship at a pharmaceutical company
An advertisement for a regulatory writing internship at a big pharmaceutical company, seen in 2017, offered candidates with a scientific background at undergraduate or recently graduated level exposure to a key role within clinical drug development. The intern would support experienced associates, working with several of them on a variety of projects to get as broad an experience as possible, with opportunities to interact with colleagues in other countries and to shadow members of the team. Along with providing project management support, writing parts of documents and liaising with key team members, the intern would start to develop transferable skills including effective communication and negotiation, time management, problem solving and matrix team working, with training and one-to-one coaching provided. The required qualifications and skills were good written English, developed interpersonal skills, a positive work ethic, and a life science, physical science or clinical background.
Asking a company for an internship
An internship can be asked for as well as applied for. In the summer of 2020, during the first wave of the COVID-19 pandemic, one Bachelor of Science graduate, who had never had an advertised job since her first at 13, applied for roles she was qualified for on paper and received rejection after rejection. Reading between the lines, she realised she might not have the same experience level as other applicants. Given the choice between continuing her education to a full master's degree and potentially a PhD, or gaining relevant experience, she chose experience, as further study was not that enticing to her, and reached out to the managing director of a company asking for an internship. After a short email exchange and a brief phone conversation he offered her a three-month internship, which turned into a full-time position as a junior writer.
Other graduates had asked him before, but her communication, her desire to be given an opportunity and her well-written CV stood out. The phone call was a general conversation rather than a formal interview, which he does not hold, and it made clear that she had the personality and character to fit his growing team. He believes courage, confidence and tenacity are key in life and business, found them in her in abundance, and, with the company entering a busy period, gave her the internship. His own first boss had taken a chance on him as a brash 24-year-old, so it was natural for him to do the same for someone of a similar age, raw talent and character. He does not believe a PhD makes for a better writer; he got as far as an MSc and quit his PhD a couple of months in because he realised it was not for him.
The graduate advises anyone considering a career in medical writing to reach out to companies for an internship to gain an insight into what the industry really involves. The managing director advises new graduates looking for an opportunity in medical writing to do the same, to gain some actual industry experience.
The first months
The managing director, whose own first project as a trainee medical writer was a phase III clinical study report, believes newcomers need a combination of treading softly and a baptism by fire to show whether they have the character and raw talent to handle what the professional world will throw at them, so he threw the graduate into the deep end. By his account, with no medical writing experience she surpassed expectations, delivering at a level one or two years above her experience, so the team felt confident letting her work on live projects with a senior writer shadowing her work. He found her fearless, with a healthy appetite for learning and the ability to take critical feedback on the chin. The company worked entirely from home, which she did not find that daunting: she had already adapted to working from home in her final semester at university and found that it suited her working style.
Within her first month she learned more about the industry than she had expected to learn in all three months. She realised why she had been unsuccessful in so many interviews: not only her lack of experience but also not knowing what the job entailed, because it is hard to sell oneself for a job one knows nothing about. She learned that medical writing needs an impeccable eye for detail and the ability to jump between projects seamlessly as well as the ability to write, and although she had always felt she had a natural ability for writing, she became aware of how challenging she found the whole writing process. She also learned the importance of managing time and the skill of assessing a brief to give an accurate estimate of the time it needs. Her first estimate, a time frame she felt was generous, was a day and a half off in the wrong direction, and she had to ask for an extension, a reminder that as a newcomer she would take longer over tasks than more experienced writers.
A newcomer may be surprised which avenues they enjoy. The graduate had been convinced from her research that her interests lay in medical communications, and although she enjoyed the variety of its projects, she found she also thoroughly enjoyed working on regulatory documents, which to her shows that a job is only truly understood once begun.
Feedback on early work
Criticism and corrections are part of the profession, and at times they require a thick skin. Red lines are a staple of the industry, received even by senior and principal medical writers, and a writer must develop a thick skin to cope with the profession's ups and downs. Some of the graduate's early work came back with what felt like a never-ending list of comments and tracked changes, leaving her feeling as if not a single sentence was useful. Her team went through her work with a fine-toothed comb and followed up with calls to discuss the reasoning behind the changes, and she credits that investment for her rapid progress and says a structured approach of mentoring, training, working and feedback has really helped her. Not putting too much pressure on herself to be perfect the first time let her fully embrace the feedback she was given. Had she begun in a larger writing team she could easily have felt like a fish out of water, not knowing what to do or whom to turn to for advice, whereas a small but supportive team gave her the confidence to ask questions however trivial they seemed.
After the internship
A successful period of on-the-job training and development of a core set of medical writing skills may result in the offer of a permanent position with the host company or elsewhere. The agency's programme had hosted 54 interns by 2016, its fifth consecutive year: 3 in 2012, 12 in 2013, 17 in 2014, 11 in 2015 and 11 in 2016. Of its alumni, 23% had become permanent employees at the agency, 29% had gone on to further study and 48% had gone into other employment. The programme also supported the company's long-term growth strategy, with many interns transitioning into permanent positions at the end of their internship.
As an internship comes to an end, the host company may offer the intern advice on alternative opportunities within medical communications or the wider pharmaceutical industry, and its human resources team and intern managers can provide employment references and application advice. For an intern who has enjoyed the internship, applying for a permanent role with the host company may be an attractive option, and at that agency promising interns who had demonstrated skills and commitment throughout their internship were offered support in applying for a permanent position.