Comparing remote internships, fellowships and rotations
A structured placement gives a writer the experience that employers ask for and that is hard to gain outside a job. Remote internships, fellowships and academic rotations hosted by an employer differ in what each side gives, how the entrant is supervised, what they produce and what they leave with.
Remote internships
Tele-internships with CME providers
Providers of continuing medical education (CME) tend to hire writers who have done CME work before and who understand the industry's requirements and regulations firsthand. In 2012 a recruiter reported that accomplished writers with experience in other fields of medical writing but none in CME were seeking full-time posts with CME providers, while the providers wanted to fill entry-level posts but were adamant that applicants must have CME experience. Because there are few opportunities outside a job to create the documents CME writers are most often hired to produce, writers eager to enter CME are in a bind. A CME internship with an established medical education provider can be the answer to this problem.
For a writer who wants to write CME, landing an internship can be the best thing to do for their job prospects. In many ways internships are auditions: CME providers can get to know the intern and assess their work, and this can lead to paid work. A CME internship, whether arranged through a company that specialises in CME internships or by the writer, gives real-time CME experience for the résumé and can result in a recommendation attesting to the type and quality of the CME work produced. Because CME internships are most often unpaid, placement supervisors are happy to give the intern guidance and advice in exchange for work.
Courses offered by professional organisations, online training programmes, e-books and blogs can be a source of professional development, but none of them gives the on-the-job training that might secure a foot in the door of an employer. In 2012 the tele-internship was an emerging alternative to traditional training, gaining popularity among medical writers and others seeking professional development. It offers the supervision, guidance and feedback a mentor extends, and the intern–supervisor relationship brings further benefits that can make a writer more attractive in the job market:
- Interning is typically free of charge: the intern does not pay the placement supervisor for mentoring, and the supervisor gives guidance and feedback in exchange for the intern's work.
- Internships are structured with specific tasks and milestones, clearly defined and assigned over a finite period of time.
- Placement supervisors automatically provide mentoring, which benefits the placement organisation because it ensures that the products the intern develops meet client expectations and organisational needs.
- The intern is not expected to be an expert, which lets them enjoy the learning curve.
- The supervisor can testify to the intern's performance as an "employee": the intern develops products that the placement typically hires others to write, so the internship mimics an employee–employer relationship.
A tele-intern has seven things to do for the internship to succeed:
- Choose the placement wisely: decide which type of CME provider would like to hire the intern in the future (a medical education company, medical association, hospital or academic institution), and approach several about the possibility of interning.
- Choose the supervisor wisely: the best supervisor is placed highly enough in the organisation to give a meaningful and credible endorsement but has enough time to supervise, and should be intimately familiar with the work the intern will do and have done that kind of work themselves.
- Write an agreement that sets a concrete plan of action and lists the mutual expectations of intern and supervisor, including start date, end date, hours per week, project description, days and times for regular check-ins, delivery of a written mid-internship evaluation, and the supervisor's commitment to write an endorsement.
- Make sure the assignments benefit the intern: CME writers are most often hired to write needs assessments, create content in writing and in slide sets, and develop evaluations and surveys, and these are good assignments to add to a portfolio.
- Communicate: responding quickly to the supervisor's e-mails, texts and phone calls shows responsiveness and eagerness to succeed.
- Ask questions as they arise: the intern–supervisor relationship rests on the understanding that the intern is not an expert, and it is important to ask for clarification and feedback when needed.
- Set specific times to check in: a conference call with the supervisor at least twice a week ensures a regular, timely exchange of information and shows punctuality and reliability.
A six-month internship run from home
In 2021 a six-month medical writing internship ran entirely from home, and the distance did not hinder the intern's learning or motivation. The intern was then a student on a one-year professional training course at the Catholic University of Lyon that prepares holders of a master's degree or a PhD to work in the pharmaceutical industry. He started looking for an internship in January 2021, when teleworking was strongly advised during the Covid-19 pandemic, and as the course's first student to specialise in scientific writing he had difficulty finding a company that would accept him, despite the university's extensive professional network. While watching LinkedIn for internship offers, he contacted the writer at 4Clinics who would become his mentor; she forwarded his application to the Director of Medical Writing and Regulatory Affairs and offered, if it succeeded, to train him in the profession even remotely, and after a call in English with the director the company took him on from late April.
His mentor told him at the outset that she had never mentored a trainee in medical writing; about eight years had passed since she last mentored one, in a laboratory. Information technology tools let them mimic a shared office whenever needed, so that she could answer any question orally and see whether he was struggling with a task or focused on it. She holds that communication is the key, even more at a distance. She briefed him on several types of regulatory document and held regular meetings during his quality control and writing tasks to discuss topics such as writing style, the location of source data, interpretation and the way of presenting things.
He mainly adapted international documents, such as summary protocols and informed consent forms, to French regulations. Quality control let him see documents from a different perspective, and in his view it is a great way to learn from more experienced writers. He wrote a clinical study report as training rather than for a client, and it was the most challenging part of the internship. Good organisation is paramount because such reports are long, with a lot of data and files to manage, and he had to familiarise himself with the neutral, accurate and concise style of regulatory writing. He also came to understand the importance of being a team player and of communication between team members, and he credits his progress to the support of his colleagues and to his mentor's advice, comments, corrections and working methods. She reviewed and commented on every document he wrote as an exercise, and she saw his competence grow month after month.
He became an integral part of the team before the internship ended. At its end he was offered a permanent contract.
He advises anyone hesitating over the career to take a professional training course that includes an internship, as the best way to test their motivation and gain initial experience before applying for a job. Applying directly as a junior medical writer can be tricky, because recruiters often demand a certain level of experience. Such a course is also a good way to build a professional network and add experience to a CV.
Fellowships
A fellowship such as Hamilton House's can be a comprehensive and beneficial means for a working professional to move into medical communication without a formal educational programme. From 2001 to at least 2012, Hamilton House Medical and Scientific Communications offered a fellowship to colleagues who would like to improve their medical communication skills and explore careers in medical writing. The fellowship is designed for pharmacists, but the model can be adapted to people with other backgrounds. The company's principal, a past president of AMWA, developed it from a programme of short internships for senior pharmacy students, honing that design into a fellowship template that she continues to perfect. In her view, experience gives a newcomer the competitive advantage that can help launch a new career, and a fellowship can offer that experience.
The model centres on a one-year contract, which is negotiable, and a commitment to AMWA's standards for excellence and best practices in medical communication, and its key features are:
- A contract that defines the fee schedule for medical communication projects and a weekly face-to-face meeting timeline for evaluation, feedback and planning.
- An expectation that the fellow will develop their own goals and objectives for the year and that mutual goals and objectives will be set between the fellow and Hamilton House.
- Deliverables from the fellow that include a series of three progressively complex projects, including manuscript preparation, as well as opportunities to assist with Hamilton House's projects.
- Substantial oversight from the principal, including rigorous editing and feedback.
- A requirement to become a member of AMWA, seek AMWA's Essential Skills certificate, and take part in other educational and networking opportunities.
- On completion, a letter of recommendation for the fellow's portfolio that describes the educational and experiential components of the programme.
A community pharmacy manager who had begun coursework for an AMWA certificate learned of the fellowship as she became more involved with the association, and applied for it as a career-building opportunity. After almost two years as the programme's third fellow, she named as one advantage the chance to work on a variety of topics without being committed to a specific drug or therapeutic area; her projects ranged from chronic pain management to work with people in Australia on the prevalence of ghostwriting in the medical literature. She also collaborated on a poster presentation at the 2012 AMWA conference, and she reports improvement in her oral, written, medical evaluation, editing, data review and literature-searching skills. Of the personalised learning plan she developed with the principal, she advises: "You get what you put in, so be proactive and take the initiative whenever you can." Her advice to a new medical communicator is to stand out and be proactive: a person must take the initiative to get the fellowship, the experience or the business.
In 2012 medical communication fellowships were few and far between and the Hamilton House programme allowed for only one fellow, so its principal suggested that prospective medical writers and editors approach other medical communication professionals and organisations with the idea of using her template to customise their own fellowship programmes. To encourage a mentor to take part, she recommended making the proposal attractive, for example by volunteering to do the first project at no charge in return for feedback.
Pharmacy rotations at an employer
In the fourth year of all doctor of pharmacy (PharmD) programmes, students receive academic credit for a series of five-week full-time rotations at pharmacy practice sites. In 2008 the University of Michigan College of Pharmacy approved Arbor Communications, a medical communications agency in Ann Arbor, as a practice site, and its rotation fulfils the requirement that every fourth-year PharmD student complete a drug information rotation. After Pfizer's research and development site in Ann Arbor closed in 2007, there were few local pharmaceutical industry opportunities for pharmacy students interested in exploring a nontraditional career, and the agency's director of medical writing volunteered as preceptor to offer current students the opportunity her own preceptor had offered her, a five-week rotation at a medical communications agency.
The agency hosts four students per academic year and had hosted 17 by 2012. The director is officially the preceptor, but the entire staff contributes to each student's experience. Each student works as an entry-level medical writer within the agency's medical writing staff, and the rotation runs as follows:
- In the first week, a series of orientation meetings with the medical writers and with editorial support staff, including copyeditors, graphic designers, editorial project managers and editorial assistants.
- By the second week, actual client projects, which may include developing promotional slide decks or drafting publications such as abstracts, posters and manuscripts.
- During weeks 2 to 4, a journal club project presented to the department's 14 medical writers, and a "lunch and learn" project in which the student researches a topic, develops a slide deck and delivers a 40-minute scientific presentation by web meeting to the entire company.
- Students may also assist with research for business development opportunities and answer drug information questions submitted by staff.
- In the fifth and final week, the student completes any remaining assignments and delivers the lunch and learn presentation on the last day.
The preceptor tailors each rotation to the student's interests and career plans: some students are headed to clinical pharmacy practice, some to retail pharmacy, and a few to the pharmaceutical industry or other nontraditional careers. She was initially hesitant to take the role because of the time it takes: about 20 hours of her own time per five-week rotation, as well as time spent by colleagues in other departments. The agency offsets that time by having each student bill the actual hours spent on client work. In her experience the students have been bright, capable and fast learners, and typically efficient and productive team members, and their contributions to project work and business development benefit the agency's bottom line. Of the 17 students, four have pursued medical affairs careers within the pharmaceutical industry.
One PharmD candidate whose first fourth-year rotation was at the agency arrived apprehensive about what the profession entailed. The variety of projects she worked on during the five weeks, from slide decks and poster presentations to abstracts and manuscripts, taught her that medical writing is multifaceted and ever-changing. One of her projects was to research continuing education programmes in medical writing. She found the rotation challenging and enjoyable, and she took more satisfaction than she had expected from completing a project. Unlike in her rotations in a hospital or clinic setting, she felt that her voice as a medical writer was being heard by her health care peers.