You're Promoted!

After several years in industry as a domain expert, I was unexpectedly promoted and tasked to build a Medical Affairs department at the world’s leading IVD company from scratch. (The more experienced person hired for the job never showed up.) ?I vividly recall the moment I realized I was in a sink-or-swim situation: I had all the clinical and scientific expertise I needed, and even the support of my former boss (now a peer), but I was in over my head from a leadership perspective. The sudden immersion into multiple roles—scientific expert, regulatory reviewer, and external face of the company on important policy issues—all while trying to solve our staffing gaps, sent me spinning. Besides that, I had missed a deadline for regulatory signoffs with two of our HCPs who were impatiently waiting to begin the next phase of clinical trials. How was I going to find the time to address this before it turned into a crisis?

The time demands left me feeling very guilty about my two young boys at home with my wife, also committed to her career. I sought the support of an excellent executive coach, Dr. Alexander Schuster , who quite literally saved my life by teaching me that my expertise and experience to date was just the raw material for my future success, and this new role would be the crucible.

Are you meant to be a leader?

When you assume the leadership of a medical function (or as a team leader within a scientific function like R&D or compliance), you deal with the same creative tensions between various functions and departments discussed in the previous chapter, but now the stakes are higher because you carry the responsibility for what your team achieves (or fails to achieve). For many the shift from expert role to management is a welcome opportunity for growth, but not everyone is meant to be a leader. Opportunities and pitfalls abound. Research and development are expensive endeavors; patients’ lives are at stake. So, it’s important to ask: is this a good fit for me? One of the best ways to consider this question is to consult a coach or mentor who knows you well and can provide perspectives on your particular situation.

Regardless of what area your promotion may be in—preclinical, clinical development, education, regulatory or financial—your responsibilities will shift dramatically. Whether you run a large team or small, leading your team will now take the majority of your time, even if you are also an expert in other subjects. I have known very, very few leaders who were effective at both deep subject-matter expertise and true leadership; usually they are so ego-driven (or afraid of stepping out of their comfort zone) that they are unable to give up their expert role, and are often only seeking leadership because it’s the time-tested way to improve their income, power base and “build a career.” I have witnessed several experts who were promoted into leadership positions who had no interest in managing or developing people, and they were unmitigated disasters from a leadership perspective: subject to constant complaints from staff and HR, but so senior that letting them go was seen as unthinkable. So, consider carefully; don’t rush headlong.

There are also ways to accommodate your transition so that the new role fits you instead of you having to contort yourself to fit the role. In one of my organizations, we were able to establish parallel career development tracks which allowed experts to be promoted without requiring them to assume people leadership responsibilities, which went a long way toward addressing this problem. Conversely, we were very clear with individual contributors eager to take on management and leadership roles that they would be expected to hand over much of their expertise roles.

Expanding Your View

In your new leadership role, the skills of negotiation and influence remain critical but their impact and consequences increase. The first step is to effectively expand your view, and your communications, to take in the concerns and goals of others while still focusing on your own goals. This runs all the way from your new employees to your boss and your boss’s boss, up to the executive team. Even if you move to a leadership role within a medical function with significant budget and headcounts to execute on your vision, you will still have to negotiate with R&D, Commercial, and likely Finance to align your priorities from an overall company perspective. ?

90 Days to Deliver

New medical leaders generally have about three months to be perceived as delivering in their new role. You may not get to breakeven, but you need to show progress in repaying some of the investment your company has put into you in the form of training and offering you additional responsibility. Start by paying close attention to how you spend your first day, first week, first month, and then be sure to have successes to show by the end of your second and third months.

The first step, but not always an obvious or easy one, is to let go of your old role. That was Margaret’s problem. When she was promoted from MSL team leader to MSL Manager, she continued to rely on the main asset of her scientific expertise (oncology) and her ability to engage KOLs and train new MSLs to maintain a high standard.

What Margaret failed to do was expand her view upward to her boss’s concerns and to those above him. She didn’t inquire about broader business goals that were now part of her responsibility nor did she expand her networking efforts to include her boss’s stakeholders and the executive team to whom her boss reported. Worse, she ignored the prompts to do so, leaving it to her boss to communicate how her accomplishments were impacting the company’s financial goals. Eventually, she was seen as one of those “forever docs” who never takes her head out of a test result long enough to ask the bigger questions or consider the long-term results for other parts of the company.

Quick-start Checklist

1.??? Map out what you want to accomplish in your first 90 days. How do you understand your mission? In what ways will you align yourself with your new team, boss, and culture? Set specific goals for month one, two, and three in each area and consider how you will spend your time, both formally in meetings and informally in “casual” networking channels with groups and individuals. Be aware of culture changes. Pay attention to how new managers are viewed and how decisions are made. What is the discussion and negotiation process? Listen before you leap.

2.??? Focus on the relationship with your boss. Communication with your boss is central in your new role and you must take full responsibility for that relationship. Seek to understand her priorities, especially how she views your mission, what her definition of success is for you, and how you will negotiate to achieve that. Doing a good job at this sets you up as an example for others, and allows you to role model the expectations for your own team. Develop a clear 90-day plan, even if your boss does not demand it, and negotiate for clarity. This is your performance contract for the first crucial months in your role.

3.??? Establish rapport with your team. Evaluate the talents, performance, and individual ambitions of your team. What are their concerns, complaints, unresolved grievances? Set out clear expectations and avoid making early promises. You may not expect the same preparation and detail as you are delivering to your new boss, but set the tone as early as possible. Consider your new role an opportunity to accelerate others’ transitions to bring them to breakeven faster: remember they are also going through a change process with their new boss: you.

Especially seek to clarify the accountabilities and decision rights of team members or functional groups, and check regularly that these are adhered to. Plan to have a clear assessment of any needed changes in your team by the end of your first few months, and then execute on those plans after alignment with your boss. Poor performance is evident to other team members and your peers, and it is corrosive to team dynamics. Seek to build a high-performing team, as this will have the biggest impact on your success.

4.??? Map out stakeholder relationships and key messages. Start with your boss’s boss and her peers; then commercial, regulatory, compliance, and legal. Ask your boss(es) who else you should regularly communicate with. Be on the lookout for the informal networks of influence in your company, and if there is anyone your boss particularly respects, see if there is a way to build some visibility with them. Meanwhile, don’t forget the other internal applicants or candidates who were passed over for your new role; these may be your former peers if you have been promoted to lead a team. Address any remaining issues quickly and fairly, everyone is watching for favoritism. Keep those people busy, and if it becomes clear they are not going to accept your new role, find them other options as soon as possible.

5.??? Develop trusting relationship with external experts and influencers. Bring their insights back into the company to refine strategy. Start by mapping the existing relationships your colleagues have with leading voices in your disease area, as well as patient advocacy groups. Be sure to identify the critics and listen with curiosity to their positions. Identify your priority messages for external outreach, set a schedule and measure execution of field team initiatives. Actively socialize the insights the field team is bringing in, and show how they are driving Medical Education efforts (and therefore creating value for the company). Be clear about your digital strategy for external expert engagement.

6.??? Keep your own balance. Lastly, but most importantly, keep your own balance. This means setting aside time to review and plan, keeping the discipline to do the hard work when it needs doing, and then resting to keep up your energy. A good work ethic requires a good rest ethic. Have the self-awareness to know what recharges you and dedicate time for that. Don’t forget to schedule regular check-in times with your mentor.

?I highly recommend The First 90 Days by Michael Watkins; I have used the book many times in my own career transitions. This survival guide offers proven strategies for conquering the challenges of taking on any new role and thriving within it.

This article first appeared on the Leading Medical Affairs blog at leadingmedicalaffairs.com .