Version 2Nicholas Chow, PharmD, BCOP, was a Translational Clinical Oncology- Clinical Operations Post-Doctoral Fellow with MCPHS University and Novartis from 2014-2016. Check out his nontraditional path into the industry. It is an interesting read!

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“I’ll never work for a pharmaceutical company.”

A statement from my overly confident, naïve, 1st year pharmacy student self.   So, what led me to “The Dark Side” – as it is often pejoratively referred to by those on the outside, and by my former self? And where did I end up?  What made me decide industry vs. a clinical path?

I am, by nature, led by a strong curiosity and I easily wander towards the unique and complex, down non-traditional paths.

Caveat: I already had a full-time job in a clinical setting, as a Clinical Coordinator for the Investigational Drug Service.  In that role, I was evaluating and operationalizing clinical trials at my hospital- primarily in oncology phase 2 and 3 studies.  Oncology practice is driven by research, but the level of evidence needed was often sacrificed for the urgency of novel therapies to be available to those where standard of care was failing.  As such, the pivotal trials were no longer robust, multi-arm, Phase 3 studies with sample sizes in the thousands.  Rather, the hunger for new antineoplastic was creating market entry based in early phase 1 and 2 data, and surrogate efficacy outcomes.

On behalf of my patients and fellow clinicians, I felt insecure about how to evaluate the quality of early phase trials. I also was concerned whether or not there was sufficient data to show that the benefits of these new drugs outweighed the potential risks (physical and financial).  With this gap in mind, I applied to the Translational Clinical Oncology, Clinical Operations fellowship in Early Clinical Development at the Novartis Institutes for BioMedical Research (NIBR).

You can probably consider me to be the most UNPREPARED fellow in terms of expectations.  I had no industry experience from my alma mater (University of Florida) and didn’t know that you were supposed to attend the “social” at Midyear as part of the interview process.  I also didn’t know the amount of time fellows would eventually interact with one another, and the experience level of the average fellow.  But, I did humbly become a fellow, and soon recognized how different I was from the typical fellow.

At NIBR (pronounced ‘nibber’), you are embedded in the hub of nerds.  I felt right at home – across the street from MIT and a T-stop away from Harvard.  Here you are working on the R&D side of Industry, where the bench-top scientists are involved in discovery and novel targets.  As part of this institution, the need for quick application to a clinical setting requires an adept team that can operationalize a clinical trial on a multi-site, multinational level; this team is clinical operations.  This team is nimble and must adapt very quickly to issues with clinical supplies, early toxicity signals, market competition and clinical practice changes.  They are responsible for writing protocols and collaborating with multiple line functions (pharmacologists, PK scientists, biostatisticians, medical leads, regulatory manager, data managers, labs, vendors and clinical supplies) in order to be able to bring a clinical trial to reality.  It’s an amazing feat, to say the least, and I cannot say enough about the impressive teamwork and interpersonal skills of my mentors.  I quickly learned that I had to excel at operations: project management, meeting coordination, scientific writing, vendor management and supplies forecasting.

My reward for enduring 2 years of pay-cuts, freezing winters and distance from my partner, family and 4 dogs – are the unquantifiable and priceless friendships with my co-fellows who have made me a better person.  Although I had more experience in clinical practice, my co-fellows were extraordinary in their tacit abilities.  I thank Martin for teaching me fraternity, Angela for quiet confidence, Theresa for calm, LeeAnne for excellence, Jude for humility, and Jen for sisu.

Post-fellowship, I followed a non-traditional path into academia, where I was an Assistant Professor for a couple years.  I’m currently the Clinical Pharmacy Supervisor of Clinical Trials at the Miami Cancer Institute of Baptist Health South Florida where I’m building my own team of talented pharmacists and technicians to support an Investigational Drug Service.  I didn’t leave industry at a closed door; but, the post-fellowship career decision making process would be enough material for a second blog.

I also dedicate this piece to the brilliant “Novartians” whose leadership impressed me on a regular basis (Ping, Lisa, Heather, Melissa, Mary Ellen, Alyssa, Marc, Ken and Keith) and who supported my naïve jump into industry (Saero, Tami, Kinjal, Joanne, Stephanie, Helen, Jennifer and Christine).

I now know first-hand that there are excellent, pharmacists and non-clinicians engaged in bringing the newest of treatments to our patients. Although the industry is driven by business need, industry pharmacists can still practice with a patient-focus, and there’s nothing “dark” about that.

Tip for new fellows:  Enjoy your time with your co-fellows.

Tip for students interested in fellowship:  Never say never.  There’s no cookie cutter or secret to being the perfect fellow candidate; so, don’t let your fear of not being that candidate stop you.

Tip for life: The majority of your life challenges will not be about managing difficult tasks; it will be about managing people.

Warm regards,

Nicholas Chow, PharmD, BCOP

Clinical Pharmacy Supervisor, Clinical Trials

Miami Cancer Institute

Baptist Health South Florida

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