In the complex world of clinical development, companies face a persistent hiring dilemma: should they bring in a specialty physician straight from academia or an industry-experienced generalist? As therapies evolve and disease states become more nuanced, the need for both specialist and generalist physicians in clinical development is evident. However, deciding which type of physician to hire can significantly impact a company’s long-term success. 

Increasingly, companies are opting for board-eligible physicians to fill specialized roles. For instance, hiring an endocrinologist for a metabolic drug development program offers a competitive advantage with deep, specialized knowledge. However, while this approach provides unparalleled expertise in niche therapeutic areas, it may also raise some key concerns. These concerns include the adaptability of the physician to a fast-paced industry environment, their willingness to thrive in a collaborative setting after coming from an independent academic or private practice, and whether the company can afford to compete with the high salaries offered in private practice. Additionally, companies need to evaluate whether their pipeline can support the long-term retention of a specialist, especially in the event of a failed project. 

Specialist vs. Generalist: success stories and industry experiences 

When deciding between a specialist and a generalist, it’s important to weigh both their potential impact and the risks they pose.  

Camilla Fedi, our Senior Consultant in Medical and Clinical Development, commented: 

“In the past, generalists were more in demand across the industry. However, in my recent experience, more placements in clinical development are trending towards specialist physicians. CROs, like pharma and biotech companies, have also embraced this trend. These candidates often appeal to CROs because they mirror the highly specialized models that sponsors tend to follow, and they bring the niche expertise required due to the increasing complexity of clinical studies. Despite this shift, it’s crucial to remember that generalist physicians remain a viable alternative. Generalists with extensive industry experience offer a different set of advantages. They bring broad therapeutic knowledge, adaptability, and a continuous learning mindset—qualities that make them well-suited to roles that require flexibility across multiple projects or therapeutic areas.

One of the key points I want to emphasize is that although specialists might seem like the more refined option, generalists can contribute immense value, particularly in drug development environments that demand versatility and a broad perspective.” 

Risks of hiring specialty physicians in Clinical Development 

Hiring specialty physicians for niche roles, particularly in clinical development, comes with its share of challenges. Firstly, there is the issue of higher salaries. Specialists often command top-tier compensation, which may not be feasible for every organization. Moreover, specialists tend to have deep knowledge in only one therapeutic area. If a company needs to pivot or has multiple projects in areas outside the specialist’s expertise, they may not be as effective as a generalist. 

Specialists also face challenges in adapting to the clinical trial process. Generalists, by virtue of working across different therapeutic areas, quickly acquire knowledge in various fields and often become adept at managing the complexities of clinical trials. Specialists, on the other hand, might not have the same level of trial management expertise. Additionally, specialists may be less coachable or manageable, especially if they have spent years operating with a level of autonomy in private practice or academia. There’s a risk that they might feel more self-entitled, which can make integration into a team-oriented environment more difficult. 

The future of Clinical Development: Specialists on the rise 

Looking ahead, the demand for specialists is likely to increase over the next five to ten years. The complexity of new therapies, such as gene and cell therapy, and the increasing prevalence of rare diseases will drive this shift. Companies developing treatments for these conditions often prioritize hiring physicians who are experts in a particular disease state, even if they are less experienced in clinical trials. This focus on disease-specific expertise is becoming more prominent, particularly in fields like oncology, neurology, and rare diseases, where in-depth knowledge is critical to advancing therapies. 

Generalists will likely continue to play an important role in early-phase clinical development, where the process can be more manageable, and the need for specialized expertise is not as pronounced. Specialists, meanwhile, are expected to dominate in late-phase trials, where the stakes are higher, and the need for disease-specific knowledge becomes crucial. 

Financial and operational considerations: Specialists vs. Generalists 

When deciding between a specialist and a generalist, financial and operational considerations are key. Specialists typically come with a higher price tag, not only in terms of salary but also in terms of long-term retention. If a clinical asset fails, a company may struggle to retain a specialist whose expertise is no longer needed. 

In contrast, generalists can often be repurposed for other projects, providing greater flexibility and cost-effectiveness. Generalists are also more versatile when it comes to managing multiple assets across different therapeutic areas. This adaptability can be particularly valuable for smaller companies or those with pipelines that span several therapeutic fields. Specialists, on the other hand, are more likely to focus solely on one asset, making them less flexible in terms of workload and potentially increasing the risk of turnover if that asset fails. 

Practical advice for hiring teams 

For hiring teams tasked with deciding whether to hire a generalist or a specialist, a few key considerations can help guide the decision: 

Management skills: generalists vs. specialists 

Finally, there is a distinct difference in how generalists and specialists approach management. Generalists, accustomed to working across various therapeutic areas, often develop a more collaborative management style, working effectively with cross-functional teams. Specialists, however, may be more accustomed to working independently and may need more guidance and coaching to adapt to the collaborative nature of clinical development teams. 

In conclusion, while there is no universal solution to the specialist vs. generalist debate, the decision ultimately depends on a company’s unique needs, the complexity of the research, and pipeline. Both generalists and specialists bring unique strengths, and leveraging a mix of these talents can greatly benefit the clinical development landscape. 

Hiring managers must carefully consider whether the complexity of the research calls for a generalist or a specialist. If the decision leans towards hiring specialists, managing expectations around timelines and compensation becomes essential. Furthermore, partnering with specialized recruiters can streamline the process of sourcing top-tier specialist talent, ensuring the right fit, at the right time, for the organization’s needs.