Women in Industry
Two female leaders in retina discuss how moving from the clinic to the laboratory provided alternative paths to leadership.
Some retina specialists find their calling in the clinic. Others find their calling in industry. New Retina MD sat down with a pair of industry leaders—Anne Fung, MD, of Genentech, and Namrata Saroj, OD, of Regeneron—for a conversation about transitioning professional life from the clinic to the laboratory. In keeping with the cover focus of this issue of NRMD , they discussed how gender intersects professional development in industry, offering a baseline against which to compare maturing careers in the clinic and a blueprint for young doctors considering a move to the private sector.
1. Tell us about your background prior to joining the industry side of retina.
Anne Fung, MD: After completing a residency at Stanford and a fellowship at Bascom Palmer, I joined Pacific Eye Associates in San Francisco as a medical retina specialist. During my first 10 years there, I enjoyed growing the practice and led the clinical research program. I served as site principal investigator (PI) for several multicenter trials and also as the national PI for two of my own investigator-sponsored trials (ISTs). Since residency, I have learned to navigate the clinical trials process—from writing my first institutional review board (IRB) applications, to learning about different trial designs, to analyzing data for abstract and manuscript submissions. Realizing that many residents are not offered a structured course in research or writing, I worked with the residents at the California Pacific Medical Center to design a curriculum, course book, and calendar in preparation for their annual research symposium. Working with the residents continues to be a rewarding activity.
Namrata Saroj, OD: My interest in working in eye care was established early. After completing my optometry training at the University of California, Berkeley, I moved to New York and started working at a private optometry clinic for a few months. Within a short time, I knew that, in the long-term, I did not want to limit myself only to seeing patients. So when I came across a position for clinical research manager at the LuEsther T. Mertz Retinal Research Center at Manhattan Eye, Ear, and Throat Hospital, I decided to take the leap. The head of the research department, Joan Daly, who has been an excellent mentor through the years, was looking for someone with ophthalmology experience. Even though I had no experience with clinical trials, she hired me. The department managed all clinical research led by the physicians at Vitreous Retina Macula Consultants of New York. This was my entry into the world of retina and clinical trials. Therapeutic interventions for retinal diseases were coming into play, and it was exciting to be involved in retinal research during that time.
2. How did you and the private sector first decide to join forces? Who approached whom?
Dr. Fung: I first collaborated with industry during fellowship—as a subinvestigator on phase 3 trials and on one of the first ranibizumab [Lucentis, Genentech] ISTs originated by Philip J. Rosenfeld, MD, called the PrONTO study. Shortly after completing my fellowship, I continued working with Genentech as an external investigator on phase 3 and IST studies and as a member of the ranibizumab speakers’ bureau. Over the next decade, I gained a considerable respect for the company’s commitment to rigorous science and high-caliber teams. In 2012, I happened to see a LinkedIn e-mail advertising an opening at Genentech in medical affairs. I called to find out about the position, more out of curiosity than actual interest. But after hearing about it, I was highly intrigued by the possibility of joining the medical affairs team, which defines and answers unmet clinical questions. This represented an opportunity to be infinitely curious and to have at hand the resources to answer my questions.
Dr. Saroj: During my time at the Retinal Research Center, I worked with several companies on both industry-led and investigator-initiated trials. Through these projects, I met Ram Palanki, PharmD, who was Genentech’s medical science liaison (MSL) for the Northeast at the time. He was relocating, and the company was looking for someone to take his place. I had been at the Retinal Research Center for about 5 years, and a move to industry was the next logical step. I had limited understanding of the pharmaceutical industry, and even less of what a MSL did; my exposure for the most part had been in the clinical trials arena. Once again, I decided to take the leap. It was a fantastic opportunity to start my career in industry with a company with an excellent reputation, as well as to work on a product that had the entire retina community buzzing.
3. Have you found that industry was largely a boys club? Did you find it similar to practice in that sense?
Dr. Fung: No, not at all. Genentech has many women leaders, including our chief medical officer and head of global product development, Sandra Horning, MD. Within the ophthalmology program, I work with Jill Hopkins, MD, and Almira Chabi, MD, the ophthalmology medical directors who oversee, respectively, our sustained delivery program and the development of lampalizumab, our molecule in phase 3 for geographic atrophy.
I also am fortunate that gender has not been an issue in my private practice—the male and female partners were equally supportive during maternity breaks, and the partnership track was the same for all of us.
Dr. Saroj: It is true that men dominate the retina community as well as the industry. However, my experience has taught me that one’s work and credibility supersede gender. I worked with a practice that at the time had only male physicians; they treated me as their colleague, providing me with projects and opportunities based on my skills and experience. The respect that I gained from them carried through in my industry experience. I have been lucky enough to work with excellent and accomplished women mentors and role models, who have continued success. There are plenty of successful women to demonstrate that, if one chooses and wants to become a leader in the field, opportunities are available irrespective of gender. These women continue to inspire me to think beyond inequalities and focus on what I can do as an individual, and not just as a woman.
4. What mechanisms for mitigating institutional biases did you learn in practice thattransferred to the private sector?
Dr. Fung: I haven’t thought of them as such, but upon reflection, these mitigating skills have been honed from a very young age—as is likely the case for most of us. I attended an all-girl elementary school, a coed high school, and a women’s college. Throughout all phases of my educational training, I have had the chance to learn about working with and without biases and have tested many approaches to working with challenging situations. The mechanisms that work best for me include staying honest and doing the right thing for the right reason; being comfortable with not speaking immediately, particularly if I sense that I am not prepared; believing in my resources; forming supportive alliances; and continually learning new ways to present information in a compelling manner.
Dr. Saroj: The physicians I worked with before moving to industry fostered a collegial environment that encouraged exchange of ideas. This experience helped me acquire essential skills to mitigate potential gender bias as I made the transition to industry: Have confidence; don’t be afraid to speak up, question, and provide input; and have an opinion. These skills are required not only to succeed within an organization, but also to interact with retina specialists. Being in industry, you will work primarily with male industry colleagues, and, depending on your role, you will continue working with the male-dominated retina community.
5. Have you noticed a difference in your approach to the retina industry now that you have spent time in the private sector?
Dr. Fung: I have gained a great respect and appreciation for the processes that take place behind the scenes in the private sector, payer groups, and with the government. As a physician in daily practice, my challenge was quite local—the patient in front of me, my technicians and staff, and perhaps the payers. Practice and research kept me busy enough that I did not have time to really learn about the wider health care system. I now understand and appreciate why it takes so long for medicines and devices to come to market and why seemingly simple requests from MDs take so long to implement. This being said, I continue to have a tremendous enjoyment of and respect for the practice of medicine—what a lucky place we are in to make a difference in our patients’ lives.
Dr. Saroj: The field of medicine continues to advance because of the symbiotic relationship that exists between physicians and industry. I got some perspective on how much work is required in drug development and commercialization when I was at the Retinal Research Center. However, working in industry has really deepened that understanding. The goal of industry is similar to that of retina specialists, which is to make sure patients have access to the best medications. A lot of people work behind the scenes to make sure this happens. I have much more of an appreciation for each individual who works directly or indirectly on making it possible to bring new medicines to patients. I also think that there is limited understanding on the industry side of how much work sites—investigators, coordinators and technicians—have to do for clinical trials. The burdens of patient coordination and the administrative work associated with clinical trials are often underestimated.
6. What advice would you give to a young female retina doctor interested in joining industry?
Dr. Fung: It depends on her area of interest. If she is looking to join an early development team that is discovering new mechanisms of action and designing drugs to mitigate those processes, then she should hone her skills in basic science concepts, animal models, and the basic pathophysiology of diseases.
If she is interested in joining a clinical development team to help design and execute protocols for phase 2 or phase 3 studies, then she should become an investigator on clinical trials and learn the ropes—everything from writing and managing IRB submissions; to identifying, screening, consenting, and keeping patients engaged throughout the study; to analyzing data; to writing abstracts and presenting on the podium.
If she is interested in joining a medical affairs team, then she should be highly engaged with the clinical discussions in the field she is joining so that she can be in touch with the questions most important to her colleagues and patients. Experience in conducting clinical trials is also important, as registries and phase 4 studies are often designed and run by medical affairs teams.
If she is interested in joining the commercial side of a company (strategy, marketing, etc.), then I would advise she enroll in an MBA program or find other immersion in business and operational skills. Once she masters these skills, she should make contacts with various companies and learn about the values and cultures of each; these are similar to the residency programs we trained in—some more nurturing, others more competitive.
It’s important to find the right balance for you. Most importantly, love what you do—if you do, your work will shine and there will always be opportunities.
Dr. Saroj: I think, first and foremost, someone interested in joining industry should really evaluate the reasons why she wants to make this move. Going from a practice (where one’s primary responsibility is seeing patients) to industry (where one spends a lot of time in front of the computer and in meetings) is a tremendous change. There is a degree of flexibility, but there are also periods of high intensity. It is important to determine what role you would want to play in the organization. There are lots of great opportunities for physicians in industry, but it is important to find a role that would best suit preference and experience. I would suggest talking to people across different companies to understand the different functions of their organizations and get a good understanding of roles and responsibilities.
I encourage young retina specialists to interact early and often with industry if opportunities are presented. Participating in clinical trials, relevant speaker programs, and data analyses provide a way to familiarizing oneself with different aspects of an industry role and help establish contacts—both of which are extremely helpful as one considers a move into industry.
Anne Fung, MD
• leader of the US ophthalmology medical affairs group, Genentech, South San Francisco, Calif.
Namrata Saroj, OD
• senior medical director, ophthalmology retina affairs, Regeneron, Tarrytown, N.Y.