April 30, 2023
“The expansions of your expertise and your external network are two key fundamental things that one should be focusing on as you think about developing your career towards a CMO pathway.” Dr. Christopher Morabito, Astria Therapeutics.
Welcome to this week’s Emerging Biotech Leader recap. In our previous Episodes, we touched on the topic of careers and what to know about the role of Medical Affairs. In doing so, we uncovered two key trends relevant to career progression within that function: working collaboratively/cross-functionally and utilizing your network.
As it turns out, these two themes are also the basis for a thriving career as a Chief Medical Officer (CMO), a position that has continued to see increased demand. If you’ve been examining what’s next for you as a clinician, or you’re new to the CMO role, this episode will review what it takes to be a CMO, how you can make the transition from clinical practice to being a CMO, and—true to our show’s description–the pitfalls you should avoid along the way.
Kim and Ramin are joined by Dr. Christopher Morabito, Chief Medical Officer of Astria Therapeutics. Chris’s background provides the perfect foundation to truly understand what CMO involvement is like, be it across Big Pharma or in an emerging biotech. As is often the case on our show, when we bring these industry perspectives together, you’ll hear that CMO responsibilities and functions will vary depending on the size, scope, and stage of a biotech company.
In this episode, Kim, Ramin, and Chris also dig into:
Listen along and enjoy the actionable takeaways that our hosts and Chris provide.
Chris was junior faculty in neonatology at UCSF, before becoming the Chief of Neonatology at Lehigh Valley Health Network, where he worked for about 5 and a half years. Here’s how he went from these two roles to working at Merck.
“I practiced neonatology. During my fellowship training, I spent a lot of time at the bench looking at cardiovascular development, which was very fulfilling. However, I realized quickly that it takes a lot of grant writing time to be successful, and I didn't have that kind of patience.
“So, I decided to focus on clinical practice instead, and I went off to lead a group of neonatologists in a neonatology facility in Pennsylvania. And I did that for a number of years.
“During that time, I had some amazing, fulfilling events and activities in my professional life and my personal life. Everything was great. But something was missing, and it took me a few years to figure out what that was. It turned out, I believe, now, in retrospect, that it was this desire to do more for larger populations of patients.”
Once that lightbulb went off, Chris got further clarity on “doing something more for the community, broadly defined,” so he started to look at roles on the industry side. He was VP of Medical first for a few years for a medical communications and strategy company, then went on to work for Merck as clinical monitor (clinical research physician) working on early and late stage development of cardiovascular disease.
Chris is one to practice what he teaches, it took him 12 years and a few diff hats to land a CMO title. Prior to that, he also held the positions of Sanofi and Takeda as a global program lead, head of Portfolio Strategy, head of R&D Integration after a major acquisition, then Head, Research and Development, Plasma Derived Therapies reinforcing the value of working cross-functionally.
As clear cut as Chris’s pivot story from the hospital to industry to CMO sounds to us all, Kim did surface that there can be a stigma around making a transition from working 1-on-1 with patients to moving into Big Pharma and biotech, aka “the dark side.”
Chris and Ramin agreed that a preconceived notion does exist; however, Chris believes that this perspective is unfair. What is fair to say, from Chris’s observations, is that the transition isn’t always easy. As part of the cross-functional work required to become a CMO, you undergo a total shift in leadership style, contribution, and identity. In clinical practice, doctors call the shots, but those are not the dynamics of being a CMO.
In his own words: “You have to prepare for it. There is a shift where you are no longer the lead, sharing the orders. You do become a team player where your weight is equal.”
There are CMOs for biotechs. And then, there are CMOs for IPOs. Ramin wanted to understand just how vast and varied a CMO’s roles and responsibilities can be.
What Chris offered in response was a level-set to define what a CMO does regardless of company size: “The CMO is the role that's responsible for linking the target profile of a drug, or drugs, to the medical community with medical community defined as health care providers (those who treat patients) and patients and their caregivers combined.”
Listen for specifics on how the CMO is truly a “link” and steward of the clinical strategy. Chris also elaborates further on the distinction between working at a Big Pharma company vs. working at a biotech with a thought-provoking question from Kim on the mindset shift that’s required.
In the here and now as well as the future, the CMO role will continue to be externally facing. Prompted by Ramin’s inquiry on what to share with aspiring CMOs, Chris reflects on just how important having a network is.
“As you go through your career, as hard as it is, maintain relationships. They don't have to be people that you talk with on a regular basis, but you should at least know them, connect on LinkedIn with them, call them, text them every once in a while, maintain a personal relationship….develop a virtual Rolodex so that when you do need somebody who has special specialty expertise in pediatric investigational plans for a rare disease, you could pick up the phone literally and call that person and say, ‘Listen, can we tap into your expertise for this? Or who do you know that we could tap into for this expertise?’”
Kim also points out that this “network effect” isn’t just specific to CMOs. CEOs, Medical Affairs, whomever it may be, “there’s a very common theme that you can't really do it yourself.”
Listen to Episode 11, Leading and Succeeding, What it Takes To Build A Biotech.
Also, just because the CMO role is externally facing doesn’t mean introverts should shy away from it. Chris himself identifies as an introvert, which totally surprised Kim….but may provide reassurance if you can relate.
Much like learning to be more of a team player, Chris provides encouragement that you can also learn how to lean into the external nature of the CMO role through exposure, preparation, and experience. It’s also key to remember you will have to deliver both good news and bad news.
Here’s how Chris builds himself up to take this on, especially when the CMO role requires communication across multiple stakeholders: investors, the FDA, the clinical community, and so forth.
“I honestly do a lot of prep work when I do these kinds of sessions. I take notes. I reread my notes before these meetings. I have a little bit of a meditation session beforehand. Maybe some of you know the power pose. I do all those things. And then, I get to it.”
Rounding out the variety of stakeholders a CMO may interact with, Ramin shares an article from McKinsey as a resource for our listeners: “Is Your CMO’s Role Evolving Fast Enough?” The long and short of it is: one of the chapters covers reporting structure and how it varies from org to org. Ramin has seen companies that have the CMO report to the president of R&D, while others report directly to the CEO.
Chris shares more about what he believes works while providing real stories on some of the pitfalls he has seen, too. To pick up all of this insight, and Kim’s complimentary thoughts on why post-mortems are so key, listen to the full interview.
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