6 myths about being a CRA

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As a Clinical Research Associate, I am frequently being asked a wide range of questions about my life, including topics such as travel, money, and lifestyle and just about everything else. Therefore, I've decided to address some of the most common beliefs - or, to be more precise, myths - about being a CRA. I hope this article provides you with some valuable insights and clears up any confusion you may have had!

The CRAs get to travel to fancy places

Let's start with the obvious - CRAs travel a lot. As I mentioned in my previous articles, most companies require around 8 days on site per month (not including travel to and from sites, which should also be considered depending on the distance or your mean of transportation).

However, as a CRA, especially at the beginning of your career, it's rare to have the opportunity to select your own site locations or even choose sites from a list. Most likely, you'll be assigned somewhere in Bulgaria, and chances are it ain’t gonna be glamorous.

Site locations depend on study indications and where the best PIs that you will be working with are. When I started monitoring, my first sites were in Sofia (the capital), Plovdiv, Ruse, and Kozloduy. I had a normal amount of visits per month, nothing excessive, but it still required a lot of travel. Considering that I'm a very active person with a routine for workouts, a strict eating regime (or at least it used to be strict, as I was trying to and eventually did lose 13 kg), and a dog, I had to adapt to incorporate my lifestyle with the responsibilities of being a CRA and spending a lot of time on the road. I had to figure out where I could eat healthily, work out, walk my dog, or meet friends while away from home.

As your career progresses, you may gain some flexibility depending on your location preferences and, of course, your employer.

In 2019, I frequently visited Kozloduy, a very remote small town. At some point, I began spending at least one to two full weeks per month there, so I started bringing my dog with me. Here, he actively helps me monitor patient questionnaires.

During our morning walk in the city, Ari and I visited an important historical landmark: the Radetzky ship. It is now permanently located on the Danube riverbank near Kozloduy. Walk for Ari, 8 km run for me 😰 Bonus points if you manage to outrun the mosquitoes!

With that being said, I absolutely love traveling and exploring new cities. I have always managed to combine my lifestyle and activities with my job. I have seen some awesome, even if not-so-fancy places, such as the sunset over the Danube on the Ruse riverbank, the old town in Plovdiv, and even the winter in the Vrachanski Balkan. All of these places have their own charm, but they certainly do not qualify as your typical “glam destination”.

I love the sunset over the Danube River in Ruse. This city holds a special place in my heart, because I used to spend my summer vacations there as a kid, with my grandparents.

If you're wondering, this is what an awesome visibility day looks like in the mountains near Montana and Petrohan. If you're assigned to sites in this area, I'd recommend investing in some high-quality winter tires to make sure you're prepared for anything!

The CRAs make a lot of money

Well, this is not a myth! 😜 LOL, just kidding.

To be fair, I realize that this is a very sensitive topic, and I even contemplated whether I should include it at all. But the reality is that everyone works for money, no matter how much they love their job, and I am no exception. CRAs do make enough to live a very good, even privileged life (by Bulgarian or worldwide standards), and I would be lying if I said that this didn't influence my decision to choose this career path. As a clinical research associate, you can expect a highly competitive salary ranging from 70k to 120k annually, depending on your level of degree, experience, the company you work for, and the number of site visits per month.

Many companies also offer yearly and performance-based bonuses, as well as car and meal allowances, full health insurance, Mulisport, and team building activities. Some larger CROs also offer a sign-in bonus.

Taking all of this into consideration, being a clinical research associate is a very sweet job. However, you cannot expect to retire in your 30s and take a sabbatical. You will earn enough to have a comfortable and worry-free life, and you will be able to provide for yourself and your family as long as you work and have a savings plan. But do not expect to live a millionaire lifestyle, buy a private jet, or live in a mansion on the French Riviera.

The CRAs have the luxury of making their own schedule

Compared to other positions in clinical research or other jobs in general, CRAs have a more flexible schedule. With proper planning and time management, you can arrange your schedule to fit your needs while still complying with the monitoring plan for your studies, site requirements, and upcoming DMCs.

However, keep in mind that with freedom comes responsibilities as well. You may have arranged your schedule for the month or the next three months, but you could receive a Sponsor request for an emergency visit, re-SDV, additional review of safety data, or some sort of integration between EDC and the central lab, SAE, or audit notifications. These requests may not fit neatly into your schedule, but you will be expected to promptly react and perform the required visits or tasks, regardless of how many hours it will take.

Nevertheless, in my opinion, this is a fair price to pay considering that, for the most part, you have the freedom to work remotely and manage your activities to suit your schedule. Also, I have some excellent podcast recommendations for long drives across the country. 😜

CRAs only perform administrative tasks

Surprisingly, it's a common myth that portrays CRAs as individuals who only perform administrative tasks, such as filing paperwork, coordinating meetings, and reviewing documentation. However, my friends, this doesn't come close to describing what we do (it's called the CRA wizard for a reason 🧙‍♂️).

CRAs are highly skilled professionals who play a crucial role in managing and monitoring clinical trials. We're responsible for ensuring that clinical trials are conducted in compliance with relevant regulations, protocols, and standard operating procedures (SOPs), monitoring patient safety, and collecting accurate data. We must stay up-to-date with ever-changing information on a yearly, monthly, or even weekly basis. We're the first point of contact for our investigators, project managers, project assistants, vendors, and sometimes even the hospital's accountant or lawyer. Our skill set includes everything from managing clinical trials and critical thinking to working well under pressure, coming up with fast solutions, and working extensive hours while still looking presentable at the job.

I have jumped fences (literally) to deliver site lab supply kits. On one occasion recently, while in the process, I almost received a parking ticket while hanging from the fence in question. I had to explain to the police that I am a respected expert in my field and that I was just doing my job.

I have physically moved such amount of OSFs, that I could probably qualify for heavy lifting competition.

I have driven through mountains and rivers (again, literally), through storms day and night, and through remote and off-road areas (long live the Tucson) to reach clinical sites or hotels in the middle of nowhere. Once, I saw a llama (which is definitely not a typical animal you see every day in Bulgaria) tied to the front door of a hotel where I was staying.

Once, I had the opportunity to witness a TURBT procedure (if you're curious, you can google it) being performed on a patient from the front row, right behind the PI's shoulder. Fortunately, the patient was not one of the subjects in my study. Despite my initial apprehension, the procedure turned out to be quite fascinating.

CRAs don't have a significant role in patient care

I'd like to address another myth about Clinical Research Associates: that we are not involved in patient care. However, as I mentioned earlier, CRAs are responsible for monitoring the safety and well-being of patients enrolled in clinical trials.

I often hear people say things like, "Yeah, but you're not actually involved in the research itself," or "The Pharma industry is evil anyway, you're working for the bad guys," or "You guys don't even care about the patients, it's all about profit." But let me be clear: CRAs ensure that patients are receiving appropriate medical care, review medical records and charts, and assess adverse events or side effects related to the investigational drug or device being studied. CRAs play a critical role in safeguarding the health, rights, and welfare of patients participating in clinical trials.

We CRAs get extremely excited when a drug that we have worked on for a long time receives approval, or when an investigator shares results showing that a patient has no sign of tumour progression or recurrence, or whenever someone's life is changed for the better. These things make all the paperwork and monitoring tasks worth the time invested. And it feels great to be a part of all of it!

CRAs are not required to have a strong scientific background

One of the biggest misconceptions about Clinical Research Associates is that they do not require a strong scientific background. Actually, I am often being asked “Why did you study pharmacy if you were going to work as a CRA anyways? I know people with degree in arts, who are doing it!”

However, in reality, CRAs are typically required to have a solid scientific foundation and understanding of clinical research principles, regulations, and guidelines.

Usually CRAs are required to have background in medicine, nursing, pharmacy, life sciences, or other related fields. Moreover, we often undergo extensive training and certification programs to develop our expertise.

While it is not impossible to enter the industry with a degree in finance or psychology and then gain some medical knowledge on the job it will certainly be more challenging. The majority of people working in the industry do have a medical degree - this includes your colleagues, hiring managers and the primary investigators (PIs) at the clinical sites. Therefore, having some sort of medical background will give you a better reputation and frankly, will make your job a lot easier.

In addition, being a CRA requires a degree of medical and pharmaceutical knowledge. You will need to participate in medical discussions with investigators, monitor a lot of safety data (including adverse events and patients' treatment), and have a basic understanding of each therapeutic area you're working in. In my opinion, considering all of the factors, a medical background is a must for the position. Remember, a CRA is not an entry-level position.

It's important to recognize that CRAs play a critical role in the conduct of clinical trials and contribute significantly to the advancement of medical knowledge and patient care. My ambition is, that dispelling these myths can help provide a more accurate understanding of the important work that CRAs do in the field of clinical research.

And speaking of misconceptions, have you heard any about clinical research associates or site investigators? I'd love to hear from you in the comments or via message.

Peace out! ✌️