by Rochelle Aguilera, CPC | Principal Medical Affairs Recruiter
When we talk about career growth, we tend to picture a ladder. You start in one role, perform well, earn a promotion, and eventually move into management. In many professions, becoming a manager is viewed as the natural sign that someone has “made it” to the next level.
But does that model really fit Medical Science Liaisons?
After years of talking with MSLs at nearly every stage of their careers, I’ve noticed how often career growth is treated as synonymous with management, assuming everyone eventually wants to manage a team.
Many MSLs simply don’t.
That doesn’t mean they lack ambition. Some of the most accomplished MSLs I encounter are highly motivated to keep learning, take on more responsibility, and increase their impact. They just don’t necessarily want that growth to come through direct people management.
One reason is that management can take MSLs away from the very things that drew them to the profession in the first place. The focus shifts toward coaching, performance, hiring, and the many internal responsibilities that come with leading a team. There’s often less time for the science and less opportunity to personally build and maintain the KOL relationships many MSLs find most rewarding.
For someone who loves sitting across from a thought leader for a meaningful scientific exchange, staying close to emerging data, attending congresses, and building long-term relationships within the medical community, becoming a manager may not feel like moving forward. In some ways, it can feel like moving away from what they love most about the role.
Fortunately, both MSLs and the companies employing them are beginning to recognize that there’s more than one way to build a successful career in Field Medical Affairs.
Some MSLs move into management or transition into Medical Director, strategy, training, or operations roles. Others advance as individual contributors to the Senior, Principal, or Executive MSL level. And some discover that they genuinely love being an MSL and want to spend the rest of their careers doing it.
That last option deserves more attention than it sometimes receives.
What If Being an MSL Is the Career Goal?
There was a time when staying in the same general type of position for many years could be perceived as a lack of progression. I think that mindset is changing, particularly within Medical Affairs.
Being an MSL isn’t necessarily a stepping stone to something else. For many people, it’s the career they worked extremely hard to obtain in the first place.
Think about what attracts people to the role. MSLs get to remain close to the science while building relationships with leading experts in their therapeutic areas. They have autonomy, are constantly learning, support research and clinical development, gather insights from the field, and serve as a scientific bridge between their organizations and the medical community.
For many MSLs, that’s an incredibly fulfilling career.
Experienced MSLs also understand something that can be difficult to appreciate early in a career: no two MSL jobs are exactly alike. The title may be the same, but the actual role can look dramatically different from one organization to another.
At a large pharmaceutical company, an MSL may have a highly defined territory and clearly established responsibilities within the Medical Affairs structure. At a smaller or mid-sized biotech company, that same MSL might have the opportunity to wear many more hats.
They may become heavily involved in a launch, help shape field strategy, participate in advisory boards, support clinical trial sites, contribute to investigator-sponsored research, work closely with Medical Directors, help develop processes, mentor newer MSLs, participate in congress planning, or take ownership of national projects.
For some MSLs, moving to a smaller or mid-sized organization where they can have broader exposure and greater influence can feel as much like career advancement as receiving a new title.
That changes the career question. Instead of asking, “What position comes after MSL?” it may be more useful to ask, “What kind of MSL career do I want to build?”
Management Is ONE Path, Not THE Path
There are certainly MSLs who want to become managers. And for them, Field Medical leadership can be an exciting and rewarding progression.
But being an excellent MSL doesn’t automatically mean someone will enjoy being a manager.
The two roles require different skill sets and involve very different day-to-day responsibilities. Some people thrive on coaching and developing others and ultimately want responsibility for an entire team. Others would rather continue building their scientific expertise and working directly with KOLs. Both are valid career paths.
There should be room for both.
For MSLs who want more strategic involvement without traditional people management, roles such as Medical Director and Scientific Director can provide another option. Depending on the company, these positions may work closely with MSL teams while taking on more responsibility for medical strategy, scientific priorities, congresses, advisory boards, insights, data dissemination, or cross-functional initiatives.
In those roles, an MSL may help shape strategy and support the field team without directly managing individual performance. For MSLs who want more strategic influence but not people management, that can be an appealing middle ground.
Unfortunately, this is also where another major career consideration often enters the picture: location.
The Relocation Problem Is Real
For many experienced MSLs, the biggest barrier to moving into broader Medical Affairs roles isn’t qualifications, readiness, or ambition. It’s relocation.
I hear this often in conversations about career progression. An MSL may have spent years developing scientific expertise and demonstrating leadership within an organization. They are ready for something broader, only to discover that many Medical Director, Scientific Director, strategy, or headquarters-based opportunities require a move.
Early in a career, relocating for the right opportunity might be relatively easy. But ten or fifteen years later? It can be a very different decision.
People have spouses or partners with careers. Children are established in schools. They may have aging parents nearby. They own homes and have built communities and support systems. At that point, relocating for a promotion isn’t just a career decision. It can mean asking an entire family to change its life.
MSLs are also somewhat unique because being field-based is built into the profession. Someone can spend a decade successfully advancing within Field Medical Affairs while living hundreds or even thousands of miles from corporate headquarters. They may have deliberately chosen the MSL career because it allows them to build a meaningful career while remaining in the region they call home.
Then, suddenly, the next rung on the traditional career ladder requires moving to headquarters. Many experienced MSLs look at that tradeoff and decide it simply isn’t worth uprooting the life they’ve built.
That doesn’t make them less committed to their careers. Sometimes it just means their definition of career success has evolved.
Companies should pay attention to this.
If an organization has an experienced, high-performing MSL who understands the science, culture, KOL landscape, field organization, and internal processes, does that person truly need to relocate to contribute at a more strategic level?
For some roles, the answer may legitimately be yes. Certain roles benefit tremendously from being in-house and closely connected to leadership and cross-functional teams. But it shouldn’t automatically be the default for every strategic opportunity.
Medical Affairs organizations already operate across regions and time zones. Field teams routinely collaborate virtually with Medical Directors, Clinical Development, HEOR, Market Access, Commercial, and other internal partners. We’ve learned that sitting near headquarters and having an impact on the organization are not the same thing.
Companies that create more flexible career paths may have a real advantage when it comes to retaining experienced MSL talent. Remote strategic positions, hybrid arrangements with regular headquarters travel, national field-based roles, and senior individual-contributor positions can allow people to grow without forcing them to uproot their lives.
Sometimes the best person for the next role may already be sitting inside the organization. They just may not be sitting in the right zip code.
Sometimes Moving “Up” Means Finding a Role Where You Can Do More
Another shift I see among experienced MSLs is that many become less focused on chasing titles and more interested in the substance of the opportunity.
A Senior MSL at one company may have considerably less strategic responsibility than an MSL at another. A Principal MSL title may sound like the obvious next step, but an MSL role at a growing biotech could offer far more exposure to leadership, launches, clinical trials, pipeline development, advisory boards, and cross-functional strategy.
Company size can make a tremendous difference.
Large pharmaceutical organizations can provide resources, structure, established processes, and clearly defined career paths. But smaller and mid-sized companies can offer something different: visibility and breadth.
When the MSL team is smaller, every person matters. An MSL may have more access to senior Medical Affairs leadership, and more opportunity to contribute beyond a traditional territory, help build processes that don’t yet exist, or take ownership of national projects.
Some MSLs find that kind of visibility and variety energizing, especially after years in a highly structured organization. It can expose them to areas of Medical Affairs they might otherwise never experience and allow them to stretch professionally without leaving the field role they enjoy.
That’s career growth, too. Sometimes moving “up” means moving somewhere you can do more.
Rethinking What It Means to Level Up
Maybe we need to stop viewing Medical Affairs careers as ladders and start viewing them as a collection of possible paths.
One MSL may eventually become a National Director or Vice President of Field Medical Affairs. Another may move into a Medical Director or Scientific Director role and become deeply involved in strategy. Another may become a Principal or Executive MSL who mentors colleagues and leads broader initiatives while remaining in the field.
And another may spend twenty years as an MSL, moving between companies, therapeutic areas, launches, pipelines, and increasingly complex opportunities. None of those careers is inherently more successful than another.
What matters is whether the person is still learning, contributing, challenging themselves, and doing work that feels worthwhile.
For MSLs considering their next move, career planning may be less about asking, “How do I get promoted?” and more about asking, “What do I want more of?”
Maybe it’s more science, more strategy, a new therapeutic area, a launch, or the opportunity to mentor others. Maybe it’s a smaller company where the role has more breadth, or a larger one with more resources. And for some, it may simply be the opportunity to keep doing the work they love at a higher level.
Those answers will look different for everyone.
Leveling up doesn’t always mean becoming the boss. Sometimes it means finding the version of the MSL role that allows you to make the greatest contribution while continuing to do the work that drew you to Medical Affairs in the first place.