Experiences of a rookie Field Based Medical Advisor (FBMA) | Guest Blog

From Pharmacology to FBMA: The Twisted Journey

A scene I come across almost every time after the exchange of basic pleasantries in a flight during a business trip!

Stranger: Hey! what do you do?

Me: I am a doctor! 

Stranger (with awe and respect): Oh great! So what do you specialize in?

Me: I am a Pharmacologist

Stranger: What is that???

Stranger (now with confusion): Do you work in a chemist shop? 

When this kind of a question comes from a person of a non-medical background, it seems very hard to explain, but fair enough. It doesn’t really hurt. But then there are days when this stranger, despite being from a similar background will stare at you as if ‘how can you call yourself a doctor? You don’t even see patients!’

So, this is my life. I completed my MD last year in the field of Pharmacology. Now it may come as a surprise to many people that I chose this subject over my available options of choosing a medical/surgical or so-called the clinical fields. But why would I ever do that? Who will ever choose pharmacology or for that matter any para-clinical or a preclinical field by choice? It is always taken up when there are no choices left!! After all, growing up, the image of a doctor has always been that of seeing patients. And I can say that now, after being in the industry, it is easy to argue a concept or an understanding or even a choice, but it Is hard to change the inherent beliefs. So, it wasn’t easy taking up a subject and telling the world, that yes I wanted to be a doctor and I even am, but I don’t want to see patients

Now the PG days, being a student, in this field are really not very interesting. I don’t know about others, but mine was mostly regular, very boring 9 to 5 college days where you read, take classes and just mind your own business. But, God was kind and I still had an awesome hostel life to look forward to, every day.

So in the hospital, when I used to accidentally bump into a batchmate, the first question used to be ‘ what are you doing in the hospital?’  And to be truthful, the only time I used to go there was while working on my thesis, doing audits, collecting ADRs or simply having coffee. All these words are not exactly what someone would call interesting, unless obviously, one understands the gravity of these small tasks, which to be very frank, as of now, still seems way too far ahead of us.  While I worked on my thesis, my clinical batch mates used to envy me. Because I was never tired, never a person dreading a 24-hour duty, never missing out on a holiday. I always had my plans ready, mapped out for the entire month.

In our department, we had the usual stuff. By usual I mean, when people don’t want to do much work, people who take this subject to have a chilled out life and like to gossip. But to give enough credit to my college, I was fortunate that we used to have plenty of seminars and journal clubs. Now when I look back and think of the way I critically appraised the journal articles, it seems very childish. But they laid the very foundation of where I never knew my life was going to start.

So, now we come to the advantage of being a pharmacologist. At the end of 3 years, when people were searching for jobs, I already had one in my hand, even before my exams. Fortunately, there are plenty of jobs available for a pharmacologist. The question is what all? Well, there is a whole spectrum of jobs that one can take (which is beyond the scope of my current topic of discussion), though most easily available and the toughest among them is that of a field-based medical advisor (FBMA). So, yes, I became one too!

Here is the beginning of a journey which is poles apart from that of a post-graduate life. Why so? because technically, the job profile of an FBMA isn’t exactly structured in our country. It sounds glorious when you enter with huge hopes in the industry and you are told that you have to handle an entire region by yourself. But simply put, you just do what is the need of the hour in your area as per the requirement of your sales colleagues or as decided by the marketing team. This can be a full range of things, from waiting outside a chamber for hours doing nothing to just getting on stage to introduce to the speakers, to being a ghost writer or just sitting and preparing slides for which you will never get the credit and then occasionally conducting small-scale meetings. This added to the fact that one doesn’t have a fixed routine and plus one has to travel to really small places sometimes, can be frustrating. It won’t be wrong when I say, that I get more emergencies than my father. Sometimes, the doctor gets a doubt suddenly just before a meeting, sometimes a slide set or an article is needed within 24 hours. Whatever be it, I have to be available, always.

These feelings will be echoed by many people in the same field. They are right too. So there came a time when I had to tell someone what this job means to me. To be very fair, this is just my perception on the take of things and anyone may agree to disagree.

It has been one and a half year since I have worked as an FBMA and  I know how much I have grown in terms of my knowledge and as a person.

When I started with my induction, I had to learn everything about the molecule and the disease in a month! This along, with the working formats of any corporate, like using outlook, was a huge challenge for a person like me. I found it next to impossible, but I tried my best. With the help of my Head office based colleagues and an excellent mentor I would say, I managed fairly well. That was the first time I realized how much I am capable of pushing myself at every stage in life. After PG entrances, this was the first time I did it again.

After my induction (which was not even a full month), I came back to handle my region. New people, new faces and with no clue what is the next step, I felt like I had been thrown into the turbulent waters without a life jacket. So here was where I started fighting my battles, which are invisible to the outside world

The simplest and the most important role of an FBMA is to conduct meetings to discuss the scientific data on the relevant subject and molecules in question in an unbiased manner. So, I was naturally very frightened and nervous during my first meeting, wondering what questions will be thrown at me. But when I finally spoke in front of the doctors, most of them actually did not bother listening. This was my first battle. To figure out how to make people listen. Trust me, I have been trying to decode the formula since then, but at least, I knew where to work on myself now. This is when I learnt and concentrated on the art of presenting. Somehow I never bothered about it in college. But here it mattered! I read many books, I learnt a lot. So when people say that why are  FBMAs only taking small meetings, I am happy to say that it is needed. It is always better to start from basics and learn along the way. So then why do clinicians get to talk at big meetings? Because they also started from stage zero! We just weren’t there to witness it.  At that point, they were new too! Today at whatever stage they are, it is either because they have their experience visible as grey hair or they have the power to influence or capture the audience. They may not be good with statistics, but they are good with science!

I can be there too! Not today, but someday! There is enough for everyone in this world.  So, I learnt that insecurity about how small your work is just a mirror image of how small your thought process is. Gradually my meetings improved and I liked them more. They are still not perfect, but I am walking down that path, every day.

Then came the most dreadful part, the field visits! Imagine being a doctor and waiting outside another doctor’s office for hours with your sales colleagues and then your batch mate passes by and gives that derogatory look that says ‘you have to sit like a medical representative! see this is the difference between a real doctor and you’.  Strangely, I am a tough nut to crack, so it never bothered me. I have spent those hours, teaching science to my colleagues and learning sales tactics from them in return. For all what we may say, the world is run by sales, which may appear harsh but it is true. I learnt how my colleagues deal with things when they go wrong with customers, when the competition grows and when targets need to be reached. I realized I was happy, not being in their place. So, I learnt humility and I felt blessed.

Inside the chambers, my experiences have been widely different. Some people have been kind and really fair and insightful, some haven’t bothered much to talk. This was the first time I learnt how many types of people there can be! I listened to their version of current scenario of the medical profession, of the fears of litigation, of the over-hyped trials by media. There again, came the feeling, I felt blessed! I didn’t want to be on the other side of the table. I got reminded of a very simple saying which I had learnt from my childhood days ‘the grass is always greener on the other side’. So, I am not a person who feels that I ever made the wrong decision.

Apart from meetings or field visits, how else do I spend my time? After all, I don’t have an office to go to every day. So I may as well sleep till late and enjoy. That’s what the world would like to believe. I can’t keep an account of how many queries I answer, how much time I spend running here and there, or how much time I spend planning my month, just to see it get devastated by some new thing that might come up. But this is what a true test is! Isn’t it?  Push yourself every day because you love the work, without the need of incentives or any acknowledgements.  Be persistent, learn to adapt, face new challenges every day and be patient when things go wrong.

One year back, the doctors didn’t know me by my name. Today, they call me directly. They want me to present. They discuss cases. It may seem like a petty thing for a third person. But I feel like I make a difference. I matter.

In a money-driven industry, where science is hard to sell, this evolutionary role of a medical advisor may just be the foundation of a changing health industry. Criticizing a role, a job or any subject is way too easy, what is tough, is having the knack to learn from what you have at every step in your life. From a ‘Field Based Medical Advisor’  to an imperative role of being the ‘Fundamental basis of Medical affairs’; You are what you believe yourself to be’ – Paulo Coelho

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impas Natesh Prabhu Administrator & Chief Editor | Clinical Pharmacologist | Diabetic-Sexual Medicine-Regenerative Therapy Consultant | President, Indian Medical Pharmacologists Association