For the interest of all you future doctors, I am writing about my experiences in the world of pharmaceutical sales. I am presently a mature medical student in London and have just completed my first year. Before returning to the same university from which I had obtained my degree two years earlier, I was a medical representative. I worked in central London, my territory stretching out to include all the hospitals, pharmacies, and surgeries from Harley Street to Enfield—no small distance, particularly when looking at the concentration of such establishments in that area.

Degree level education …
I initially graduated with a BSc in human sciences, which encompassed immunology, biochemistry, and genetics. Afterwards I applied for a job as a medical representative. I did, and still do, believe that this job can save overworked doctors precious time by keeping them up to date with the latest developments in the pharmaceutical industry, by word of mouth. In order even to be considered for such a job, applicants had to have a degree at a grade no lower than a 2.1. After being subjected to numerous gruelling interviews, overnight visits to assessment centres, and further final interrogations at head offices, all over the country, I was finally offered a job by Pfizer.

… followed by in depth training …
The initial training course for this particular company included being sent to a hotel for no fewer than 10 consecutive weeks. All 100 new recruits were resident here, and the lectures and seminars started at 8.30 am every day. The first week was spent concentrating on the pharmaceutical industry in general—teaching us about the business and giving us various talks on self motivation and stress management. Little did we realise just how valuable this advice would become once we were out on the road. We were also divided into tutorial groups in order to concentrate in depth on each of the three specific products we would be representing.

For each product the first task was to gain a fairly detailed knowledge of the scientific basis behind the medical area involved. Next we had to study extensively every competitive drug within the same treatment area, including each one’s side effects, price, dosage, and contraindications. The final few sessions would be spent learning about the product’s niche within the market, rounded off with some role playing in order to master the art of selling, while abiding by the strict code of conduct set out by the Association of British Pharmaceutical Industries.

… and a tough final exam …
Having lived with our work colleagues for two and a half months in the austere hotel environment, we were relieved to reach the last week of the course. Looming ahead, however, was the all important end of course exam. It consisted of three separate sections on each product area, including detailed questions on physiology, pharmacology, knowledge of doses, side effects, cost, etc—and, of course, knowledge of these aspects for every possible competitor product.

The pass mark was no less than 80%. If this was not attained first try, we had one more chance before our position within the company was brought into question. Happily, most recruits worked very hard and passed with flying colours, and we were able to journey back home in celebratory mood. Work began in earnest the following Monday morning.

… and an even tougher working environment
The driving was continuous and lonely, and getting lost was upsetting and tiresome. These were minor inconveniences, however, compared with the unpleasant treatment received on actually coming face to face with doctors. Any courtesy and respect for the fact that we were intelligent human beings and had often waited for hours to be seen were sorely lacking. The doctors were rude, belligerent, corrupt, and sarcastic. Our qualifications mattered not one whit. The gifts we brought were seized greedily, and copious demands made for further material goods. On occasion doctors would even stoop to rifle through our bags themselves, in order to find more goodies. Our humbleness in their presence served merely to inflate their gross egos still further, and if their surgery had been busy then we served as excellent verbal punch bags before they went for their lunch. Bargaining and bartering skills were far more important to most doctors than knowing details about the quality of the products we represented. Meals out were a popular trading tool that included propositions of little dinners for “just the two of us”—with or without a meaningful wink—for us female reps.

Many doctors seemed to think that what they had been taught at medical school decades before was far superior to the information coming straight out of the research laboratories and data from clinical trials. Our knowledge, although it was admittedly only focused on three areas of treatment, had to be accurate, detailed, and kept constantly up to date. Yet we were met with laughter and scorn and were ruthlessly belittled and taunted. Once sufficient degradation had been endured at one practice we would then have to drive to the next establishment and do our utmost to get to see another of these vile creatures. The knowledge that the very same ordeal awaited us did nothing to build our motivation.

A happy ending?
On reading this you may think that I am one of those presumptuous, pushy sales reps who consequently deserved such treatment. After a couple of months on the road I was actually diagnosed with clinical depression, hardly having the esteem to speak out aloud, let alone be pushy and arrogant. My regional manager was both supportive and easy to talk to, expressing concern at my misery, and the company’s friendliness, sympathy, and understanding were of great value to me and helped me to get where I am now.

This is in no way meant to reflect badly on the pharmaceutical company for whom I worked, nor on every doctor in London. If one could take the heat and enjoy the numerous perks offered by most good companies, the job could be fantastically flexible and offer many opportunities. I realised, however, that what I wanted to get out of my career would be better met by means of a proper medical course, enabling me to sit “on the other side of the desk,” utilising my people skills, experience, and scientific interest through something that is challenging, interesting, and fulfilling.

In conclusion, I beg all you doctors out there to sympathise with those numerous medical reps who will soon be clamouring at your door. They are all highly qualified and have far more to offer than free meals and pens. Not all medical representatives are pushy and arrogant, and one thing is for certain—whether they like it or not, their company will have instilled into them the importance of respecting doctors at all times. Do not abuse the position of power this places you in.