Clinical Research Associate (CRA) – A Growing Career Path in Biotechnology / Pharmaceutical Industry

A clinical research associate (CRA) is a professional who oversees all aspects of clinical trial conduct. They oversee clinical trials to test drugs/medical devices/biologics/or in vitro diagnostics for their effectiveness, risks and benefits to ensure they are safe to allow on to the market. CRAs are also known as clinical trial monitor or clinical monitor. A CRA may be involved in some or all stages of the clinical trial depending on the type of position and the employer a CRA work for.

Type of CRA

In-House CRAs

CRAs who work for a sponsor company are called in-house CRAs. An in-house CRA may be overseeing all aspect of clinical trial conduct, from planning to clinical study report (CSR) generation for submission to regulatory bodies. Below are some job functions of an in-house CRA.

· Designs study documents such as, study designs, synopsis, site specific protocols, informed consent forms, case report forms, site study procedure manuals and project tools, monitoring plans, and tracking tools, clinical study reports, budget and contract negotiation.

· Performs independent monitoring of sites including: conducting site pre-qualification, initiation, monitoring visits, and close-out visits.

· Maintain frequent contact with and work effectively with investigators and coordinators.

· Coordinate with the ethics committee, which safeguards the rights, safety and wellbeing of all trial subjects.

· Review and resolve discrepancies in clinical data with clinical sites or through a contract research organization (CRO).

· Low amount of travel may be required (e.g. up to 25-30%).

Regional CRAs / Home-Based CRAs

CRAs who work independently from home are called regional CRAs or home-based CRAs. Regional or home-based usually don’t handle planning and preparation of clinical trials. They generally handle the monitoring function and oversee trial conduct. Thus, they can work from home and they usually travel quite a bit more than their in-house CRA colleagues.

· Performs independent monitoring of sites including: conducting site pre-qualification, initiation, monitoring visits, and close-out visits.

· Maintain frequent contact with and work effectively with investigators and coordinators.

· Coordinate with the ethics committee, which safeguards the rights, safety and wellbeing of all trial subjects.

· Review and resolve discrepancies in clinical data with clinical sites.

· High amount of travel may be required (e.g. up to 75-80%).

CRAs Who Work For a CRO

CRAs who work for a contract research organization (CRO) can be either in-house CRA or monitoring CRA. They usually work out of a CRO’s office. As the goal of the CRO is to provide full range clinical trial services to sponsor companies, CRAs who work for a CRO may be called upon to perform in-house or monitoring functions depending on the project and client’s needs. One note to mention is that CRO is sensitive to the economic cycles. When the economy is good, CROs may hire a lot of CRAs to meet the higher numbers of clinical trial demands. When the economy is bad, CROs may turn around and lay off CRAs as work demand reduces. In addition, CRAs who work for a CRO are expected to work hard. They may be assigned to oversee multiple studies with high number of sites (>10 sites). That being said, a CRA position at a CRO is usually a good way for a new CRA to gain experience. Another benefit in working at a CRO is getting exposure to a variety of therapeutic areas that may enhance a CRA’s credential and career progression.

Education and Skills Needed


Although there are no exact rules, general educational requirements for a CRA role is typically a bachelor of science (BS) or a bachelor of art (BA) degree in life sciences, medical sciences, or healthcare related field such as nursing. Advanced degree is not required, but can be helpful for career progression.


CRAs perform variety of functions relating to clinical trial. As different functions require different skill sets, below are some skills that can be helpful in a CRA’s job performance:

· Excellent communication skills (both written and oral). This is important as CRAs work with clinical trial sites (Principal Investigator and staff), regulatory review boards, key opinion leaders (KOLs), and colleagues.

· Ability to motivate and train others. This goes along with the communication skills. CRAs will need to train and monitor the progress of clinical trial conduct at different clinical sites.

· Attention to details. CRAs will need to be able to see mistakes and identify incorrect trial data / results. The work also involves documentation and recording of information. Detail oriented skills is critical to the monitoring work to ensure that clinical trial results are recorded appropriately and are accurate based on source data on medical records.

· Problem solving skills. Unexpected events and issues often will come up throughout different phases of clinical trial. CRAs are the main contact for all the issues that may come up. Thus, CRAs should maintain flexibility and positive approach toward unexpected issues.

· Multi-tasking, time management, and organizational skills. Multi-tasking skills are essential as CRAs are often handle different tasks at the same time. Time management skills are the key to effective work schedule arrangement in order to avoid overload. Organizational skills will help CRAs when working with stringent record keeping and regulatory requirements from regulatory bodies that regulate clinical trials.

· Ability to travel. Although travel can vary depending on the type of position, CRAs are expected to travel to clinical sites as needed. Ability to handle travel both domestically and internationally is one of the skills needed for CRAs.

· Knowledge of good clinical practice (GCP) and FDA Code of Federal Regulations (21 CFR 11, 50, 56, 312, 812, 45 CFR 46). These are some of the documents that govern clinical trial conduct. Familiarity with these documents is essential. If you are new to the industry, they can be learned.

How to Get Into a CRA Role

It’s not impossible to get into a CRA role straight out of college. Some sponsors and contract research organizations (CROs) may recruit recent graduates with the necessary traits and skills. However, most employers will require some relevant prior experience for a CRA role.


Similar to many other career fields, experience is the key to obtaining a CRA position. My own career path started with a bachelor of science in engineering. I worked in an academic research lab for 6 years after college before switching to a clinical research coordinator (CRC) role at a hospital for 3 years. From there, I transitioned into a clinical research associate (CRA) role at a sponsor company, an in vitro diagnostic device manufacturer, for 3.5 years. I then progressed into my current position overseeing clinical trial management at a non-profit drug company. Switching job had helped me gain experience and pushed me to develop new skills. In addition, every new position was an increase in responsibilities, job title, and compensation.

What if you don’t have prior experience?

This question came up when I switched my career path from working in an academic research lab to working in clinical research. It also came up again and again as I changed jobs into roles with greater responsibilities. The key to conquer new career path without prior experience are:

· Build on prior applicable skills and knowledge

· Willingness to work hard and start somewhere

These two factors were the reason that helped me transitioned into a clinical research coordinator (CRC) position in an emergency room setting at a hospital. I had applicable skills in science and research when I was in academic lab. The other factor was that I was willing to work at night and on the weekend. In addition, I had to push myself beyond my comfort zone. I was recruiting pediatric patients into clinical trials in emergency setting. Imagine yourself as a parent who brought a really sick child into an emergency room late at night, participating in clinical trial is probably not the first thing on your mind. This pushed me to work hard to succeed. I used the same approach to advance my career into a CRA role and into my current role as a manager.

Different pathways toward a CRA role

Similar to my career path, those without experience can get into clinical research at a lower level. These starting positions may be directly or indirectly applicable to clinical research industry. Once experience has been gained, a clinical research associate (CRA) position can be pursued using the applicable skills and knowledge acquired.

Directly applicable starting positions may include:

· Clinical research coordinator (CRC) role at a clinical site

· Clinical trials associate (CTA) role at a sponsor company

· Nursing role with patient care experience.

Indirectly applicable starting positions may include:

· Pharmacy or medical sales

· Clinical laboratory work

· Clinical data work

· Academic or pharmaceutical research

Clinical Research Training

Although experience is the key toward a CRA position, there are training programs that are offered through colleges and universities as well as online training courses that can help increase the chance for a candidate who looks to get into clinical research. These may include postgraduate degree and certificates in clinical research. The cost and time investment for these training programs should be considered carefully and compared to the pathways listed above for pros and cons. Training may also be done part-time while one work full time in one of the starting positions in clinical research. Specific curriculum will vary from institution to institution. Below are some general areas that a clinical research training program should cover:

· clinical research ethic

· clinical research practice

· clinical trial design

· clinical document writing (study design, protocol, informed consent, case report forms, etc.)

· clinical trial monitoring and management

· risk management

· regulatory requirements

Career Development

Career progression can be different depending on company and business environment. However, with motivation and previous experience showing success in clinical research, one should be able to progress either within the same company or at another company. Below are different levels of CRA title that we can use as a rough guide in gauging CRA career progression:

CRA Title

· CRA I – starting level with 1-2 years of experience. CRA I may be working on different parts of clinical trial, such as setting up trial master files, document preparation, and site correspondence. Some supervision from more senior CRA may be needed to help guide CRA I on different clinical trial related functions.

· CRA II – mid level with 3-5 years of experience. CRA II should be working on all stages of clinical trial. Job function can range from clinical trial design and planning, protocol and form generation, site selection, monitoring, to clinical report generation. CRA II should be working independently with little or some supervision from more senior CRA.

· CRA III / Senior CRA / Lead CRA – senior level with 5 or more years of experience. CRA III, Sr. CRA, or Lead CRA should be able to perform any of the clinical trial tasks proficiently. They are also expected to supervise, train, and mentor more junior CRA.

Beyond A CRA Role

Many CRAs may choose to remain in CRA role as a career. Some CRAs may become consultants after gaining years of experience. Beyond a CRA role, career progression may include management role such as:

· Clinical trial or clinical affairs manager

· Senior clinical trial or clinical affairs manager

· Associate director of clinical research

· Director / vice president of clinical research

The sky is the limit for opportunities and career progression beyond a CRA role. One note is that advance degree (M.D., Ph.D., MBA, etc.) may be advantage as one progress higher in clinical research career.

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