As originally asked by Andrew Fung.

I’ve worked at a few large organizations, where the job package typically is rounded out with incentives, benefits, opportunity for internal promotions, etc. But if I’m considering employment at a med device start-up, should I have a different perspective?

Andrew Fung
Client Technology Advisor, Microsystems and Nanotechnology at CMC Microsystems
Thanks for the very insightful replies all around.
@ E Larson, warning noted! What are the up sides that should balance out the risks?
@ M Ward, indeed difficult to do due diligence as a candidate. Sounds like I’d want to evaluate the qualifications of the entire “C suite” and ask to read their Strategic Development Plan!

Eric R. Larson
Consulting Engineer
A critical set of considerations involves what state you are in in your life. Are you up for the risk involved? Do you want to work odd hours? (either ungodly long, or painfully short). Can you weather long periods of unpredictable income? Can you be productive in an environment where everything is uncertain? Can you deal with upheaval and change? Can you turn on a dime and refocus on a new target on a moment’s notice (a target that you may or may not understand – or agree with).

Most people want to talk about the potential rewards of a start-up company. They neglect to address the uncertainties involved, and how it may affect other aspects of their life. They also tend to forget that most start-up companies fail.

Choose wisely, grasshopper.

DR. MICHAEL WARD
Global Director, Clin/RA/Pre-Clin, at MicroPort NeuroTech (Shanghai)
Andrew, you definitely need a vastly different perspective when making the change from large company to start-up. All the above comments are true so I won’t repeat. But recognize that you need to bring a fairly broad and deep set of experiences or your value will be minimal to the company. You will not have the depth of personnel or gamut of departments around you as you experience in large companies. You will have to roll your sleeves up and do most things yourself or share among a small staff.

I think working in a start-up is a very valuable experience. You need to choose wisely though. If the startup has no product(s) on the market but has a full slate of marketing and sales folks already before that first FDA approval, be cautious. People are a huge drain on limited cash and a start-up should only employ the type of expertise it needs at the moment….not in the future. The best start-up infrastructure I have seen was a small CV company in Minneapolis (CABG) – they had mainly R&D engineers to develop the product(s), QA, consultant RA person and consultant Clinical Research expert plus their leader. They worked ‘lean and mean’ and were very successful. It is difficult to vet when you are interviewing; however, if there is evidence of excess spending (such as lavish building, furniture, perks etc), run away as fast as you can. If the CEO is from another world that medicine or medical devices, also run quickly away…he will take the organization down faster than you can say, “Where’s the door!”

The medical devices industry attracts any Tom, Dick, or Mary who thinks he/she has the best invention since sliced bread and will not be convinced otherwise. It’s also a ‘get-rich-quick’ opportunity as the time from concept to market can be years faster than in other industries and the profits are large. So it attracts those looking for a quick kill and a lot of money. With those motivations, failure is almost certain. The leadership has to be experienced, intelligent, rational, and have a good scientific grounding. The company plan should be practical and prudent – not biting off more than it can chew. If the company is developing a product and wants a plethora of indications on the first pass, that’s not going to happen before the cash runs out.

The successful medical device start up not only manages money prudently but also keeps things simple….getting its foot in the door with that first indication…others can be sought at a later date once the sales begin to expand on the first application. The advantage noted above that things move very quickly in start-ups is valid to the degree that there are still some checks and balances to deter or negate bad ideas. I have personally seen 3 start ups fail – all with robust products but with individuals within the leadership who took the company on a diverging and expensive pathway (unnecessary one too) that ate up cash before initial success was achieved.

So, after all the warnings, would I recommend taking the plunge? Sure I would, as long as you collect all the useful advice you get here and try to apply it before singing the dotted line. If you switch over, you are in for an adventure, that’s for sure. Good luck!

Robert Fehse
Sales, Application Engineer Precision Metal Stamping
I always like wearing many hats and the exposure to all aspects of the business not just one dedicated area.
It can be a great learning experience and rewarding.
It can also be risky result in super long hours and may not take off. Make sure you have a plan B

Tamara R Pearlman, CPC
Senior IT Recruiter, Career Coach, and Entrepreneur! Making a Positive Difference in the World of Recruiting!
Good question Andrew and good answer Erich. I am hearing from medical device candidates that start-ups are striving to cut costs on compensation by getting reps to work straight commission. Not a good move for any rep on a product that is not tried and true. Some companies have asked reps. to do buy-ins and sell for the company. Red flag – underfunded – advice: run.
The best advice I can give as a recruiter is that there has to be a solid base that one can live on as the territory is developed for the “new” product, there have to be benefits as after all we are human, stock options and commission has always been a huge part of medical device sales.
On the inside, it comes down to base, benefits, stock options and bonus’. The market is full of medical device sales reps; however the supply and demand for great medical device R&D, engineers, scientists, etc. is tighter. Thus, one should be able to negotiate a viable start-up package that one can truly live on, or have a recruiter at your side to negotiate same.

Erich Coiner
Mechanical Engineer
The one thing a startup has to offer is equity. They will try to make stock options as large a part of your compensation package as they can. In exchange they will try to pay less than market rate for your services. You have to decide if the potential upside is worth working at a wholesale rate for a few years.
You also get to wear many hats and enjoy moving at a pace that large companies can only dream of. I really enjoyed my time in a medical startup. It also provided good employment through the last recession.