Keep in mind that pharma trials are very different from device trials, i.e. Phase I, II, II vs. no phases. The larger CRO's can do both types, but there are smaller ones that specialize in one or the other.

From a Big Pharma standpoint in terms of clinical research, it is very money driven and results driven. For example, for a double blind test, the intent is to remove as much bias from the test subject and investigator as possible. However, because of this, statistical test can be fabricated and systematically wrong. Many test can give false negatives and false positives. For a pharmaceutical company, they will only want to publish the positive results of the study which leads to publication bias. This can easily be done if they don't register their test prior to running it. By doing that pharmaceutical companies don't have to disclose all their test results and open it up for scrutiny.

A CRO can possibly do the same, however since a CRO is a third party they can likely give more push back to register clinical studies prior to executing them.

Generally I feel that working in a small CRO is better. It makes you to develop yourself and gives you lot of experience to move in to the world of Big Pharma. Innovative excellence and growth in the career only happens if you know everything from the scratch of the domain. So it would be better.

I do agree with you that working in a small group or company has a lot of benefits, However, the salary is not that high as bigger companies. But also from my experience, I do learn a lot in smaller companies as more resources is open and usually, people work there have multiple hats and you get involved in a lot more than your role duties. For me, it is good for the learning process and builds my career, but for long-term future and stability, I would like to transfer to one of the big companies. In my personal opinion, it is the tread off between salary and learning curve and has a more solid background to be involved in more that one role and exposure to different things.

I would like to think of a CRO as a local credit union, and a Big Pharma as Bank of America. One would be more intended to resolve a certain community’s financial needs and the other’s focus is to take advantage of anyone’s financial struggles. But when it comes to choosing between the two to work for, I would probably choose Big Pharma. I think if I were to have a real impact on policies at some point in my career, working for a big company would make me understand the problems better and then be able to change them. That can be when I rise up the ladder, or when I quit and become a politician. I understand that there is a lot of politics involved, for example, there are Big Pharma lobbying groups that want to keep the consumption of marijuana illegal, as it tremendously alters the benefits for other legal drugs. A quick research would show that CEOs of Big Pharma companies have donated millions of dollars to prevent the legalization of certain drugs in one state or another. I think by working for these companies and knowing first hand how they influence the political system, would make my career life more interesting and would prepare me to be a person of knowledge who can be influential on policymaking.

I agree with you that CRO would be a better place to work, especially because it is smaller and it gets easier for the employees to be known to each other, grow together and have fun while working. There is less pressure in this type of work environment. However, big pharma is very competitive and money-driven. They also provide great benefits and higher salaries to the employees. In my opinion, I think I would work for big pharma companies for a while and move to a CRO later in my life. Hence I will learn to grow and adapt in a fast paced and stressful environment. Working at a CRO will become easier for me then and I will have a lot more to offer there after having some big pharma experience.

Although I have not had the experience in working in either a small CRO or big pharma, as someone who is new to the industry, I think I would opt for working in a small CRO. I work for a small startup and working with a smaller company provides more opportunities to learn or be a part of every step of the process whether it be producing a medical device or managing a clinical study. Working in big pharma might be something I would like to be a part of once I’ve gained more experience from a smaller CRO as it will provide more opportunities for professional growth on top of being able to provide more benefits.

Personally, I would choose CRO. From research throughout my job search, I did not particularly like what I saw in Big Pharma. While the earnings and benefits may be more, I feel like there are other areas in which one may lose. As a newbie in the workforce, I think a CRO offers a chance to actually gain an understanding of what is going on versus pushing out results to meet deadlines and possibly doing things incorrectly. Maybe it could be an option later on in life, but I do not think that Big Pharma is for me at the moment.

I opt for: Small CRO and being an account manager covering the NIH and smaller biotechs. I have noticed that the smaller labs and companies are more tight knit and things seem to run smoothly. Whereas at the NIH there are numerous hoops to jump through. I also notice some researchers are reluctant to work because of the ethical issues in big pharma. If the goal is money, big pharma is the way to go, if you want to see the fruits of your labor then small CRO.

Big Pharma has established its position and those names and reputations stand highly recognized. However, the CRO is a contract research organization that is a life sciences company that provides support to the pharmaceutical, biotechnology, and medical device industries in the form of research services outsourced on a contract. On one hand, it's the middlemen for innovative biotechnology company startups that need to collaborate and get a foot in the door. The idea of "support" is what draws me to this type of company over Big Pharma. There has been a shift in Big Pharma in recent years to either start small biotech sectors or acquire pre-existing ones. I think that a CRO is a good fit for anyone who has the mindset of a team player in the big leagues. 

I have no experience working in industry. If I had to choose though, I think I would prefer to work in a small CRO. Hopefully I could find one that matched my morals and was goal oriented and not money oriented. I think that's the biggest problem with Big Pharma. Sometimes it's not about helping people or saving lives. Sometimes it's just about making money. We saw a perfect example of that when the company that made EpiPens jacked up the price. That medication saves lives. It should not be expensive. Same thing with insulin. I would want to work with a company that is willing to cut some profit to keep a much needed medical device affordable to most families. Healthcare and medication should be accessible for everyone. We all play a part in making that true. So, do we work for companies that exploit people for the sake of a profit or do we find somewhere that pays enough so we can live, but also keeps medical devices affordable for those that need it most. Of course, this not true for all of Big pharma or small cro's. We as people have power in our choices to make this world a better place for all that live here. 

Based on my experience with Big Pharma, I would definitely choose a small CRO in a heartbeat. Despite their size and resources, Big Pharma always seems to be so disjointed and unorganized whenever it comes to getting things done. Too many hurdles to jump through and not enough help from higher up. Something about the size being smaller makes CROs a lot more manageable, and the people around you are more open to helping out.