Dr. Vibha Jawa's career shows a powerful strategy: learning drug development fundamentals in large companies (Amgen, Merck) and applying them in nimble startups. This cycle across different environments accelerates learning and deepens expertise in a specialized field like immunogenicity.

The transition from a leadership role at a large pharma company like Gilead to a biotech CEO involves a massive shift in scope. Instead of managing one large function with a large team, a biotech CEO is hands-on with every aspect of the company, from science to finance.

The core job of a scientist isn't knowing facts, but figuring out what's unknown. This problem-solving 'toolbox'—how to think, act, and work with teams to tackle new problems—is directly transferable to the CEO role, enabling leaders to navigate unfamiliar domains like corporate finance or legal structures.

While startups must be nimble, analytical processes from large corporations are invaluable. The key is applying the same rigorous thinking to decision-making but compressing the timeline. Having prior experience with similar situations allows leaders to make informed choices more quickly.

Transitioning a biotech from discovery to development is not just a scientific step but a cultural one. According to Ron Cooper, it requires moving from a flexible "innovation and ideation culture" to a rigorous "engineering culture" focused on process and precision in areas like clinical trials and large-scale manufacturing.

The transition from a resource-rich environment like Novartis to an early-stage biotech reveals a stark contrast. The unlimited access to a global organization is replaced by a total reliance on a small, nimble team where everyone must be multi-skilled and hands-on, a change even experienced executives find jarring.

Resolution Therapeutics' CEO builds his team with leaders from varied backgrounds across different diseases and drug modalities. He believes this diversity creates more robust problem-solving, as challenges that are novel in one area may have been solved in another, enabling faster and more informed decisions.

Luba Greenwood argues that unlike in tech, many biotech CEOs lack P&L experience. In today's cash-constrained market, CEOs need to be able to build financial models and understand finance deeply to be effective, a skill she personally developed after transitioning from law and science.

John Maraganore's transition from science to business wasn't a choice but a reluctant career change forced upon him by Biogen's CEO. This involuntary pivot, which he initially resisted, provided the essential business experience he later needed to become a CEO, demonstrating how career-defining moments can be externally imposed.