Case study: Recruiting a fractional Chief Medical Officer
Fractional medical leadership is accelerating oncology breakthroughs.
Our client is an early-stage European biotech developing first-in-class therapies in oncology. Its science centres on targeted protein degradation, with a proprietary platform designed to address cancer drivers that have historically been considered undruggable.
Backed by international investors and supported by global research partnerships, the company had built a strong scientific foundation. A lead programme was advancing towards IND submission, and the business was entering a pivotal stage. The transition from discovery to clinical development would define its trajectory.
The leadership team was lean, ambitious and science-led. What they needed next was experienced medical oversight to shape early clinical strategy, engage regulators and strengthen investor confidence.
The challenge
The brief was clear but far from straightforward.
The company required a senior oncology leader who could immediately guide IND-enabling activities, design early-phase trials and represent the clinical strategy externally. However, they were not looking for a traditional full-time CMO at this stage. Instead, they wanted a fractional appointment of around 20 hours per week, with flexibility to scale as the pipeline progressed.
This created a unique set of challenges:
- The individual needed deep oncology expertise across early and late phase trials.
- They required credibility with regulators, key opinion leaders and investors.
- They had to be comfortable operating in a resource-conscious, early-stage biotech.
- They needed the appetite for a part-time consultancy role with long-term potential.
The available talent pool for this combination is small. Many experienced CMOs are either committed full-time or seeking permanent executive roles. Others may have strong academic credentials but limited industry exposure across IND submissions and global regulatory engagement.
For our client, this appointment was critical. They needed strategic medical leadership that could elevate the entire organisation.
Our approach
We began by refining the scope of the role with the founders and board. In early-stage biotech, clarity is essential. We worked collaboratively to define what success would look like in the first 12 to 18 months, what responsibilities could realistically sit within a 20-hour structure, and how the role might evolve.
From there, we executed a focused international search, drawing on our specialist oncology network. Rather than relying on active applicants, we approached senior medical leaders with relevant experience in early-phase oncology development, regulatory submissions and portfolio strategy.
A key part of our process was assessing not only technical expertise but mindset. We prioritised individuals who had worked across both biotech and larger pharmaceutical organisations, and who understood the agility required in a start-up setting.
The successful candidate brought over two decades of oncology development experience. They had led Phase I to III registration-directed trials across solid tumours including breast and prostate cancer. Their background included work with global pharmaceutical companies and emerging biotechs, as well as collaboration with academic and charitable research groups.
Importantly, they had extensive experience of IND submissions and regulatory interactions, alongside strategic input into oncology portfolios and in-licensing assessments. This combination of operational and strategic capability aligned perfectly with the client’s needs.
Throughout the process, we acted as a close partner to both sides. We facilitated open discussions about expectations, time commitment and long-term ambitions. We ensured alignment on how the fractional structure would operate in practice, including governance, communication rhythms and decision-making authority.
By managing the offer process carefully and transparently, we created clarity and confidence from the outset.
The outcome
The company secured a UK-based fractional Chief Medical Officer who could start quickly and integrate seamlessly into the leadership team.
The fractional structure delivered exactly what the company needed: immediate senior expertise without overextending financial resources. At the same time, it created a pathway for the role to expand as programmes progress into clinical trials.
For the candidate, the position offered the opportunity to shape an innovative oncology pipeline while maintaining a flexible portfolio career. For the client, it meant credibility, strategic clarity and accelerated momentum at a defining moment in their growth.
This case demonstrates how adaptable executive search can unlock non-traditional leadership models. In early-stage life sciences, timing and structure are often as important as the individual themselves. By combining a network-driven approach with close, founder-level engagement, we helped our client secure the right expertise at the right time, positioning them strongly for the transition from preclinical promise to clinical reality.
If you are exploring fractional or full-time medical leadership to strengthen your clinical strategy, we would welcome a conversation about how a tailored, specialist search can support your next stage of growth.
Talk to our Founder and Director, James Trott.
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