Worked for over seven companies over the years, and I have only two MSL managers who would qualify as truly good leaders. The problem with many MSL managers is that they focus too much on justifying their own existence with metrics that are meaningless, and it's the same with Medical Affairs management above their level. We've been fighting the metrics question for a long time, and we have too many widget counters, frustrated Excel spreadsheet junkies and Salesforce.com groupies that try to provide "objective" data. Sorry to say that since the first MSL (depending on whose story you believe as to who actually created the role--and that's always fun to listen if you are in need of verbal Ambien), Medical Affairs management has been trying to quantify a return on investment--and too often they get caught up in numbers even they don't understand. I just do the job and I've never been rated below "excellent". This is not a job for the faint of heart or for the brainless, but many of the team leaders I have had in the past just didn't get the point that what they thought mattered isn't what senior management believed.