English Proficiency for Medical Affairs (MSL): Advanced Scientific Discussions with Global KOLs

To excel as a Medical Science Liaison (MSL) in a pharmaceutical company's Medical Affairs (MA) department, it's essential to not only engage with domestic Key Opinion Leaders (KOLs) but also to conduct scientific discussions with global KOLs and effectively communicate in global MA meetings. However, many professionals express concerns like, "I can read scientific papers, but I can't debate them in English," or "I'm not confident I can facilitate an advisory board in English."

This article provides a systematic guide, outlining specific situations where MSLs need English, offering practical phrases for each scenario, detailing the required proficiency scores, and explaining efficient training methods.

Why English is Crucial for MSLs: The World of "Scientific Dialogue" Beyond Medical Representatives

A Medical Science Liaison (MSL) is a professional who engages in peer-to-peer information exchange based on scientific evidence with Key Opinion Leaders (KOLs)—influential physicians and researchers in specialized fields. Guidelines from the Japan Pharmaceutical Manufacturers Association (JPMA) and EFPIA Japan clearly define MSLs as facilitators of "medical and scientific exchange not intended for promotional purposes."

This marks a fundamental difference from Medical Representatives (MRs). The need for English for MRs is limited, as their activities are primarily domestic, and language skills are not often a key factor in their selection. In contrast, for MSLs, English proficiency directly impacts the quality of their work for the following reasons:

Operating as part of a global MA organization. This is a given in multinational pharmaceutical companies, but in recent years, even Japanese domestic companies have been globalizing their MA departments. Regular meetings with headquarters (HQ) or regional offices are conducted in English, requiring strong communication skills for developing medical plans and sharing insights.

The quality of scientific dialogue with KOLs. Being able to read medical papers in English is a minimum requirement, but it's not enough. MSLs need the ability to critically evaluate data from papers in English, present hypotheses to KOLs, and engage in two-way discussions to draw out insights from clinical practice.

Impact on career path. English proficiency acts as a gatekeeper for career progression from MSL to roles like Medical Advisor, Medical Lead, or Global MSL. In reality, a lack of English skills can limit the scope of one's responsibilities and restrict opportunities for promotion.

5 Scenarios Where MSLs Need English in Their Work

The English proficiency required for an MSL is not a one-dimensional skill of "being able to read papers" but a complex set of abilities that vary by situation. Here are five key scenarios where MSLs use English in their daily work.

① 1-on-1 Scientific Discussions with Global KOLs

While KOL meetings, a core MSL duty, can be conducted in Japanese with local experts, English proficiency directly determines the quality of discussion in global KOL engagements.

What's needed here is more than just the ability to convey information. It requires the "skill of questioning"—setting an agenda before the meeting, presenting the latest clinical data, and drawing out insights based on the KOL's clinical experience. KOLs are busy, and to gain medical insights in a limited time, precise probing questions in English are essential.

For example, when asking for a KOL's opinion on Phase III trial data for a new drug, a vague question like, "Do you think this data is good?" won't yield useful insights. The outcome of the meeting changes dramatically depending on whether you can ask a specific, context-aware question, such as, "Given the improvement in progression-free survival, how do you see this agent fitting into the current treatment algorithm for second-line therapy?"

② Planning, Managing, and Facilitating Advisory Boards (AdBo)

An advisory board is a meeting where multiple KOLs are invited to gather expert opinions on a specific medical topic. In global or regional AdBos, an MSL must lead discussions in English in front of 5 to 10 international KOLs.

MSLs are required to have "facilitation English" skills to control the direction of the discussion, ensure all participants have an equal opportunity to speak, and ultimately bring the conversation to a conclusion with actionable items. As participants are international authorities, it's crucial to use language that is both respectful and effective at moving the discussion forward.

This requires the ability to naturally use phrases like, "Before we transition to the next topic, I'd like to summarize the key points from this discussion," to shift topics, or "Dr. [Name], we'd value your perspective on this — particularly given your experience with [specific area]," to encourage a specific KOL to speak.

③ KOL Engagement at International Conferences

International conferences such as ASCO (American Society of Clinical Oncology), ESMO (European Society for Medical Oncology), and AHA (American Heart Association) are prime opportunities for MSLs to build relationships with global KOLs.

At conferences, English skills are tested in various settings, from formal to casual, including brief scientific discussions at poster sessions, networking after symposiums, and engagement at company booths. A particularly important skill is the ability to naturally transition from small talk to a scientific discussion.

The ability to bridge social conversation to a specific scientific point, for example, by saying, "That was a fascinating presentation on [topic]. One thing that caught my attention was the subgroup analysis — could I ask about your interpretation of...?" can determine the success of KOL engagement at a conference.

④ Global MA Meetings (Regular Meetings with HQ/Region)

For MSLs in multinational pharmaceutical companies, monthly or quarterly global MA meetings are an unavoidable English-speaking scenario. In these meetings, MSLs are expected to report medical insights gathered from the Japanese market in English and provide input on global medical strategy from a local perspective.

A key reporting skill is to distill fragmented information from individual KOL meetings into strategic implications and communicate them concisely. You need the English ability to convey insights, not just raw data, such as, "From our KOL interactions across Japan, the emerging insight is that there is a significant unmet need in [area], particularly regarding [specific gap]."

Furthermore, there are many situations where you need to explain circumstances unique to the Japanese market (e.g., regulatory environment, treatment practices, insurance system differences) in relation to global strategy, making cross-cultural communication skills also important.

⑤ Critical Appraisal and Scientific Discussion of English Papers

While reading English scientific papers is a fundamental prerequisite for MSLs, it's not enough. You must be able to read a paper and then discuss its study design's strengths and limitations, the clinical significance of its results, and its relevance to your company's products orally in English.

For instance, when discussing a new randomized controlled trial (RCT) with a KOL, you need to be able to naturally use English expressions for critical appraisal, such as, "The primary endpoint was met with statistical significance, but one limitation worth noting is the open-label design, which may have introduced assessment bias."

Internal Journal Clubs are also increasingly being held globally, meaning opportunities to summarize papers and lead discussions in English are definitely on the rise.

MSL English Proficiency Benchmarks: The Reality of TOEIC, VERSANT, and IELTS Scores

MSL job descriptions often state requirements like "business-level English" or "TOEIC 730 or higher." However, the actual English proficiency needed for MSL work varies greatly depending on the position and scope of responsibilities. Here is a breakdown of practical capabilities by score.

Entry Level: TOEIC 700–750 / VERSANT 47–52

At this level, you can read English scientific papers without issue. For an MSL position at a Japanese domestic pharmaceutical company, this level may be sufficient for hiring. However, real-time discussions with global KOLs and spontaneous responses in global meetings are often difficult, and job duties tend to be limited to domestic KOL engagement.

Mid-Level: TOEIC 800–860 / VERSANT 53–58 / IELTS 6.5

This level allows for two-way discussions in 1-on-1 meetings with KOLs. This is the standard proficiency required for MSL positions at multinational pharmaceutical companies. While you can handle reports and presentations in global meetings, there is still room for improvement in facilitating AdBos or leading complex scientific debates.

Advanced Level: TOEIC 900+ / VERSANT 59–65 / IELTS 7.0+

At this level, you can facilitate AdBos in English and lead discussions in global medical strategy meetings. This is the proficiency required for career advancement to Medical Advisor, Medical Lead, or Regional MSL. You can flexibly handle unexpected questions from KOLs and accurately convey nuanced scientific opinions.

"You Can Become an MSL Without English, But Your Career Will Stall"

The reality is that there is considerable variation in the English proficiency of current MSLs. It is possible to secure an MSL position without being fluent in English, as long as you can read scientific papers. However, a lack of English skills limits opportunities to participate in global projects and makes it harder to be selected for overseas business trips. In career progression within the MA department, English proficiency almost certainly becomes a gatekeeper, making it crucial to strategically improve it from an early stage.

[By Scene] A Phrasebook for MSLs to Use Starting Today

Here are some practical English phrases for various MSL work scenarios. It is highly recommended not just to memorize them, but to customize them for your specific therapeutic area and products, and to practice them through role-playing.

Starting a Discussion with a KOL & Setting the Agenda

Phrases for making the most of limited time at the beginning of a KOL meeting.

• "Thank you for taking the time today, Dr. [Name]. I'd like to share some recent data from the [study name] trial and get your perspective on how this might impact clinical practice in [therapeutic area]." (Clearly states the meeting's purpose and shows you value the KOL's opinion)
• "Based on your clinical experience, how would you characterize the current unmet need in [disease area]?" (Uses an open-ended question to draw out insights from clinical practice)
• "I recall from our last discussion that you mentioned [specific point]. I'd like to follow up on that today." (Shows continuity and helps build an ongoing relationship)

Presenting Evidence and Eliciting Scientific Opinions

Expressions used when presenting data and asking for a KOL's interpretation.

• "The phase III data demonstrated a statistically significant improvement in overall survival, with a hazard ratio of 0.72. What are your thoughts on the clinical relevance of this magnitude of benefit?" (A question that distinguishes between statistical significance and clinical relevance)
• "How does this compare with what you're seeing in your clinical practice?" (A question to explore the gap between evidence and real-world practice)
• "One interesting finding from the subgroup analysis was [specific result]. Do you think this has implications for patient selection?" (Asks for interpretation of a subgroup analysis)
• "I'd appreciate your insight on how this data might influence treatment sequencing decisions." (Elicits the KOL's view on the impact on treatment algorithms)

Phrases for Paper Discussions (Critical Appraisal)

Frequently used expressions when evaluating and discussing the quality of a scientific paper.

• "One limitation worth noting is the single-arm design, which makes it difficult to attribute the observed benefit solely to the intervention." (Points out a limitation of the study design)
• "The hazard ratio of 0.7 is encouraging, but the confidence interval is relatively wide, crossing 1.0 in some subgroups." (Urges caution in interpreting statistical results)
• "While the primary endpoint was met, the difference in overall survival did not reach statistical significance, which raises questions about the durability of the response." (Discusses the results by distinguishing between primary and secondary endpoints)
• "How do you weigh the efficacy signal against the safety profile observed in this study?" (Asks for the KOL's judgment on the balance between efficacy and safety)

Facilitation English for Advisory Boards

Phrases to use when moderating an AdBo.

• "Welcome, everyone. Today's advisory board will focus on [specific topic]. Our objective is to gather your expert perspectives on [2-3 specific questions]." (Opening and clarification of objectives)
• "Dr. [Name], could you elaborate on how this might impact treatment sequencing in your practice?" (Asks a specific KOL to elaborate)
• "That's an excellent point. Dr. [Name], I notice you had a different experience — would you like to share your perspective?" (Draws out differing opinions to stimulate discussion)
• "Before we move to the next topic, let me capture the key takeaways from this discussion. It seems the consensus is [summary], with some divergent views on [specific area]." (Summarizes the discussion and transitions to the next topic)
• "We're approaching the end of our session. I'd like to ask each of you for a final thought on the most important action item moving forward." (Closing and confirmation of action items)

English for Reporting Insights and Presenting at Global Meetings

Phrases for reporting on MSL activities in Japan to the global team.

• "From our recent KOL interactions in Japan, the emerging insight is that clinicians are particularly interested in [specific aspect] of the data." (Reporting an insight)
• "The key medical gap we've identified in this market is the lack of [specific element], which represents an opportunity for [specific action]." (Identifying a medical gap and making a proposal)
• "One unique consideration in the Japanese market is [specific regulatory or practice difference], which may require a tailored approach to our medical strategy." (Explaining circumstances unique to the Japanese market)
• "I'd like to propose that we explore a collaborative research initiative with Professor [Name] at [institution], who has expressed strong interest in [research area]." (Proposing a collaborative study)

Effective Learning Strategies to Improve an MSL's English Skills

Improving English for an MSL requires a different approach from general business English. Here are learning strategies that focus on scientific vocabulary, evidence-based discussion skills, and relationship-building with KOLs.

The Cycle of Reading Papers and Practicing Oral Output

The foundation of English learning for MSLs is to elevate the skill of reading English papers to the level of being able to "discuss them in English."

A recommended training method is to read a new paper in your therapeutic area and then practice creating a three-minute oral summary in English. Record yourself, listen back, and identify and correct any unnatural expressions or points where you hesitated. Continuing this with 3-4 papers a week will significantly improve your fluency in explaining paper content within three months.

Establishing a Journal Club held in English within your company is also effective. Even with a small group, the ideal format is a monthly meeting where a designated person presents a paper in English, and participants engage in a Q&A session in English.

KOL Role-Playing: Practical Simulation-Based Training

The most effective way to improve English for MSL duties is through role-playing that simulates actual KOL meetings.

Specifically, this involves a simulation where a native English-speaking instructor plays the role of a KOL, and the MSL presents the latest clinical data and leads a discussion. The instructor, as the KOL, can throw unexpected questions or scientific objections, which helps train your ability to respond spontaneously in English.

For example, you can practice how to respond as an MSL when the KOL-actor objects with, "But the comparator arm in this study doesn't reflect real-world practice. How would you address that concern?" This type of training cannot be achieved in general English conversation lessons and requires specialized English training with an understanding of the pharmaceutical industry context.

Preparing for Conference Presentations and Poster Discussions

Once you are scheduled to attend an international conference, preparation is key to your success.

First, identify potential Q&A scenarios at your company's booth or poster and create an English script. Next, have it reviewed by a native speaker to correct any unnatural phrasing or grammatical errors. Finally, practice repeatedly until you can respond naturally without relying on the script.

For conference networking, the first 30-second self-introduction (Elevator Pitch) is crucial. Preparing a template like, "I'm [Name], an MSL with [Company], focused on [therapeutic area]. I've been particularly interested in [specific topic] and was hoping to hear your thoughts on..." makes it easier to initiate conversations at conferences.

Input You Can Absorb in Your Spare Time: Recommended Resources

The following resources are effective for daily input.

For podcasts, the Audio Summaries from NEJM (New England Journal of Medicine) and The Lancet Podcast are perfect for catching up on the latest papers during your commute. They naturally enhance your scientific English listening skills.

For industry media, regularly checking English publications like Pharmaceutical Executive, STAT News, and BioPharma Dive will expose you to global trends and expressions in the pharmaceutical industry.

As a resource from a professional organization, the MSLS (Medical Science Liaison Society) offers online training materials and webinars (currently in English only). It's a two-for-one resource for learning MSL-specific skills in English.

Conclusion: An MSL's English Proficiency is a Combination of "Science × Dialogue"

The English proficiency required of an MSL is a complex skill that cannot be measured by a TOEIC score alone. It is the ability to accurately convey specialized scientific knowledge in English, the questioning skills to draw deep insights from KOLs, and the facilitation skills to lead discussions at international conferences and AdBos. Comprehensively developing these abilities is the path to becoming a globally active MSL.

While it's true that "you can become an MSL without English," it is also a reality that "you will hit a career ceiling if you can't speak English."

Please feel free to contact us for a consultation. Our expert counselors, who are well-versed in the pharmaceutical and life sciences industries, will listen to your current English level and professional challenges to propose the optimal plan for your career advancement as an MSL. We offer practical, job-specific English lessons, including KOL role-playing, AdBo facilitation practice, and scientific paper discussion training.