Very low pay for this industry. Very disorganized- there are too many systems that no one really knows how to use, are redundant, yet you are expected to use. Monitoring is a low priority - even though that’s your job title. Being a good monitor is not truly recognized when it comes to performance review, only “initiatives”, like being on round tables etc. There are a tremendous amount of calls just to have calls. Communication is a challenge, as everything must be said in the correct way and to the correct person (no talking to someone not in your escalation chain.) When it comes to oncology, upper management is far too involved in what CRAs do and they refuse to listen to input from experienced CRAs. They create business “solutions” that do not work well in the medical field. The quality of sites are not important as long as you get sites that promise to give you patients. Everything is about enrollment and query numbers. What actually happens once patients are on study gets far less attention.