Writen by Fateh Cheklat, Sophie Hammer et Vanessa Montanari

The hospital CSC works within the precincts of the hospital and is an employee. The CRO CSC, for his part, works within a CRO, he is provider employee. The hospital CSC and the CRO CSC have the same training and are responsible for the same tasks: coordination and organization of clinical research on site according to good clinical practice, filling of CRFs, assistance to investigators, etc. They are carried by similar objectives.

However, the CRO CSC will have much more cost-effective targets (patient inclusions, number of protocol visits completed…). For his part, the hospital CSC will more easily manage emergencies (inclusions, SAE …), requests of investigators and clinical research associates.

Let’s see what links them and what separates them!

Therapeutic areas and occupational risks of hospital CSC or CRO CSC

The hospital CSC sometimes works on a single therapeutic area and, in most cases, does not move to other centers. He is in constant contact with medical personnel (investigators, nurses, doctors, etc.) and with patients. He is the one who plans the visits and examinations of the patients and informs the medical staff as well as the patients of their respective calendar.

The hospital CSC works regularly in a hospital and, according to his missions, is exposed to risks of occupational contamination by handling biological samples or by direct contact with patients.

The CRO CSC may need to work on several studies in different therapeutic areas. He can also be moved to different centers. In general, there is little contact with patients or biological products, therefore the risk of contamination is reduced.

In some areas, such as oncology, the hospital CSC sometimes meets with patients in a worrying medical condition. In some cases, he should not be weak hearted to endure the sudden disappearance of certain patients or the personal difficulties they may have.

For the CRO CSC, this is often limited to the re-reading of files. However, it may happen that a CRO CSC intervenes with the patients (telephone calls, patient questionnaires…)

Team spirit, tasks and careers of hospital CSC and CRO CSC

The CRO CSC is an integral member of the team. He must integrate with the rest of the team to be able to organize everything, which is not always easy!

Concerning the movement of CRO CSC, there are several possibilities depending on the projects:

• sometimes the CSC is hired for a full-time assignment in a hospital department, then it does the job of a hospital CSC. So there will be no travel to do except the home-hospital shift,
• he may be required to travel several times a week in different centers, depending on the workload of the project.

The CRO CSC carries out certain tasks that are unusual for a hospital CSC and that are close to the CRA profession: appointment with the doctor for the visit to the center, preparation of the visit, writing confirmation letters, reports and follow-up letters of the visit. Of course, all this within a limited period of time set in the procedures of the CRO!

Depending on the project, the CRO CSC can be single-task (CRF filling only) or intervene at different scales (patient contact, tube technics…).

As for wages, they are indexed on the level of diplomas, whereas in CRO it depends on experience. However, I do not think I am mistaken in saying that the hospital CSC is paid less than the CRO CSC, even if the latter has a doctorate.

With regard to working hours, in the hospital, the CSC is at 35 hours; While in CRO, it may be necessary to work more.

In terms of evolution, in the hospital, it is more difficult even if it is not impossible. However, the positions remain precarious (fixed-term contract <= 18 months or fixed-term contract with interminable renewal). In CRO, everything depends on the size of the structure and the number of projects. Evolutions are possible towards the profession of CRA or manager of CSCs.

Like any profession these two profiles have advantages and disadvantages. The hospital CSC will have fixed schedules while the CRO CSC will have a better salary. However, the hospital CSC can be hampered by his precariousness, the risks of infections by the biological products to be manipulated and being upset by the difficulties of the patients. The CRO CSC suffers from a workload that can be difficult to manage and the impression of not really being « part » of the team in the hospital.

And you, where do you practice? Which of the two motivates the most?