Becoming a Clinical Trial Manager (CTM) is an exciting next step. You’ve worked hard to get to this point. 

But even research professionals who transition to CTM after being top-notch Clinical Research Associates (CRAs) or Clinical Trial Assistants (CTAs) are in for some surprises. All of your experience is helpful, but it doesn’t fully prepare you for the comprehensive CTM role.

It’s a common assumption to think, “I was a strong CRA/CTA, so I’ll naturally succeed as a CTM, too.” 

Realistically, though, most people don’t become strong Clinical Trial Managers right away.

There are a few things to know before becoming a CTM. Most CTMs don’t learn these lessons until they’re already in the role. But, we’re sharing them with you right here, right now. 

Lesson 1: Not Every Issue Is a Protocol Issue 

CRAs and CTAs check the protocol for every problem, challenge, question, and difference of opinion. Generally, this is the right thing to do. It’s expected of these roles.

But it’s not always necessary for Clinical Trial Managers. Instead, CTMs have to learn that while every clinical trial has protocol issues, every issue is not a protocol issue. And then they decide what is a protocol issue — and what is not. 

Along with protocol issues, CTMs deal with communication challenges, unclear expectations, and collaboration mishaps, among many others. Examples of non-protocol problems include:

• Vendor delays from unclear communication
• A site that misses enrollment deadlines due to unrealistic expectations
• Cross-functional disconnect between data management and operations
• Misalignment on task responsibilities between an In-House CRA and Field CRA
• Training gaps at study sites that result in errors

Instead of diving deep into the protocol with every issue that arises, the best CTMs step back and assess the broader dynamics. Then, they can (quickly) identify whether the root cause is procedural or interpersonal. Learning to tell the difference is one of the first big shifts when moving into CTM-level thinking.

Lesson 2: You Don’t Need to Have All the Answers

Clinical Trial Managers are involved in research studies from Start-Up to Close-Out. It’s no secret that there is a lot of information for CTMs to know. Many new CTMs and CTMs new to Start-Up or Close-Out feel they should be experts in everything.

That’s a lot of pressure. And that pressure can lead to overwhelm and even burnout. 

Newer CTMs don’t realize, or have a hard time accepting, that they don’t need to know everything. It’s actually normal not to have all the answers.   

Rather than an intense focus on perfection, it’s better to emphasize resourcefulness. That means, instead of having all the answers, you will be more effective if you know where to find the answers or who to ask. 

When you don’t know the answer, here are some of the best places to look or people to ask:

• Standard Operating Procedures (SOPs)
• Past studies in the same or similar indication 
• Cross-functional partners (DM, Regulatory, Safety, etc.)
• Escalation pathways (CRAs and CTAs talk to the CTM; CTMs may escalate to the PM)
• Mentors, other CTM colleagues or even a Line Manager

The shift from “I should know this” to “I can figure this out” is one of the biggest growth moments for CTMs. It reduces overwhelm and strengthens your credibility. Because what teams actually want is a CTM who is transparent, resourceful, and dependable — not a walking encyclopedia.

Lesson 3: The Shift from CRA (or CTA) to CTM Requires a Mindset Change

CRAs and CTAs have a long list of responsibilities each day. Whether it’s working with sites, monitoring, and writing reports, or barreling through administrative study tasks and the eTMF, CRAs and CTAs do a lot of work. 

Clinical Trial Managers, on the other hand, are in a leadership role and tend to be more involved with:

• Strategic oversight
• Cross-functional leadership
• Decision-making
• Risk identification and management
• Problem solving

When a CRA or CTA becomes a CTM, it can be tough to switch your mindset from “doing” to “leading.” It’s common for new CTMs to struggle with delegating (it’s not possible to do it all as a CTM – you need to lean on your team), communicating effectively, and leading and guiding rather than executing tasks. 

If you’re trying to grow as a leader, you can focus on specific leadership skills that will make a difference, including:

• Prioritization
• Collaboration
• Confidence
• Communication
• Organization
• Empowerment

It can take time to shift your mindset, but you can start small. Rather than writing the meeting agenda or minutes, schedule a meeting with the CTA to discuss your expectations for their involvement in meeting planning. 

Instead of contacting sites struggling to recruit patients for a study, ask the CRA to schedule a visit or meeting to discuss recruitment ideas. 

Shifting from a task-focused role to a leadership-focused role is a gradual process of building confidence, trusting your team, and stepping into a more strategic way of working. The goal isn’t to stop doing the work — it’s to stop doing all the work. As a CTM, your impact comes from how well you empower others, create clarity, and keep the study moving forward. 

How These Lessons Can Prepare Aspiring CTMs

You’ll learn a lot of lessons as a Clinical Trial Manager. These are three that may make a meaningful difference in a smooth transition into the role.

And you can work on each lesson as you prepare to level up. Here’s an example for each of the three lessons discussed above:

• Lesson 1: The next time you’re dealing with a study issue, think about how you would handle it if you were a CTM. Is it really protocol-related, or was there a communication breakdown?
• Lesson 2: When you don’t know the answer to a question, consider the best place to find the answer. 
• Lesson 3: Evaluate the study you’re working on and try to identify a risk. For example, if patient retention is declining, how would you address it? You can even share your strategy with the CTM.

It’s all about building skills to gain experience, boost your confidence, and have concrete examples to share during interviews. Other ways to do this include:

• Ask to lead a meeting
• Offer to help the CTM with a specific task
• Request an opportunity to get involved with a cross-functional project

As you look toward your future, ClinEssentials is here to provide support. We offer a valuable (free) resource library, an Introduction to CTM Mini Course (available December 2025), and the CTM Training Course (you can choose between a live or self-paced course).

Remember these lessons as you continue your journey in Clinical Research. They apply to most leadership-level positions and will be here for you to reference whenever you need.