Scaling Medical Excellence: Insights from Merck with Wendy Fraser

Most Medical Excellence leaders support one region or a defined set of therapeutic areas. At Merck, Wendy Fraser's function is accountable for Medical Affairs work around the world and across every therapeutic area the company covers, which makes scale the central design problem.

In this episode of OnPoint: The Medical Excellence Podcast, recorded at the close of 2024, Scott Thompson talks with Wendy Fraser (Merck) about how a Medical Excellence team of 38 supports a Medical Affairs organization of roughly 3,000 people, about 1,200 of whom engage in scientific exchange. Wendy explains why Merck renamed the function The Center for Scientific Exchange Excellence. The Center for Scientific Exchange Excellence is the organization within Medical Affairs at Merck that enables those who engage in scientific exchange on the company's behalf, organized around best practice rather than titles or roles. From there, the conversation covers balancing global consistency with local relevance, a consultative operating model, safe-to-fail experimentation, listening communities across the field, and what MSLs will need over the next five years. If your Medical Excellence team is small and your organization is not, start here.

Key Takeaways

• Organize around scientific exchange, not titles. Merck's Medical Excellence function chose to focus on its center of excellence work "not on titles, not on roles," because many roles engage in scientific exchange and, as Wendy puts it, "it's just described differently globally."
• Consult rather than push: With a small team supporting a large organization, Wendy is direct about the limits: "We cannot push. We're small. And the organization is very large and there's a limit to that." Her team builds an "inspired shared vision" with each country and region, then partners on how to get there.
• Local relevance takes deliberate effort. What works in one market "has to be regionalized. It has to be localized." Wendy notes that "the amount of pre planning calls that any solid training team does, almost can't be counted."
• Pilot the culture, not just the process. Merck follows a sequence of "pilot, pilot, launch, rollout," narrowing each pilot to a single country or TA. Wendy is clear about what the pilots are for: "What we pilot is the culture. What we pilot is the unknown. What we pilot is the resistance to change."
• Safe to fail requires sponsorship. "Safe to make a mistake and safe to fail is quite honestly, very difficult to live by." Wendy credits leadership that welcomes experimentation "all the way up to our CEO," and a debrief discipline that is lived, not scheduled: "Debrief is not a calendar appointment. It's a real thing."
• Make the MSL's job easier, because Wendy expects the core value of scientific exchange to hold while the enabling work changes. "MSLs today are absolutely burdened," she says. "Admin for every single MSL is overly burdensome. We've got to fix it."

About Our Guest

Wendy Fraser is Executive Director, Global Field Medical Center of Excellence and Scientific Training at Merck. At the time of recording, her team of 38 supported scientific exchange across Merck's global Medical Affairs organization, including the Global Scientific Training Organization, and the function had recently been renamed The Center for Scientific Exchange Excellence. She has worked on the Center of Excellence in one form or another for more than 15 years and is active with the Medical Affairs Professional Society (MAPS), where she has represented the Field Medical working group. Wendy later returned to the show for a panel on generative AI in Medical Affairs.

Connect with Wendy on LinkedIn: https://www.linkedin.com/in/wendy-fraser-86316710/

FAQ

What is the Center for Scientific Exchange Excellence at Merck?
The Center for Scientific Exchange Excellence is the name Merck's Medical Excellence function adopted for its center of excellence work within Medical Affairs. Wendy Fraser describes it as the organization that enables those who engage in scientific exchange on the company's behalf, covering both scientific acumen, through the Global Scientific Training Organization, and the how of scientific exchange. Merck chose to focus the function on best practice rather than on titles or roles, because many roles engage in scientific exchange and are described differently around the world.

How can a small Medical Excellence team support a large global Medical Affairs organization?
At Merck, a Medical Excellence team of 38 supports a Medical Affairs organization of roughly 3,000 people by working consultatively rather than directively. Wendy Fraser's team builds a shared vision with each country or region, uses a set of questions to assess where that market is today and where it wants to be, and relies on cross-functional partners in areas such as technology and process to scale the work.

How does Merck move a new Medical Affairs capability from pilot to global rollout?
Wendy Fraser describes a sequence of pilot, pilot, launch, rollout. Each pilot is narrowed to a specific country or therapeutic area so the team can understand the feedback and adjust, while the build keeps the eventual global audience in mind. She explains that the pilots are less about testing the launch process, which the team already knows well, and more about understanding culture and resistance to change before a broader rollout.

How do Medical Excellence teams gather ongoing feedback from field teams?
At Merck, one member of Wendy Fraser's team built listening communities across Medical Affairs, including groups for leaders of leaders, for those who lead Medical Science Liaisons, and for MSLs themselves. These communities let the Medical Excellence team hear what is landing, what is not, and which language resonates with the people executing the work.

How is the MSL role expected to change over the next five years?
Wendy Fraser expects the core of scientific exchange, peer-to-peer discussion around the contextualization of science, to remain. What she hopes will change is how MSLs are enabled: faster and easier preparation, quicker access to the content they choose, simpler narrative building, and lighter administrative work. Defining and measuring that value is still an open question for the field. In a 2025 Medical Science Liaison Society survey of 1,023 Medical Affairs professionals across 63 countries, 67% said MSL performance is difficult or very difficult to measure accurately, and only 3% rated current KPIs as very effective (Pharmacy, 2025).

Curious how this applies to your organization? Let's talk.

About OnPoint: The Medical Excellence Podcast

OnPoint: The Medical Excellence Podcast delivers insightful conversations on the most pressing issues facing top Medical Affairs professionals. Listen to stay ahead of industry trends and be inspired by leaders shaping the future of Medical Affairs.

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