Clinical research organizations (CROs) continue to focus on attracting and retaining top talent, particularly for the essential role of clinical research associate (CRA). Turnover in these positions has been a persistent challenge, reaching a peak in 2018 and experiencing a significant spike during “The Great Resignation” in 2021. Although turnover rates have recently returned to historical averages, they remain high, particularly for CRA roles, with nearly 23% turnover in the U.S.
BDO’s CRO Industry Global Compensation & Turnover Survey offers an in-depth look at talent and compensation across the global marketplace. This insight highlights key findings based on the comprehensive survey report, which provides extensive data and analysis to survey participants.
While Overall Turnover Declined, Turnover for Clinical Monitoring Roles Remains Stubbornly High
After reaching historical highs in 2021, turnover across all job families generally decreased in 2022 and continued to decline further in 2023.
The most significant reduction occurred in the database management job family, where turnover dropped from 29.0% in 2022 to 12.0% in 2023.
However, the Clinical Monitoring job family, which includes the CRA role, continues to experience high turnover relative to the overall average, with only modest decreases year-over-year.
FIGURE 1: Average Total Turnover in the U.S. by Job Family
Source: The BDO 2022-2024 CRO Industry Global Compensation & Turnover Surveys: U.S. Results average turnover levels reflect calendar years ending December 31.
Among the countries reporting, those with the highest turnover are listed in Figure 2. Retaining talent in these countries has been more difficult than in the U.S., where average turnover was 19%.
FIGURE 2: Countries with Highest Turnover
Source: 2024 CRO Industry Global Compensation & Turnover Survey: Outside the U.S. Results; turnover levels reflect the 2023 calendar year ending December 31. Chart reflects all countries surveyed with sufficient data to report average statistic.
Overall Tenure Rises, Led by Exempt Employees
On a positive note, overall employee tenure has risen to 5.3 years from a low of 4 years in 2022. Exempt employees were the group with the longest tenure, while CRAs continue to have the shortest tenure.
FIGURE 3: Average Length of Service Years by Employee Group
2024 Brings Lower Clinical Research Associate Turnover and Shorter Time to Hire
According to BDO’s CRO turnover pulse surveys conducted in October of each year, the median total turnover rate for CRA roles has decreased from a high of 30% in 2022 to 22% in 2024. The turnover rate for 2024 is nearly identical to that of 2023. Additionally, the average time to fill these roles has also decreased from a median of 1.9 months in 2022 to 1.6 months in 2024.
FIGURES 4 and 5: Total Turnover Rate (%) for CRA Roles and Average Number of Months to Fill CRA Positions1
Companies Boost Pay to Combat Turnover
According to BDO’s 2024/2025 CRO Industry Global Salary Planning survey, CROs reported salary increase budgets of 3.57% and actual merit increases of 3.37% for 2024; however, the actual average salary increases for CRAs, as reported in our annual Compensation Survey, exceeded 4%, with executives and paraprofessionals averaging increases of 4.6%. These figures surpass the comparable 10-year annualized salary increases for CRAs,2 which ranged from 2.17% to 3.50%.
Using Survey Data to Focus on Retention and Performance Enhancement
For CROs, turnover has decreased and tenure has increased in 2024, particularly among CRAs, continuing the trend towards longer overall tenure. This presents a key opportunity to retain and reward the top performers while facilitating the exit of employees who do not meet the expected performance levels.
BDO’s survey provides the insights companies need to develop and design competitive pay programs that will motivate and reward the best performers.
BDO helps companies design compensation strategies to meet business goals while providing advice to evaluate the tax implications of the programs. For more information, contact BDO.