Everyone Is A Consultant Now

By Jon Newton, Principal Consultant, NewtonBio Consulting Ltd.

Something structural has shifted in how clinical development gets staffed. The past few years delivered a rapid succession of shocks: a pandemic that normalized remote work, a step-change in generative AI, tighter capital, and turbulence in the public institutions that fund and guide research. Add the strain on public health systems, uneven biotech financing, and unclear regulatory signaling, and the familiar org chart of the drug development enterprise starts to look less like a fixed structure and more like scaffolding being taken down.

The through-line is not that AI is doing the work. It is that AI has given organizations a rationale to restructure, and the economics of that restructuring are hollowing out the middle of the workforce. Entry-level roles are being absorbed by automation. Experienced people in their 50s are being shown the door before retirement. And the layer of middle management that once connected the two is thinning because there are fewer juniors to manage and fewer projects to oversee.

Yet the work still has to be done. Protocols get written, sites get monitored, submissions get filed, and none of it happens without deep domain knowledge and human judgment. The gap of real demand versus shrinking permanent headcount is being filled by a fast-growing population of consultants, contractors, and boutique firms. My thesis is simple: In clinical research, it seems almost everyone is becoming a consultant, and that may be the shape of the workforce to come. This article lays out why, and what leaders should do about it.

The Middle Is Disappearing From Both Ends

The squeeze is happening simultaneously at the bottom and the top of the career ladder across industries. On the entry-level side, junior postings in the U.S. have fallen roughly 35% since early 2023, and unemployment among recent graduates ages 22 to 27 climbed to 5.7% in late 2025. That’s well above the 4.2% rate for all workers, with about 43% of that cohort underemployed.¹ Brookings research found AI could automate over half the tasks in a typical entry-level role, roughly five times the exposure faced by senior positions.² The traditional bargain of early-career work where entry level candidates trade rote tasks for mentorship and exposure is breaking down when the rote tasks are exactly what gets automated first.

At the other end, experienced professionals are being pushed out ahead of schedule. A June 2026 analysis from the Center for Retirement Research at Boston College found that workers 55 and older in the most AI-exposed occupations have been leaving their jobs at an accelerating rate since late 2022, and the pattern looks more like involuntary displacement than voluntary retirement.³ Challenger, Gray & Christmas attributed roughly 55,000 U.S. layoffs in 2025 directly to AI, in a year that saw the highest overall job-cut total since 2020.⁴

Whether AI is the true cause or a convenient cover, restructuring framed as an AI efficiency play has become routine, and it carries legal risk. A widely reported 2026 lawsuit alleged that one large technology company's “performance-based” layoffs disproportionately hit older employees, with workers 50 and older claimed to be roughly 2.5 times as likely to be terminated as those under 40.⁵ For clinical organizations weighing similar moves, the lesson is that “we restructured around AI” is not a defense against disparate impact scrutiny. The practical consequence, intended or not, is a workforce with fewer juniors to train, fewer seniors to do the training, and therefore fewer managers needed in between.

The Same Pressure Is Reshaping The CRO Market

This is not only a talent-side story; it mirrors what is happening to the service providers themselves. The global CRO market is large and growing (estimated at roughly $80 billion to $92 billion in 2025) but it has bifurcated into a handful of full-service giants and hundreds of niche specialists, with the mid-tier caught in between.⁶ Several midsize CROs are managing genuine financial headwinds and pressure to restore margins, while consolidation continues to pull scale toward the largest players.⁶ Sponsors, especially small and emerging biotechs working with constrained capital, are outsourcing more selectively and questioning whether a large full-service relationship fits an early single-asset program.

The result is a market that increasingly rewards two extremes: the mega-provider with global reach and the focused specialist that does one thing exceptionally well. What gets squeezed is the undifferentiated middle. The worst case is being big enough to carry overhead but not big enough to compete on scale and not focused enough to win on expertise. The same “vanishing middle” dynamic reshaping careers is reshaping the vendor landscape.

Where The Displaced Work Is Going

The people leaving these organizations are not leaving the industry. They are reappearing as independent consultants and boutique shops. Full-time independent workers in the U.S. more than doubled from about 13.6 million in 2020 to 27.7 million in 2024, and high-earning independents making $100,000-plus grew from roughly 3 million in 2020 to 5.6 million in 2025.⁷ Fractional executive engagements (i.e., a CMO, a head of clinical operations, a regulatory lead retained part-time across several programs) have moved from stopgap to strategy.⁸ Notably, independent professionals tend to adopt AI tools faster than their full-time counterparts, which makes a lean consultant plus modern tooling a credible substitute for a larger fixed team.⁷

For seasoned clinical professionals displaced in their 50s, this is often a welcome trade rather than a demotion. Many have no desire to return to a five-day commute; consultancy lets them deliver high-value work remotely, on a schedule that suits a later career stage, without the exclusivity of a single employer. For sponsors, the appeal is a white-glove level of attention and senior expertise that is hard to get inside a large organization, assembled as a custom team fitted precisely to the program's needs.

What Leaders Should Do About It

This shift is not a problem to wait out; it is an operating environment to plan for. A few practical moves:

Build a deliberate hybrid workforce model. Stop treating contractors as emergency capacity. Map which capabilities must stay permanent and in-house (institutional knowledge, sponsor relationships, quality oversight) and which are better delivered by specialists engaged for defined scopes. Budget for independent talent as a planned line not an overage.

Protect the apprenticeship pipeline on purpose. If AI absorbs the entry-level tasks that once trained new staff, the exposure that produced your next generation of leaders disappears silently. Redesign junior roles around supervising, reviewing, and validating AI output, and pair new hires with senior mentors including retained consultants, so tacit knowledge still transfers.

Pressure-test AI-driven restructuring for bias. Before any reduction framed as an efficiency or automation initiative, run a disparate impact analysis by age and other protected characteristics, and document the business rationale. The reputational and legal cost of getting this wrong now rivals the savings.

Choose partners by fit not size. For a focused early-phase or single-indication program, a specialist or a nimble midsize CRO partnered with a niche technology provider may deliver faster, more tailored execution than a full-service giant. Evaluate agility, therapeutic depth, and cultural fit alongside scale.

Treat partnership as a growth strategy. Smaller providers and technology firms increasingly combine forces to offer clients a seamless bespoke capability neither could build alone. If you are a sponsor, look for these alliances; if you are a provider, cultivate them rather than trying to own the entire stack.

The Game Has Changed

AI and the post-pandemic labor market are not a passing disruption; they are the new terrain. The fallout of fewer entry-level roles, earlier senior exits, a compressed middle, and a stressed vendor tier are real, and some of it is painful. But it is also generative. The large players will keep acquiring. The undifferentiated middle will keep struggling. And the winners increasingly look like the agile, focused, exact-fit outfits, whether that is a boutique CRO, a niche technology firm, or an individual with 25 years of experience and a laptop.

New graduates may struggle in the short term, but as return-to-office efforts push forward, they may find opportunity precisely in the roles more senior professionals now decline in favor of independence and balance. The workforce is not shrinking so much as rearranging itself around expertise delivered on demand. In clinical research, everyone is becoming a consultant. The organizations that plan for that reality rather than resist it could be the ones that keep the work moving.

References:

1. Metaintro. “What the 2026 Job Market Looks Like for New Grads.” April 2026. Federal Reserve / labor-market analyses on recent-graduate unemployment and entry-level postings.
2. Brookings Institution research on AI task automation in entry-level roles, as summarized in MarketBeat, “AI Is Dramatically Decreasing Entry-Level Hiring,” May 2025.
3. Sanzenbacher, G. “Are the Careers of Older Workers Being Cut Short by AI?” Center for Retirement Research at Boston College, June 2026.
4. Challenger, Gray & Christmas data on 2025 U.S. layoffs, as reported by CNBC and Mashable, 2025–26.
5. Franchet v. Meta Platforms, filed San Francisco County Superior Court, March 2026, as reported by the Associated Press and others.
6. IntuitionLabs, “CRO Consolidation: How Mergers Impact Clinical Trials,” April 2026; MarketsandMarkets CRO market sizing; Fortrea Q2 2025 results and company financial disclosures.
7. MBO Partners, State of Independence in America; The Interview Guys, “State of the Gig Economy 2025”; Carry, “2026 Gig Economy Trends,” 2025–26.
8. SoloWorkforce, “2025: The Year Independence Became a Power Position,” January 2026; Upwork Future Workforce Index 2025.

About The Author:

Jon Newton is principal consultant at NewtonBio Consulting Ltd. and a fractional C-suite, advisory, consultant, and board member. He has more than 25 years of experience in clinical development, spanning clinical operations, corporate development, data strategy, and strategic partnerships, including prior VP-level roles at global CROs. He has led clinical operations across APAC, EU, and U.S. markets and advises several digital health ventures.