Ten years ago I was cold-emailing strangers looking for work. Today clients come to me without any outreach at all.
That gap didn’t close overnight. But it started with a few specific moves, and they’re the same ones I’d recommend to anyone trying to break in now.
I’m unapologetic about recommending freelancing as a first move into medical writing. Full-time roles at agencies involve a lot beyond the writing itself, things like client relationships, project scoping, strategy, and budgets. Freelancing lets you experience the actual work without all of that. It’s also how a lot of medical writers start, which means the infrastructure for it exists. People expect to hire freelancers. Use that.
Step 1: Commit to 2+ hours a day
No sugar-coating this one. Breaking into a new field takes concentrated effort. Two hours a day is enough to build your materials, do meaningful outreach, and follow up. But only if those two hours are protected and deliberate, not squeezed between experiments.
Step 2: Have a portfolio on your own website
Apparently this caused some controversy on LinkedIn. I stand by it. Hiring managers are busy, and freelance clients especially so. They typically have a specific problem and they want it solved quickly. A portfolio hosted on your own site makes you an easy yes. A LinkedIn profile alone does not.
Step 3: Network before you apply
If you work in science, you are probably 2 or 3 connections away from someone already working in medical writing. It is one of the most common career pivots for academic scientists. Start there.
No direct connections? Use LinkedIn to find second-level connections and ask for introductions. Cold outreach for informational interviews is completely normal in this field, but lead with something real. Reference their work or offer something useful. Be a human being, not a template.
Step 4: Apply selectively and pitch proactively
Most freelance gigs are never publicly listed. The ones that are posted will have the most competition. So respond to listings, but don’t stop there.
Find the people at relevant companies who are in a position to hire freelancers. Send a short, targeted message on who you are, what you offer, and how to reach you. Keep it brief, and keep follow-up limited and respectful. One move that consistently works is to close your message by asking if they know someone more appropriate who they could forward it to. It’s a low-friction ask that often opens doors the original message didn’t.
Step 5: Avoid the race to the bottom
I’ll be direct: I don’t recommend Upwork, etc for medical writing. These platforms tend to drive fees down in a field that deserves specialist compensation. If financial pressure means you need paying work quickly, take what you need, but keep the networking and direct outreach running in parallel and transition out as soon as you can.
Final word: Zero to one changes everything
This is a tough market right now, I won’t pretend otherwise. But the strategies above will put you ahead of most people applying for the same work. And the hardest part isn’t the tenth client, it’s the first one. Once you go from zero to one, the narrative shifts completely. The portfolio grows and the referrals start.