Holly Scott has her finger on the pulse of medtech.

As a VP and senior partner at search firm The Mullings Group, Scott matches medical device developers and manufacturers with professionals ranging from executives to engineers.

We reached out to Scott for our annual analysis of the medtech industry as we ranked the world’s largest medical device companies through our Medtech Big 100 list.

In our conversation, Scott offered career development tips for medtech professionals — including how the Medtech Big 100 list can help — as well as her perspective on key medtech trends, including M&A activity, spinoffs and layoffs. (The following has been lightly edited for clarity and length.)

MDO: We’ve been tracking a lot of M&A activity and spinoffs over the past year and wanted to know what trends you’re seeing and what do they mean for innovation?

Scott: “We’re seeing investment and hiring trends that are very similar to 2019, which is actually good because we’re now in a resumed cycle of healthy growth and expansion. Medical device in general has never been the fastest to expand under normal conditions. … The bigger organizations are doing what bigger organizations do after a fatty year. They see the the bottom fall out and they realize they have to revert back to their core competency. The big trend of reorganization, spinoffs and M&A is expected and exactly what we thought was going to happen this year. And it is smart and it’s necessary if the strategics want to continue to grow Edwards alone, they’ve doubled down on structural heart with their critical care spin out, and they have now two announced acquisitions — actually three — in structural heart in the last 30 days. There’s a lot of focused, hyper growth. So what does this mean for innovation? That’s a good thing. First of all, innovation is best served when it’s either a build-to-buy or assumed build-to-buy in medtech. The distribution channels are already set. Why would we reinvent the wheel when it comes to the cost to actually build and drive an independent commercialization strategy? The FOMO that investors have had in the last few years is starting to get to them, and we’re seeing more investment happening where it makes sense. And those narratives around, ‘Well, let’s see how you do in clinicals, let’s see the clinical data, let’s see how you do in commercialization, let’s see the commercial data,’ those are still there. But they’re definitely paying closer attention and watching who else, what other sharks are swarming in the waters. So overall, there’s a healthy balance of increased attention in innovation and increased diligence in innovation, which is why we got ourselves in trouble with these big, frothy years in 2020, 2121 and early 2022. There was so much going on so quickly that the diligence just wasn’t happening the way it needed to be. We’re seeing a lot of that balance out. It’s funny, because unemployment is still low. It really has been overall. In our industry, though, there are pockets that have been hit in a more substantial way. A lot of the tech, the real SaaS-based technologies that were heavily invested in got a lot of the rug pulled out from under them when they entered last year and this year. So there have been organizations that have had to respond to market conditions. But overall, the trends are moving in a healthy way.”

MDO: How might medtech professionals use industry research like the Medtech Big 100 for career development?

Scott: “When you think about innovation and you think about the top 100, you’re not talking about the same companies. You’re talking about very different organizations. However, you can look at the macro trends and see what they’re paying attention to and where they want to grow. So obviously, when you think structural heart, you’re going to think Edwards. It’s recency bias as well as just their their superiority in that space. You don’t necessarily think about the other strategics, because they’re not as hyper-focused. When you think big picture about your career, I don’t think startups equal risk. I don’t think big companies equal safety. I think both can provide excellent career development opportunities. And when we think about where we’re going, I encourage everyone to think in essentially three years, because that experience you gain over the next three years is what allows you to be fundamentally marketable in your next opportunity, whether that’s internal or external. What kind of growth, what kind of experience could I gain that could platform me either within a large organization, or perhaps where I’d want to go next level and market myself? So you want to think about the big trends in the market and think about what you’re going to gain, because nothing about big equals safety and nothing about small equals risk. In medtech and life sciences, it’s about building on your expertise and making sure you’re positioned well to continue to be marketable. I certainly can’t — even if I’m representing the client — guarantee that a large company or a small company is going to provide a long-term career path past the next few years. Strategy changes, funding changes, resource allocation changes. The difference is in a young company, you tend to see the writing on the wall. In a larger organization, it’s less obvious what they’re doing behind the curtain. So when you look at a list like this, and you think about where you are career-wise, think about where you’re going to get the experience that’s going to benefit you and drive you to where you’d like to become marketable over the next few years. It’s not selfish. It’s smart, and it’s the way to think about what is going to be your next step and how you can best position yourself for it.”

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MDO: What are the career opportunities and challenges for medtech professionals going through spinoffs, sales or acquisitions?

Scott: “Whether you’re being acquired or whether you’re being spun out, first take a deep breath. Let’s see where this goes. In parallel to exploring what’s next for you, they are really two different entities. I don’t want anyone to panic and jump or do anything that would that would be contradictory to your success creating your own potential path. If you determine that you are interested in looking, first of all, you’re going to want to to really focus on the kind of work you’ve done most recently, because that’s going to lead to more open doors for you, and then a slight edge toward what you believe the market is trending toward. So let’s just say you’re designing or developing cardiovascular implants. Let’s say you’re in the structural heart space, and you’ve been involved with TAVR and you were one of the companies that were acquired recently. You may want to think about the other companies that are early in the TAVR space and start creating a network around those organizations. It’s very easy these days to find out who’s doing what. The magic of our business is no longer about finding people. It’s about connecting and engaging the right stakeholders and getting the attention, so it’s more empowering for anyone individually than it ever has been. You can think about who and where you may want to work in your next gig, and actually go to those individuals and and share with them your interests. So I would encourage you to step back and don’t do anything too rash. The fact is, some of these organizations are going to be left to be fairly independent, and they may be great places to work. The incentives with larger companies tend to be higher, and they may be OK. Now, if you’re with a startup and you’re acquired, nine out of 10 times the individuals who are within a startup — especially on the innovative side, on the R&D side, the engineers — are not as happy. They tend to want to go do innovative things again. However, you tend to have some runway to do that and start thinking about what’s next for you. Maybe it’s your own gig you want to start. Maybe it’s something you’ve been tinkering with. Maybe you want to start thinking about investors or partners or start building your network in an area where you’re passionate. And let’s just say you are in TAVR, maybe you want to consider imaging and cardiovascular imaging or a catheter-based technology rather than just specifically valves. There are areas that you can start exploring in parallel and those markets are growing. Check the market. Is it an area that’s continuing to accelerate? Is it one that investment dollars continue to go into and if so, that is usually a good bellwether for opportunities in terms of next steps career-wise.”

MDO: Do you think we’re through the worst of the medtech layoffs and people can rest easy?

Scott: “I don’t think anyone should ever rest easy. Coming back to career and career development and ownership, we have to continually add value, and as long as we’re continuing to add value, we have the responsibility and we can bank on the fact that we’re contributing to the bigger picture. Now, does that mean that you’re absolutely out of the realm of being laid off? No. Do I believe that the worst of the layoffs are over? In general, we have seen the big shifting within the strategics in the last 18 months, and that’s coming in off of their frothy years and that adjustment to the right. But we will continue to see the smaller, more subtle, nuanced layoffs happen. The ones that are under the radar and they’re not affiliated with a facility closing and the big headline layoffs that you hear about, because the big strategics are going to constantly have to adjust to what the new market looks like. Commercialization in medtech, in hospitals, in ambulatory surgical centers, in home health is changing so dramatically that it’s impossible to do projections that are entirely accurate. That’s why we’re seeing so many so many organizations continue to miss their quarterly objective numbers. It’s just a moving target. Because of that, it’s impossible to say it’s done. But I do see a passionate push toward continuing, healthy growth in medical and healthcare, so with that, there’s ample opportunity on both sides: on the innovative side as well as on the large, strategic side.”

MDO: What else are you seeing out there about medtech career opportunities?

Scott: “It was interesting that for so many of the CEOs surveyed in the Deloitte CEO Survey for 2024, their two big concerns these days are geopolitical influences and labor shortages. The fact that those two are competing is a strong indicator that the market is still going to continue to be robust for medical device, medtech and life science professionals. Has the game of finding a new opportunity changed? Absolutely — and for the individual’s benefit, because you really do have more access to information than you ever have before, and it really becomes about building a valuable network. So I would encourage anyone who’s sitting on the other side of a decision outside of their hands to remember that you are empowered and there are a lot of tools out there that can provide insight into how you can find that next opportunity.”

Related: Medtech booster Frank Jaskulke on M&A, spinoffs, layoffs and Medtech Big 100 trends