Something to keep in mind: the majority of employees in pharma are not healthcare professionals. The majority of employees in Medical Affairs (including Med Info) and Pharmacovigilance are. A good proportion in Regulatory Affairs also are HCPs. I would also say the majority of HCPs in Pharma have not done a fellowship, but a fellowship definitely is a leg up. There is no 1 way into this sector. Each person seems to have just found their own way there. The overwhelming majority got their first pharma job by taking a chance and just applying through a website. Some first worked at a CRO or agency, then leveraged that experience. With CRO experience - it becomes quite easy to get into pharma.
Although the perspective of fresh grads is that industry is tough to get into with a limited number of spots, the perspective of many hiring managers in the industry is that there is shortage in the talent pool. Somewhere in between that gap is where both have to meet. A prospective candidate with limited experience has to do the legwork and sell their transferable skills hard, and the hiring manager has to be willing to be sold (and have the flexibility of developing you up to speed).
Getting into industry is not rocket science. Passing pharmacy school is much more difficult. Frankly, getting promoted to a PIC or district manager position in retail is much harder. The industry WANTS more pharmacists or otherwise qualified people to jump in so that the talent pool grows. The one caveat is that there is no good "roadmap" for everyone to follow - the closest is the industry fellowship but that doesn't begin to cover the many different ways people get in. So what does one do when you want to get somewhere without a roadmap? Just keep driving until you hit a major highway.
