A significant portion of my tenure as both an in-house and field Clinical Research Associate (CRA) was devoted to clinical study start-up operations. In managing activities such as site and vendor selection, coordinating internal and external stakeholder meetings, developing project plans, and updating clinicaltrials.gov, I seized this unique opportunity to learn as much as possible and refine the start-up process wherever feasible. Working at this early stage of clinical trials across a variety of therapeutic areas has sharpened my ability to identify stakeholders and processes that best fit the requirements of the current study.