Drawing on the searches we run, this lays out what actually separates the candidates who get these roles from those who do not. Evaluating an offer from a device startup means assessing the company’s survival and success odds as carefully as the compensation, because in this sector the outcome depends heavily on regulatory and funding events that are partly knowable in advance. The diligence you do before accepting matters more than the terms you negotiate, because strong terms in a company that runs out of runway before clearance are worth very little.
Key Takeaways
- Assess the regulatory pathway and its realism before anything else.
- Understand the funding position and how long the runway actually is.
- Clinical evidence quality drives both approval and reimbursement odds.
- Examine equity terms and where you sit in the capital structure.
- Judge the team and investors as carefully as the technology.
Start With the Regulatory Pathway
The first question is what regulatory route the product is on and how realistic the company’s assumptions about it are. Ask which pathway they are pursuing and why, whether they have had pre-submission interactions with the agency and what came of them, what evidence they believe is required, and what their timeline assumes. Compare their answers against what the pathway typically demands. Companies with optimistic pathway assumptions are common, and the gap between assumed and actual regulatory timelines is one of the main reasons device startups run out of money. This is knowable in advance if you ask directly.
Understand the Runway Honestly
Ask how much cash the company has, what the monthly burn is, what milestones the current financing is meant to reach, and what the plan is if those milestones slip. A device startup’s survival usually depends on reaching a regulatory or clinical milestone before the money runs out, so the relationship between runway and milestone timing is the central risk. Founders and boards will generally answer these questions candidly for a serious executive candidate, and reluctance to do so is itself informative. Do not accept a role without understanding this relationship clearly.
Assess the Clinical Evidence
The strength of the clinical evidence, existing and planned, determines both the regulatory odds and, later, the reimbursement prospects. Ask what data exists, how it was generated, what the planned studies are designed to show, and whether payors have indicated what they would need. A company with a technically impressive device and a weak evidence plan faces problems that no amount of commercial execution fixes. Where you lack the expertise to judge this yourself, it is entirely reasonable to ask to speak with the clinical or regulatory leadership, and to seek an informed outside opinion.
Examine the Equity Structure
Startup equity is frequently misunderstood by candidates who focus on percentage or share count without examining the structure. What matters is where your equity sits relative to liquidation preferences and any accumulated preferred stock, how much has been raised and on what terms, the vesting and acceleration provisions, and what exercise obligations you would face. In companies that have raised substantially, common equity can be worth far less than the headline percentage suggests in many exit scenarios. Ask for the capitalization details and understand them before treating equity as compensation.
What This Looks Like in Practice
A candidate evaluating a device startup offer examines the regulatory pathway and the realism of its assumptions, establishes the relationship between runway and the milestones the financing must reach, assesses the clinical evidence plan and reimbursement prospects, and understands where their equity sits in the capital structure before treating it as compensation.
The Mistake Candidates Keep Making
The most common mistake is negotiating hard on the offer terms while doing little diligence on the company’s regulatory and funding position, because the terms feel like the part within your control. But strong terms in a company that misjudged its pathway and runs out of cash before clearance are worth almost nothing. The candidate optimizes the negotiable and ignores the determinative.
Diligence Questions Worth Asking
| Area | Question |
|---|---|
| Regulatory | Which pathway, what agency interactions, what evidence is required? |
| Funding | How much cash, what burn, what milestones must this financing reach? |
| Clinical | What data exists, what will the planned studies show? |
| Reimbursement | Have payors indicated what coverage would require? |
| Equity | Where does common sit relative to preferences and raises? |
The Bottom Line
Evaluating a device startup offer is mostly diligence rather than negotiation, so examine the regulatory pathway and its assumptions, the runway against the milestones it must fund, the clinical evidence plan, and your actual position in the capital structure, because the company’s odds determine the value of any terms you agree. Be deliberate about this, and you will be choosing between offers rather than hoping for one.
Related Reading
For more, see Negotiating Your Compensation Package as a MedTech Executive, How to Land a C-Suite Role in the Medical Device Industry, Relocating for a MedTech Executive Role.
Frequently Asked Questions
- Q: What should I assess first in a device startup offer?
- A: The regulatory pathway and how realistic the company’s assumptions are, since optimistic pathway assumptions are common and drive the timeline risk that determines survival.
- Q: How do I judge the funding position?
- A: Ask how much cash exists, what the burn is, which milestones the financing must reach, and what happens if they slip, since survival depends on that relationship.
- Q: Why does clinical evidence matter to my decision?
- A: Because it determines both regulatory odds and later reimbursement prospects, and a weak evidence plan creates problems that commercial execution cannot fix.
- Q: What should I understand about startup equity?
- A: Where common stock sits relative to liquidation preferences and accumulated preferred, the vesting and acceleration terms, and exercise obligations, not just the headline percentage.
- Q: Is it reasonable to ask these questions?
- A: Yes; boards and founders generally answer candidly for serious executive candidates, and reluctance to discuss runway or pathway assumptions is itself informative.
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Tanya Gallardo
Managing Director, Executive Search & AI Talent Strategy
Tanya Gallardo is the Managing Director of Executive Search & AI Talent Strategy at JRG Partners, leading C-suite and Board engagements across key growth sectors including Technology, Financial Services, and Manufacturing.
With over 18 years of experience specializing in disruptive technology leadership, Tanya is recognized as a leading authority on talent architecture for future-focused executive roles, such as the Chief AI Officer (CAIO) and Chief Digital Officer (CDO). Her expertise lies in accurately assessing the cultural fit and technical depth required to ensure a high return on investment (ROI) for critical leadership appointments.
Prior to her role at JRG Partners, Tanya held senior roles directing global talent acquisition strategies at a major publicly-traded technology firm, advising on organizational design and succession planning for emerging executive functions. She is a recognized speaker and contributor to industry events, sharing data-driven insights on executive compensation, leadership development, and the measurable business impact of C-suite talent.
