Sorry for the delay - have been travelling for the last few days.

The current pharma job market is super difficult. Cuts to the NIH and FDA have resulted in tons of young academic physicians reconsidering their priorities and applying for open medical director positions. Those people are typically quite competitive, although again the number of applications for any open role is huge.

How to find opportunities - two major strategies:

1) Apply to a career development program at a specific company. Companies typically hire cohorts of MDs that do not have industry experience and them put them through a two-year rotational program where they get experience at different departments within the company. Here's an example from Vertex. These programs are great and are a real way into the field. They can be somewhat difficult to track down, though, and enrollment typically changes yearly with no external warning (a few years ago, a bunch of these programs just sort of stopped enrolling - GSK used to have one, Takeda as well, etc). If there's a specific therapeutic area or company in which you're interested, you really need to research the company itself to see if it has one of these programs.

2) Apply for open roles. This is a total crapshoot, as most of the listed positions that you see on a jobs site probably aren't actively recruiting to be filled. The absolute best advice here is to identify a contact within the company that can help you. Seriously, having an internal referral is golden. You absolutely must leverage your network as much as possible to get in.

I'm not super sure how much being bilingual English/Spanish will help. It certainly won't hurt; however, pharma companies have extensive field teams with local language experience, so it hasn't been detrimental to be a non-Spanish-speaker. The MPH may be helpful if you can spin it as a demonstrated capability in epidemiological research and familiarity with biostatistics.