Parts of middle and upper management are a mess. Some managers have poor management and people skills leading to high turnover. Promotions are biased and unfair. There is no 360 feedback, so your fate rests on your immediate manager. With the hiring spree there has been a dilution of culture. There is a mix of hard/overworked employees, and those clearly just there to collect a paycheck. A lot of burnout from individual contributors asked to do too much or pick up slack for others. Unreasonable deadlines forced by clinical trials. Not enough separation between research and production, leading to excess red tape. Too many meetings with unengaged people.