Management is not helpful and overworked conditions. Industry standard for a CRA is 6-8 monitoring visits per month, Working 11-14 while at Medpace was not uncommon with CTMs claiming still not enough work getting done. When I talked to my manager on a on-site visit, where they were with me, I asked if they could help I was informed "I am your evaluator not your assistant why would I help you". That same manager came to the site an hour late and left two hours early.