Pretty much everything else. The company is filled with very, very smart people - unfortunately, they have no idea how to train or retain their talent. Management continually scratches their heads about why their turnover rate (I HIGHLY ADVISE YOU TO ASK WHAT THEIR TURNOVER RATE IS AFTER TWO YEARS IF YOU GO IN FOR AN INTERVIEW), but they refuse to turn they eye of blame towards themselves.
The working culture is very, very unhealthy for development. Middle management is filled with corporate types who have worked at large pharmaceutical companies. So even though this is a small firm, it has a rigid corporate atmosphere and culture, which completely negates the benefits of working for a small company. The company has lots of internal corporate buzz words and mantras that you usually only see in larger corporate structures. This is because middle and upper management have brought their experience at larger pharmaceutical corporations and applied it to this boutique firm, which really alienates a lot of people who were expecting a more boutique atmosphere. You will hear a lot about "Attention to Detail", which within company culture is used as a catch-all for any mistake that you may make. You will never actually be instructed on what you specifically do wrong - just told that you need to work on abstract concepts that don't really make sense. As such, no one improves. Work deadlines are tight, but that is expected at any consultancy - however, it is harder to hit deadlines on projects that actually matter when you are getting hounded about doing internal projects that no one actually believes matter. If you make little mistakes on your work (misspelling a word, or forgetting a period at the end of a sentence) it will be treated as a bigger deal than if you were to make a big mistake (such as completely misinterpreting some data and making the wrong recommendation). Ultimately, a disproportionate amount of priority is placed on the style of your work rather than the substance or content. This is complicated by the fact that a lot of "style" (such as what color bars to make your bar graphs) is personal preference - so one of your bosses will give you the advice to color things a certain way, and then when you take his/her advice, your other boss will get mad about doing so and tell you to work on your attention to detail. Overall, it was a very frustrating experience, that could be improved with better training, clearer expectations, more focus on the specifics of how employees can improve, and less rigid culture that disenfranchises employees.