Uncommon Careers

Here, There, Everywhere - Olga Kostopoulou

Department of Surgery and Cancer, Imperial College London, United Kingdom

After my first postdoctoral appointment in a psychology department, I became an assistant professor of behavioral sciences at a medical school. I lectured on medical error, the role of cognitive biases, risk perception, and risk communication in medical decisions. During this post, I obtained a national research fellowship to study adverse events in primary health care. This award helped me develop my research on medical error, obtain further research grants, and establish a career as a psychologist working in a medical academic environment.

My interest in human error and especially medical error made the transition from a psychology to a medical department plausible. In fact, after my first postdoc, I was contemplating leaving academia, as I found the research process too drawn out and removed from real life. I am much happier when research moves in a bidirectional way, from the lab to the ecology and back to the lab, but always with an eye on the ecology.

I study judgment and decision-making applied to health care. My aim is to apply psychology theory, methods, and findings to the study of medical decisions by professionals and patients. I have conducted research in different health care contexts and have led a number of projects on medical judgment and decision support.

I employ psychology postgraduates and supervise psychology PhDs. My current PhD student is studying the role of predecisional information distortion in medical diagnosis. My current postdoc has a PhD in neuropsychology and is working with me on a project that uses signal detection theory to study misdiagnoses.

The biggest benefits to working in a medical school are access to populations of interest (i.e., physicians and patients); knowledge about research gaps and needs, which is important for obtaining research funding; and the opportunity to do research that is likely to have an impact on patients and their care. A drawback is the lack of easy access to psychological scientists from similar areas with whom to exchange ideas and learn about the latest theoretical and methodological developments. Going to conferences, being a member of scientific societies of relevance (APS, the Society for Judgment and Decision Making, the European Association for Decision Making, and the Society for Medical Decision Making, in my case), and collaborating with other psychologists are some ways to compensate for this, as is disseminating your work to colleagues who would never otherwise get to hear about it.

Another drawback is the expectation to publish in high-impact-factor journals, which is the norm for most medical journals. Publications in journals with an impact factor of less than 3 to 5 (as most psychology journals are) may be omitted from a medical school’s submission to the Research Excellence Framework, which can disadvantage an individual seeking promotion.

It is encouraging that behavioral sciences have become more prominent in medicine in the last 15 years because of  health psychology and, more recently, “nudging” and behavior change. Nevertheless, psychological scientists still have a long way to go to have their contributions acknowledged as those working in more traditional disciplines such as genetics, molecular biology, and epidemiology.