October 2003
Volume 16, Number 10
Psychology in a Community-Based Medical School
A community based medical school uses private hospitals for its clinical work and teaching, while a normal medical school would have a university-owned facility. As a result, community schools are more practice-oriented and less research-driven. I would like to address the unique challenges encountered in this type of academic setting, and the impact of a "non-traditional" academic environment on my research endeavors.
My setting is atypical, in that I have only a small number of interns and post-docs, no psychology graduate students, and no research laboratory. The medical school is not based in the same geographic location as the main university campus, and because Southern Illinois University is a small medical school, the number of faculty in any division is limited.
Similar to other medical schools, there is increased reliance on clinical revenues, which translates into burgeoning clinical loads being placed on faculty - psychology included - coupled with other service and teaching demands. The community-based scenario often places young investigators in a "Catch-22" situation: Because there is no "team" to compete for research dollars, one often cannot obtain such funding, and if one does not have research support, then there is no way to build a team. Therefore, to maintain research productivity in this type of environment, I have had to use clinical populations and have participated in multidisciplinary collaborative projects, both inside and outside of the medical school.
The upside is that the clinics and their populations have afforded a source of data that would be difficult to obtain in a more traditional psychology setting. My areas of research interest could only be maintained in this environment, or one where the psychology department has an on-campus medical school, or at least an affiliation with a medical facility.
Having worked in a medical setting for more than 25 years, I have witnessed many changes affecting psychologists. Initially there was the "triple threat" mindset - excellence in teaching, research, and service - which over the years has evolved into the "best two out of three." Psychologists were routinely based in psychiatry, but now also are found in pediatrics, family practice, neurology, and other departments. Similarly, tenure track appointments appear to be decreasing in many schools, mine included, with promotion and tenure often being separate procedures. The PhD degree was traditionally associated with basic science research, so it becomes confusing to physicians when one is a PhD in a clinical department, a psychologist, and a clinician to boot. There is a tendency to pigeonhole the psychologist into the role of a technician of some sort, or a research consultant. To better define their role, psychologists should aspire to the "triple threat" goal, and address research, clinical service, and teaching. This is the most effective way to establish credibility.
My primary area of research is in early developmental neuropsychology. More specifically, I am involved in early neurodevelopmental assessment, longitudinal prediction of cognitive and motor functioning, and developmental screening and prescreening. As a result, I work with infants and young children, although I also collect data on older children referred for evaluation because of learning or attention problems. This wide range of interest is not as disparate as it might initially appear, because many children who are at early biologic risk later have high prevalence, low severity dysfunctions such as learning disabilities, ADHD, or other neuropsychological problems. In fact, I would like to better define the relationships between the two, and identify early indicators of these school-age problems. My research could not be effectively implemented without a medical school, and would be impossible had I not received early training and experience in such an environment.
As I had indicated in Infant and Early Childhood Neuropsychology (Aylward, 1997), developmental neuropsychology requires specific training that is not routinely available in traditional clinical or developmental psychology programs. The logical extension is that both training experiences and subsequent research involve specialized populations that are not accessible outside of a medical facility. My long-term goal is to someday develop a specialized training program in this area, and to do so will require bridging psychology and medicine with both psychologists and physicians as faculty. This goal can best be accomplished in an academic environment that is "non-traditional" with respect to psychology.
