Get to know the Speaker – Dr. Ivan Koychev

Get to know the Speaker – Dr. Ivan Koychev

Dr. Ivan Koychev is a clinical academic psychiatrist at the University of Oxford with a focus on the development of treatments for neuropsychiatric disorders. His research spans the key components of neuroscience clinical trial methodology: conduct of proof-of-concept (PoC) biomarker-based clinical trials in surrogate populations, testing of repurposed compounds, development of stratification and efficacy biomarkers and creation of infrastructure for large-scale stratified recruitment into neuroscience experimental medicine studies and clinical trials. Clinically, his focus is on the assessment and management of patients with neuropsychiatric presentations in acute medical settings.

Dr. Koychev answered a few questions we had for him ahead of his talk at ICMS 2022 titled “Preclinical Alzheimer disease: Diagnosis and clinical approach”.

Here is what he had to say:

Dr. Koychev, could you briefly explain what neuropsychiatry is - more neurology or more psychiatry?

Neuropsychiatry is a subspecialty of liaison psychiatry i.e. psychiatrists working in the general hospital. As such it is a psychiatry specialty but is in practice very close to behavioural neurology. Both deal with the assessment and management of behavioural manifestations of primary neurological disorders.  

How did you decide to focus on this specialty?

Since my student years in Sofia, I have been interested in clinical and cognitive neuroscience and the way that advances in this research area can impact on patient care. The intersection between neurology and psychiatry therefore always appealed as the area most likely to be at the forefront of such innovation. 

Why did you decide to specialize in the UK and later stay there?

I was interested in doing a PhD in clinical neuroscience immediately after medical school to maximise my chances of having a combined clinical academic career. I settled on Manchester for the PhD as they had an excellent unit specialised in development of novel neuropsychiatric treatments. My doctoral work in turn allowed me to be competitive for a form of speciality training unique to the UK – integrated clinical academic training. It gives specialty trainees protected academic time. I then secured training at the Institute of Psychiatry and later Oxford which are leading centres in my specialty. 

Does neuropsychiatry have a future in Bulgaria?

Neurology and psychiatry have more in common than perhaps any other two distinct specialties. My experience is that working at the interplay between them is both satisfactory for the clinician and benefits the patients. I therefore believe that neuropsychiatry is a specialty that has a place in any healthcare system, Bulgaria included.  

What are the latest approaches in the treatment of patients with neurodegenerative diseases and is there a way to prevent them?

The last decade brought huge advances to our understanding of neurodegenerative diseases such as Alzheimer’s. We know that they start up to 20 years before symptoms and so we and others are working on testing compounds in this preclinical stage. In addition, up to 40% of all dementia cases are due to preventable risk factors (chiefly cardiovascular disorders and physical/intellectual/social inactivity). This opens the possibility for effective preventative programmes starting in middle age and can delay or event prevent the illness. 

What patients do you encounter most often?

I mostly deal with patients under neurology or neurosurgery: dementias, movement disorders, CNS tumours, head trauma, epilepsy and neuroimmunological disorders. I see them for a variety of reasons from managing psychosis, depression or agitation to adjudicating their ability to make informed decisions. 

What is the most interesting case you have had in your practice?

While it will be difficult to single out an individual case, I remain fascinated by how loss of individual brain areas can chip away facets of people’s individualities one may have thought were inherent to their being.

What is your favorite memory from your student years?

As a student I had what in retrospect I can admit was a remarkably unreliable car. It had a knack for breaking down whenever I was giving one specific good friend and a co-student a ride. This led to us one New Year’s Day pushing up an icy road in true Sisyphean style, an object that had become for all functional purposes a sleigh. The scene was complemented by our respective dates observing the proceedings with gradually less well concealed amusement. Some 20 years on, he precedes getting into any car I own with the words ‘Vanka… Are we pushing today?’. 

What advice would you give to students who have decided to pursue science in Bulgaria?

Science has moved away from a model of insular lab groups to distributed networks of collaborators. This has opened opportunities to contribute to world-class research efforts early in the career. I would therefore advise these colleagues to develop an unique skill set that would be valuable to such projects and be proactive in seeking contact with leading investigators. In terms of skills, having a good grasp of coding and analytical methods will always be a valuable complement to clinical experience. Also, a number of high-quality datasets are now available freely and can be used to get academic output early in one’s career.

We can’t wait for Dr. Koychev’s lecture at ICMS 2022! Both active and passive participants get to hear our amazing keynote speakers so make sure you don’t miss it and register now for the 20th edition of the International Congress of Medical Sciences.

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