Researcher blogs

What does it take to build an academic research career in pharmacoepidemiology? Pharmacoepidemiology is the study of the use, safety, and effectiveness of medication in real-world populations. In this career portrait, Dr. Carolyn Cesta, Assistant Professor at the Centre for Pharmacoepidemiology (CPE), Karolinska Institutet, reflects on her journey from laboratory-based pharmacology in Canada to investigating medication safety during pregnancy in population-based register data in Sweden.

Early career path

Carolyn’s academic journey began in Canada, where she completed her bachelor’s and master’s degrees in biology, pharmacology, and physiology. Her early research was lab-based and preclinical, but she always felt more drawn to human data rather than working with animal models. After her master’s degree, she managed a placenta biobank at a Toronto hospital research institute, an experience that deepened her understanding of clinical research and helped shape her next step.

In 2012, she moved to Sweden to pursue a PhD in epidemiology at Karolinska Institutet, after which she began a postdoc in perinatal pharmacoepidemiology. “My background in pharmacology made me very interested in why and how medications were being used in society,” she recalls. “Combining this interest with the epidemiology that I learned in my PhD is what led me into pharmacoepidemiology.”

During her postdoc, Carolyn also spent time as a research fellow at Harvard, supported by a Marie Sklodowska-Curie Actions (MSCA) global fellowship grant and her supervisor’s network, building collaborations that continue to influence her work today.

Current role and research focus

At the CPE, Carolyn leads a research program focused on medication safety during pregnancy. Her team uses Swedish health register data and collaborates across the Nordic countries and internationally to study drug use and safety in pregnant women. Alongside her research, she serves as the local principal investigator for several post-authorization safety studies commissioned by regulatory authorities.

Turning points

Reflecting on her career, Carolyn highlights three turning points: early exposure to research through her undergraduate program, several years of work experience between her master’s and PhD, and her move abroad to Sweden. “Those experiences helped me understand the kind of questions I wanted to pursue and the environments I wanted to work in,” she says.

Building skills in pharmacoepidemiology

When asked what skills are most important in pharmacoepidemiology, Carolyn emphasizes both analytic and collaborative abilities. “I think the ability to collaborate is a really important skill,” she explains. “To conduct relevant and high-quality studies in the field, it’s crucial to have input from clinicians, pharmacists, statisticians, and other researchers with expertise in a specific methodology or disease area, from the conception phase of the study to the final publication.”

She continues, “Having a strong analytical side is also important when making all the many large and small decisions needed to conduct a study, from determining whether a research question can be adequately answered with the data we have available, to study design choices, and whether to define a variable one way or another. Once you have the study results outputted, you then need to critically think about them in terms of validity and biases and interpret them appropriately. This all goes back to having a strong base in the principles of epidemiology and knowing the strengths and limitations of your data sources.”

When asked what she wishes she had learned earlier, she points immediately to coding and statistical programming. “I had no background in coding when I started my PhD, so the learning curve was steep,” she admits. “I learned from supervisors, statisticians, peers, and KI courses, but having some experience beforehand would have helped.”

Planning for a postdoc and academic career

For PhD students considering academia, Carolyn emphasizes the importance of planning ahead. “If you know you want to stay in academia, start exploring postdoc options halfway through your PhD,” she advises. “Reach out to potential supervisors and research groups, build relationships, and express your interest early on.”

Her own postdoc choice was driven by both topic and mentorship. After hearing Professor Helle Kieler give a seminar on her Nordic collaborative research in reproductive pharmacoepidemiology, Carolyn approached her directly. “That conversation led to my postdoc,” she says. “Even though postdocs work more independently than doctoral students, they are still in training, so having an engaged principal investigator and a supportive team really matters.”

Adapting and growing as a researcher

Carolyn values adaptability and believes exposure to new research environments is key to growth. “Every group has its own culture and way of working,” she explains. “Experiencing that diversity broadens your perspective and helps you grow as a researcher.”

She notes that funding remains one of the biggest challenges for early-career researchers. “So much depends on timing and available resources,” she says. Still, she encourages PhD students to stay open to diverse research paths. “Being in research doesn’t have to mean staying in academia. There are meaningful opportunities in industry, contract research organizations, and public agencies too.”

Mentorship and networks

Mentorship has been central throughout Carolyn’s journey. Her postdoc supervisor, Professor Helle Kieler, was a strong influence, but she also values peer mentors who are at the same stage or a few years ahead of her in their academic careers. Among her favorite networks is the Nordic Pharmacoepidemiology Network (NorPEN). “The annual NorPEN meetings are a highlight of the year,” she says. “It’s an opportunity to meet old and new colleagues, to hear about the research being done by the junior members, and to discuss the current challenges and future directions in the field. It’s a great community.”

The joy of mentoring others

What Carolyn finds most rewarding today is mentoring her own students and postdocs. “Providing them with the tools to grow, from learning their first lines of coding to doing full analyses and writing manuscripts, is incredibly fulfilling,” she shares. “Their enthusiasm reminds me why I love what I do.”

A typical week for Carolyn includes meetings with students, collaborators, and colleagues at CPE, but she also protects time for focusing on her own studies. Together with a colleague in Norway, she has a weekly three-hour online writing session. “It’s one of the highlights of my week,” she says. “It helps me stay productive and balanced.”

Practical advice for PhD students aiming for an academic career

• Start early: “If you know you want to stay in academia, start exploring postdoc options halfway through your PhD,” Carolyn advises.
• Build relationships ahead of time: “Reach out to potential supervisors, build relationships, and express your interest early on. Funding is needed to create a postdoc position, and this can take time to get into place, so timing matters.”
• Use conferences to connect: “Conferences are a great place to meet people and start those conversations. Even if you’re a few years away from finishing, showing interest early can go a long way.”
• Take initiative when you find a match: “When Helle Kieler gave a presentation at KI, I knew right away I wanted to work with her. I caught her after the talk, even though I still had two years left in my PhD, and told her I’d love to do a postdoc with her and why. That first conversation led to me writing a postdoc grant application with her support, and later, the postdoc position.”

Author’s note

Dr. Cesta’s story reflects the value of curiosity, adaptability, and strong mentorship. Her journey from laboratory pharmacology to population-based pharmacoepidemiology shows how following genuine interest and exploring new environments can shape a fulfilling research career.