For Pavel Tikhonov, good project management comes down to one main focus: alignment.

A clinical trial brings together sponsors, investigators, sites, vendors and cross-functional teams, all with different priorities, pressures and areas of expertise. Pavel sees an important part of his role as making sure those different groups understand one another and remain focused on the same objective.

“Everyone can speak a slightly different professional language,” he says. “A surprisingly large part of my job is helping people understand what other people actually mean, find common ground and turn a problem into a solution.”

It is a perspective shaped by more than 20 years in clinical research and by a career that has allowed Pavel to see the industry from many different sides.

From treating patients to impacting patients at scale

Before entering clinical research, Pavel trained and worked as a physician in St. Petersburg. He holds an MD as well as a PhD in Clinical Pharmacology and Cardiology and spent several years in practical medicine before looking for an opportunity to make an impact beyond the individual patients he treated.

Clinical research offered that possibility.

“Clinical research gave me the opportunity to become part of a global clinical development system, where what we do can ultimately affect thousands, if not millions, of patients.”

Pavel began his clinical research career as a Project Assistant before progressing through CRA and study start-up roles and eventually into project management and leadership. Today, his experience spans Phase I–IV clinical trials across a wide range of therapeutic areas, including rare disease, oncology, cardiovascular disease, CNS, infectious disease and gastroenterology.

That breadth of experience continues to shape the way Pavel manages projects and people, while his medical training gives him valuable context: the ability to see the clinical story behind a protocol requirement, data query or operational decision rather than viewing each activity in isolation.

Combined with his operational experience, that medical background helps Pavel bridge the gap between the scientific objectives of a study and the practical realities of execution – whether he’s working with medical monitors, investigators, sponsors or operational teams.

“When I ask someone to do something, very often I have done that job myself,” he says. “You understand what is reasonable, what isn’t, what the options are and what pressures people are working under.”

Part strategist, part diplomat, part firefighter

Pavel joined Confidence in 2024 after spending many years within a much larger global CRO environment. He wasn’t simply looking for another CRO. What attracted him to Confidence was the balance it offered.

“Confidence is large enough to work globally and take on complex programs, but still small enough for an individual to make a visible difference,” he says.

Being closer to clients, teams and decision-making means Pavel can see more directly how his experience influences a project. His day-to-day role can vary considerably, but the objective remains consistent: making sure everyone involved understands what the study is trying to achieve, when it needs to happen and what it will take to get there.

That means looking across the study rather than at individual activities in isolation – from startup timelines and site readiness to recruitment, resourcing and cross-functional dependencies – and anticipating how an issue in one area could have consequences elsewhere.

Risk management is central to that responsibility.

“A good project manager needs to be looking a little further down the road,” Pavel explains. “What could happen? What would it mean for the study? What can we do to prevent it or reduce the impact?”

For Pavel, effective risk management isn’t simply about responding when something goes wrong. It’s about identifying potential risks early enough to give the team time and options to respond.

That’s why Pavel describes project management as “part strategist, part diplomat and part firefighter”. The better you are at anticipating challenges and keeping people aligned, the fewer fires there are to put out.

The importance of choice

For Pavel, patients have never been an abstract part of clinical research. One of his early clinical trials brought the connection between research and patients into sharp focus. It was a Phase I study involving babies with severe refractory epilepsy. Pavel’s medical background meant he understood the reality – there was no guarantee that an experimental treatment would help these individual children. But he saw what participation in the study represented for their families: another option when there were very few options left.

“When people are in these very difficult situations, sometimes they feel that they don’t have choices,” Pavel says. “Clinical research can give them a choice. Maybe not the choice we ultimately want to give them, which would be a cure, but it is still a choice.”

Clinical research may ultimately create treatments that help thousands or millions of people. But that experience was a reminder of what participation can mean to the patients and families involved in a study today.

Finding out what a treatment really is

Pavel also resists the idea that clinical research is simply about proving that a treatment works. In reality, some of the most valuable findings are the ones that reveal where it doesn’t. From adverse events and safety signals to drug interactions, unexpected effects or patient populations where a treatment performs differently than anticipated.

Discovering those limitations during development is fundamental to responsible research.

“Contrary to what people may think, good clinical research isn’t about making a drug look good,” Pavel says. “It’s about finding out, as honestly and thoroughly as possible, what the drug actually is.”

Negative or unexpected findings aren’t failures of clinical development. They are part of what the process exists to uncover.

Still learning

That curiosity extends well beyond Pavel’s work. 

He’s a jazz enthusiast and piano player and, more recently, has taken up the ancient game of Go. The rules can be learned relatively quickly but mastering it can take a lifetime. 

For Pavel, it has something important in common with clinical research:

“You can spend your entire life getting better at it and still never run out of things to learn.”

From medicine to clinical research and project leadership, curiosity and a desire to keep learning have remained constants throughout Pavel’s career.