Kenyan gyn-onc fellows talk about ‘eye-opening’ and ‘game-changing’ observership

Gynaecologic-oncology fellows Drs. Gabriel Eliazaro and Geoffrey Wahome, who left Toronto at the end of October to return to Kenya, described their six-week observership as an “eye-opener” and “game changer.”

The two fellows are from Moi Teaching and Referral Hospital (MTRH) in Eldoret, and they visited hospital sites in Toronto through the AMPATH-U of T partnership, hosted by the department of obstetrics and gynaecology. Their training is part of larger program to build advanced cancer treatment expertise in Kenya, including treatment of gynecological cancers.

“We were incredibly happy that Moi gynecologic-oncology fellows could join us again, the first time since the pandemic,” says Dr. Rachel Spitzer, a professor in the department and Vice Chair, Global Women's Health and Advocacy. “Gabriel and Geoffrey adapted quickly to our clinical setting and were great representatives of the Moi program. I expect their experience will impact their career journeys and the care of women affected by gynaecologic malignancies in their future practice sites.”

We touched base with Eliazaro and Wahome at the end of October to ask them some questions about their time in Toronto.

What were some of the highlights of your medical learning during the six weeks?

Eliazaro:

The different approaches to gynaecological cancer treatment were an eye-opener. Under the mentorship of Professor Allan Covens and the entire Sunnybrook team, I learned about newer surgical techniques. I also came to realize the big role minimally invasive surgery plays in gyn-onc, and — in a first for me — observed the use of robotics in surgery with Associate Professor Marcus Bernardini. The brachytherapy rotations taught me how adequate planning and a focused approach can improve on patient outcomes.

Finally, the palliative care rotations made me appreciate the wholistic management of cancer patients, and how the various specialities can collaborate to ensure care for cancer patients is a continuum — how patients’ desires and comfort can be optimised throughout the treatment journey.

Wahome:

This opportunity at Princess Margaret and Sunnybrook gave me exposure to procedures that we don't have back home, such as robotic surgery and IMRT brachytherapy. I saw the difference they can make in treatment of gynecological cancers.

The experience in palliative care unit was a game changer! My interactions with Dr. Banerjee Subrata in the palliative care unit, in caring for patients with terminal illnesses, were inspiring. Drs. Covens and Bernardini gave us generous exposure to procedures in OR, especially with minimally invasive procedures.

I would like to thank Dr. Michael Milosevic for his coordination of my time in the radiotherapy department at Princess Margaret. Last but not least — I won’t forget the use of frozen sections when making decisions during surgeries.

What’s one thing that will stay with you as you continue your career?

Eliazaro:

One lesson I've learned is that the patients’ own desires have a huge role in their care — no matter the diagnosis — and that cancer care should be collaborative, bringing on board all relevant specialists to give the optimal treatment.

Wahome:

These experiences will definitely influence my practice of gynaecology oncology and I’m going to advocate for much of what I learned to be implemented back home in Kenya, to make many similar services available to our clients, especially those around palliative care.

How did you find Toronto as a city?

Eliazaro:

Toronto is a very welcoming city. Within the first week I forgot I was in a foreign city, it was so easy to blend in! And the people, staff and patients were all friendly.

I was pleasantly surprised how the entire health-care system managed to ensure primary health care runs optimally, and that specialized centres are well equipped to ensure all the citizens access the highest health care without discrimination.

We managed to tour several magnificent sites like the CN Tower, Niagara Falls, and the Toronto Islands. I appreciate the hospitality accorded by the families of Drs. Covens, Nan Okun, Rachel Spitzer, Rohan D’Souza, Heather Millar and all the faculty members who joined us in the series of wonderful dinners that made us appreciate the Canadian cuisine.

Finally, I’m grateful for the support of Joe George, the program administrator, and Dr. Milosevic, who ensured we had a well-coordinated observership program.

Wahome:

Toronto is beautiful and full of diverse cultures. The orientation we received from Joe George and Dr. Barry Rosen — as well as the organized transport system — made touring the city easy, and Niagara Falls and the apple-picking event will always be memorable to me.

I want to thank the families of Drs. Nan Okun, Rachel Spitzer, Rohan D’Souza, and Heather Millar for the invitations to their homes and the great meals.