Benazir Khan was born and raised in a traditional Sindh village in southeastern Pakistan, surrounded by farmers growing rice, cotton and sugarcane. As a girl, she could not leave her home unless she wore a full face covering and was accompanied by a male family member.
Today, Dr. Khan is one of 28 fellows in the Princess Margaret Global Oncology Leadership Development (GOLD) Program, a unique annual program for local and international fellows that allows them to gain experience in leadership and health management, skills they can bring back to their practice.
Dr. Khan's journey from a village, to studying radiation oncology in Karachi, to the Princess Margaret Cancer Centre, was a challenging one, filled with roadblocks that would deter someone less ambitious.
She applied several times to GOLD before being accepted.
"I am very determined. That is my secret weapon," Dr. Khan says with a laugh.
Launched in 2019, the GOLD program has accepted 111 fellows from 38 countries. While fellows work as full-time MDs, they also get to attend lectures and small-group sessions to build their leadership capacity and learn about problem-solving, teamwork, and collaboration, as well as health economics.
"The program has really broadened my horizons and changed my vision and will help me when I go back to Pakistan," Dr. Khan says. "I am more sensitive towards patients and people's different belief systems.
"Learning more about oncology also contributes to better treatment and knowledge exchange."
GOLD is one of several initiatives at PM's Global Cancer Program, an academic centre of excellence in education, research and knowledge translation in global oncology. It is run collaboratively with the Cancer Education Program.
"The program is helping to train the next generation of global cancer leaders and build links with our international partners to improve equity in cancer care," says Dr. Keith Stewart, Director of the Princess Margaret Cancer Centre.
The mission reflects the theme for this year's World Cancer Day on Saturday, Feb. 4, which is "Close the Care Gap." It's aimed at addressing barriers to cancer care locally and globally, whether those barriers are a result of income, education, geographic location or discrimination.
Once fellows leave the Princess Margaret, they join a global alumni network, says Tina Papadakos, Director, Knowledge Translation, Cancer Education at the cancer centre. Some form research partnerships with one another and with PM staff, creating more global synergies and reciprocal learning opportunities, while others return to their country of origin and introduce advances in treatment including in robotic surgery and radiation oncology.
In Dr. Khan's case, she had to persuade her father to set aside cultural norms about women and allow her to move from her village to the city of Hyderabad to complete high school. Dr. Khan then moved on her own to Karachi, a city of 16 million people, to attend the prestigious Aga Khan University Medical College where she specialized in radiation oncology.
"I was the first female radiation oncologist at the Aga Khan hospital. So many female patients wanted to have a female doctor," she notes.
While the hospital was supportive, Dr. Khan's humble background put her at a disadvantage with some colleagues; she wanted to come to the Princess Margaret to enhance her clinical training in radiation oncology for gynecology and breast cancers, and to build experience and credibility.
As the first radiation oncologist from Pakistan in the GOLD program, Dr. Khan is learning a lot from her peers, and looks forward to helping women patients get the cancer care they need when she returns home.
"I want to be a role model for other women doctors," she says.
Cancer care is expensive in Pakistan and there is uneven access and not enough focus on screening or diagnostics, she notes.
Dr. Alejandro Brañes is another GOLD fellow. A digestive surgeon from Santiago, Chile, he is specializing in surgical oncology and hepato pancreato biliary (HPB) surgery, a sub-speciality specific to disease of the liver, pancreas and biliary tree.
"I am learning so much about surgical oncology," he says. "Here you centralize specialty surgery, and it leads to better outcomes.
"I want to take what I have learned back to Chile and lobby for a different kind of health care delivery."
'Thanks to this training, I can be both a doctor and an influencer'
Dr. Brañes first heard about the Princess Margaret through his uncle, who did his training at the Toronto General Hospital 30 years ago. He appreciates the global network the program has given him, noting he has met fellows from the Netherlands, Mexico, Germany and Nigeria.
"In Latin America, we tend to be very social and I think I bring that to the team," Dr. Brañes says. "I love to go out with staff and co-fellows even if it is more difficult in the winter in Canada."
Funmilola Wuraola, this year's sole GOLD Fellow from Nigeria, is specializing in breast surgical oncology. Dr. Wuraola wanted to come to the Princess Margaret to develop her skills as a breast cancer surgeon, and to enhance her capacity as a leader.
"I have learned a lot about myself and know that I need to blend the compassionate side of myself with the firebrand side to become a more effective leader," says Dr. Wuraola.
Nigeria has unique challenges when it comes to cancer due to a lack of proper screening programs, absence of universal healthcare insurance and a stigma against treatment, including mastectomies.
While the world's attention is often focused on emerging infectious diseases in sub-Saharan Africa, cancer deaths are increasing due to demographics and the lack of health infrastructure required to treat the disease.
"In the last decade we have seen a steady rise in breast cancer in Nigeria," Dr. Wuraola notes. "We have higher mortalities than in high-income countries."
Dr. Wurola has found it particularly helpful to hone her skills in breast-conserving surgery at UHN, and hopes these new skills will help patients in Nigeria be more receptive to treatment.
When she returns to Obafemi Awolowo University Teaching Hospital in Ile-Ife, in Nigeria's southwest, she intends to advocate for policy change including increasing people's awareness about breast cancer, screening and treatment options.
"I want to be a voice for young people when it comes to leadership in global oncology," Dr. Wuraola says. "Thanks to this training, I can be both a doctor and an influencer."
This story first appeared on UHN News