Stephanie Gill, obstetrics and gynaecology resident at Memorial University of Newfoundland
Q. In your letter, you mention that you are working on a proof of concept of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) tell me a bit about that project and what you find most interesting about it?
Stephanie Gill: For the HIPEC project, I’m working with another resident from general surgery who’s doing surgical oncology fellowship next year, and I’m doing a gyneoncologic oncology fellowship next year. We were looking at proof of concept for a HIPEC program in Newfoundland. So basically, what that means is HIPEC is a type of treatment that can be offered to very select ovarian cancer patients. I know not all centres in Canada necessarily offer, and you have to have pretty strict criteria to be able to offer it, but because of the population of Newfoundland as well as the remote areas where people live , HIPEC may benefit them more if they cannot travel to the major cancer center to get IP chemotherapy. We looked at proof of concept of that type of treatment here and the way that we did that is we looked at all the different patients over one year who maybe would have been eligible for HIPEC, and then looked at ‘did they get chemotherapy after their surgery’ or ‘do they get chemotherapy plus IP chemo’.
[In Newfoundland] you can only get the port placed and get IP chemotherapy if you live in St. John’s, which is the main center in NL, and more than 50% of the people in the study actually don’t live in the city, so they got just IV chemotherapy because of that. So, we’re trying to prove that this could work here, and if we had enough patients and the resources, and that sort of thing, it would potentially help improve certain people’s survival. Because they would be able to get chemotherapy at the time of surgery and then wouldn’t necessarily need to have the IP port.
So, it’s a really interesting project because it’s really relevant to our population here and that it could potentially help people increase their overall survival here and allow them to still live out their days in their more rural community afterwards, and know that they still had good treatment.
The interesting thing about it is that it’s especially relevant to out population here compared to other parts of Canada where they have more access to bigger centres or that sort of thing, and that it could potentially improve the overall survival for some people.
Q. You mention that receiving this award in the past helped you cover expenses incurred while taking an elective at the University of Toronto, can you expand on how funding opportunities like this contribute to trainee education?
Stephanie Gill: I’ve won this award three times, and it was for electives in Winnipeg, Calgary, and Toronto. It just really helps you pursue these dreams because it’s important for us to do an elective away or an experience away, because you are figuring out maybe where you want to do a fellowship and see the different provinces or different centres and how they do things. Obviously, it’s pretty standardized across the country, but when you’re trying to choose where you want to do your fellowship, having that experience is really impactful on where you choose to go and how you want to spend those really critical years of your training. If you want to pursue a fellowship like gyneoncology, the cost of that comes out of your pocket and you have to be the one to pay and take on more debt to be able to pursue these opportunities. So, having something like this fund/award and having that extra help just kind of allows you to pursue it with a little bit less stress. For example, every time you go away on an elective you have to pay for your flights, your accommodations, if you need a car or parking or any transportation in the province where you’re traveling to, but then you’re also still paying all your own bills at home, so it can be really financially daunting. And not necessarily just for gyneoncology, but I know people who haven’t gone away on many electives because they just generally can’t afford it.
Any little bit of extra funding in residency helps, especially when you’re near the end because you’ve now been almost 8 to 9 years into medical education, and your debt just keeps piling up. So, I think ultimately awards and grants such as these just really give you the opportunity to feel a little bit less stressed about the financial side of pursuing your goals.
And it really gives you the opportunity to explore things that you may not have considered before, right? Like, even for myself, I ended up doing 4 electives, and having won this award a couple of times and knowing that I could apply for it again allowed me to tell my program that I actually want to do more electives, because knowing that potential support was there was kind of a nice comfort.
Q. Can you talk a bit about your first surgical exposure in medical school and why you chose to pursue cancer research?
Stephanie Gill: I was part of different Cancer Research programs prior to medical school. I worked as a research study coordinator and a research associate for breast cancer projects at the time. I started medical school thinking that I was going to do family medicine, I had this idea that I was going to do 2 years of family medicine and be done, and that was it. As medical school progressed, there was nothing that I was super passionate about and then I met a gyneoncologist outside of med school and she was like, “Oh, just come to the OR with me. You should come shadow me.” So, my first experience shadowing a surgical specialty in medical school was a gyneoncologist, and I remember coming home that day, and I was just like, “That was the best day of my entire life. This is what I was missing!”
I had gone in with this intention to do primary care and to work with marginalized populations. That was my goal, and that’s what I wanted to do. And then this whole shift happened, and I was like “Ohh, this is what I want to do. This is what I think is going to drive me and I’m going to be passionate about this area.” And just the way that I felt so alive, and I was like “Oh, this is it!” And then I kind of teetered between general surgery and obstetrics and gynecology for the goal of gyneoncology. That has been my goal since I was a medical student, and I think a lot of people thought it was crazy, ‘cause they’re like, “It’s eight years, and you’re going to do this for eight years worth of residency?!” And I was like, “I think so. That’s what I want to do.” And then that’s eventually why I ended up choosing obstetrics and gynecology as residency for the plan to go into gyneoncology. So, I think this was a rare circumstance, I know a lot of medical students don’t know what they want to do until the very end. But it was that opportunity in the OR and then the women’s health side of it kind of led me even more towards this path.
And then in terms of the cancer research part, I had worked in Cancer Research previously, I had done a master’s previously, so I always knew research was going to be a part of my career. And then again doing electives even as a medical student in gyneoncology and realizing like you have a really great bridge between medical, surgical, and research that encompasses the whole specialty and it just seemed like a perfect fit for all of my interests.
Q: It's so fascinating that you've had such a defining moment that made you like realize “This is it for me and this is where I'm going.”
Stephanie Gill: I know! Yeah, and it definitely assured me that I’m surgically motivated. And that’s what I like. I did explore other surgical specialties to be sure, but then ultimately came back to gyneoncology. And it’s funny because I’ve since worked with one of the original gyneoncologists I worked with as a medical student and I was like, “You are the reason that I’m pursuing this!” And now it’s almost 7-8 years later.
Q: Do you guys stay in touch?
Stephanie Gill: Yeah, I keep in touch with her. I messaged her when I got in to my fellowship in Toronto. And I am sure we will stay in touch throughout my training and into my career.
Q: Research is a key pillar of Ovarian Cancer Canada’s work. Can you explain, from your perspective as a trainee, your hopes for the future of ovarian cancer research?
Stephanie Gill: Even since I started residency, I’ve seen a huge change in ovarian cancer in general, I feel like in medical school, we’re always taught that this is a terminal diagnosis, it’s a very short prognosis. But even since then, so many different drugs have come on the market and people are living a lot longer with the disease. So, I think ultimately, I feel like that’s going to keep progressing. The goal is going to be to increase overall survival and it’s no longer a death sentence. We’re also going to be leaning towards increasing quality of life as well, so I think there’s going to be a point where, yes, we’re going to keep wanting to increase quantity, obviously, but with equal importance on the quality of that life.
Q: If you could share one message with the ovarian cancer community, what would it be?
Stephanie Gill: Obviously it’s a very life-altering diagnosis, but they should know that there are people out there in all different stages of their training and their careers that are passionate about improving their care and their quality of life, and just to keep hope that they’re there. We will continue to make changes and to stay strong and, you know, there are people out there that want to keep improving the care that they’re getting and that it’s like their number one passion. Yeah. I hope that they don’t lose hope, or if they ever start to think that things aren’t going to improve, I just hope that they know that there are always going to be people wanting to do more for them.