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ALUMNI PROFILECommonwealth Scholarships and Fellowships to enhance clinical skills offer award holders the opportunityto learn and practice a new clinical skill, and to network with others in the same and related specialties. Thisissue, we look at three alumni whose awards have transformed the lives of patients in their home countries.Dr Joan Agama Dellor (2011 CommonwealthScholar from Ghana, Rheumatology,Hammersmith Hospital) is a specialist inthe Department of Medicine at Korle Bu TeachingHospital, and a Fellow of the West African Collegeof Medicine. She found that her CommonwealthScholarship enhanced her skills and helped her toset up the first rheumatology unit in Ghana.At Hammersmith Hospital, Joan had the opportunityto work as an honorary Specialist Registrar with therheumatology unit. ‘It was a truly educative andempowering experience. I got the chance to runthe general rheumatology, vascular, lupus, and softtissue clinics, seeing patients independently.’Joan’s Scholarship also provided wide-rangingexperience at other hospitals. She watchednephrologists running special lupus and prenatalcounselling clinics, attended the scleroderma clinicat the Royal Free Hospital, and observed the reviewof patients with lung diseases at the respiratory unitat the Royal Brompton Hospital.Joan’s training has been integral to improvingrheumatology care in Ghana. ‘It has given me theconfidence to better practice rheumatology backhome, where I was instrumental in setting upand running the first ever rheumatology unit inGhana.’ Currently, Joan and her team are seeingover 380 patients with between 16 to 20 new caseseach month, and they are collecting data to startepidemiologic research on these cases to improvetreatment in the future.Dr Babita Ghai (2011 CommonwealthAcademic Fellow, Chronic Pain Management,Barts and The London School of Medicineand Dentistry, Queen Mary, University of London)is Associate Professor at the Post Graduate Instituteof Medical Education and Research, Chandigarh,India.Dr Babita Ghai, 2011 Commonwealth AcademicFellow in Chronic Pain ManagementBabita’s Academic Fellowship covered interventionalpain management and research, as well as sessionsat a pain clinic and supervising inpatient wardrounds. She learnt a systematic approach towardpain management and improved her skills ininterventional procedures. She was also involvedin a pain management research project as aco-investigator.The skills learnt during her Academic Fellowshiphave enabled Babita to introduce new proceduresin her daily work, providing greater pain relief topatients. She has started performing intradiscalprocedures for back pain, and recently performedthree percutaneous hydrodisctectomy procedures,which received wide media coverage.The Academic Fellowship continues to enhanceBabita’s research activities in India. She is workingtowards collaborative research with her former hostinstitution and, since returning home, has securedfunding from the Indian Department of Science andTechnology for a project on ‘Prescribing pattern,tolerance and its impact on quality of life in patientswith chronic low back pain’.Babita has shared the new techniques she learntwith her colleagues across India. ‘I am teachingmy residents and colleagues who come from allover India and also from neighbouring countries,disseminating education on pain managementwidely.’Professor Anil Jain (2009 CommonwealthAcademic Fellow, Spine and Scoliosis Surgery,Royal Hospital for Sick Children, Edinburgh)found that his Academic Fellowship helpedhim address the treatment of acute spinal conditions.Anil’s Academic Fellowship focused on deformitycorrection in spinal cases, and included the evaluationof scoliosis deformities for treatment planningand management. ‘The outpatient and inpatientexposure gave a broad outlook in the planning ofsurgical treatment as well as long-term outcomes ofspinal deformities. The Academic Fellowship reallyimproved my skills in spinal stabilisation in variousspinal pathologies.’In India, doctors face a large number of cases oftubercular kyphotic deformity in the acute andhealed stages. With Anil’s Fellowship experiencein treating congenital kyphosis and scoliosis, thecorrection of kyphotic deformity in tubercular spinecases has been refined. Importantly, as a Professorof Orthopaedics at the University College of MedicalSciences, Delhi, he has been able to pass on his newknowledge to colleagues. ‘The Academic Fellowshiphas improved surgical skills at our institution, as wellas research generally on kyphotic deformities inspinal infection.’12Commonwealth Scholarships News
IMPROVING TREATMENTOUTCOMES FOR BREAST CANCERCaryn Ross-Innes was inspired by her Master’s degree to pursue a career in cancer research –and her Commonwealth Scholarship has enabled her to realise this ambition.Dr Caryn Ross-Innes, 2007 CommonwealthScholar and cancer research scientistCaryn Ross-Innes is a 2007 CommonwealthScholar from South Africa who studied a PhD inCancer Research at the University of Cambridge.Her PhD research focused on further understandingoestrogen receptor (ER)-mediated transcription withinbreast cancer cells. She is currently a postdoctoralscientist at her former host institution.Caryn studied Biochemistry and Microbiology asan undergraduate at the University of Cape Town(UCT), followed by an Honours and Master’s degreeat the UCT Medical School. Her postgraduateresearch at UCT looked at the potential influenceof the human papillomavirus in the developmentof oesophageal squamous cancer, which affectspredominantly black males on the east coast ofAfrica.During her postgraduate study at UCT, Carynbecame particularly interested in the complexity ofthe development of cancer, and wanted to pursuea career in cancer research. ‘I saw the potential tomake a positive contribution to scientific researchand to hopefully improve patient care.’ Beingawarded a Commonwealth Scholarship in 2007allowed Caryn to follow this path.Caryn was based at the Cancer Research UKCambridge Institute, and found that the scientificcommunity at Cambridge provided a conduciveand challenging environment for conductingdoctoral research. She embraced the opportunity tolisten and learn from colleagues in the Cambridgecommunity, and met interesting scientists from allover the world. She also attended internationalconferences in Canada, Croatia, Greece, and theUSA, and was given the opportunity to presenther PhD research. The enthusiasm and excitementsurrounding cancer research within the institutefuelled Caryn’s interest and enabled her to producethree first author papers during her PhD, includingone published in the journal Nature.A key part of Caryn’s PhD work focused on furtherunderstanding ER transcriptional dynamics withinbreast cancer cells. This is a very important area ofresearch, as women with ER-positive breast cancercan be treated with anti-oestrogen drugs, suchas tamoxifen. However, the majority of womenwill become resistant. By mapping ER bindingpatterns in primary tumours with good or poorclinical outcomes, as well as metastatic samples(where the cancer has spread to other organs),Caryn and her colleagues found a core set ofER binding events that occur in all contexts, andthese represent the ER cis-regulatory elements thatcontribute to tumour formation.In addition, Caryn and her colleagues found that,even though tumours acquire drug resistanceto anti-oestrogen treatments, this is not due toa failure of ER to function, but is a result ofchange in specific ER binding patterns. This is achange which can happen surprisingly rapidly.These findings showed that ER binding can beused to predict outcomes and importantly revealthe underlying properties and target genes thatdetermine responses to drug treatment. Definingthe mechanisms used by ER-positive tumours tocircumvent drug response is one of the majorunanswered questions in breast cancer biology.Caryn completed her PhD in July 2011, and isnow a postdoctoral scientist in Professor RebeccaFitzgerald’s laboratory at Cambridge. To gain abetter understanding of how cancer research canalter patient care, Caryn decided to join a moretranslational and clinically-focused laboratory. Hercurrent research uses skills that she acquiredduring her doctoral work.Caryn is working on two main projects, both onoesophageal adenocarcinoma. Using the genomicskills that Caryn gained during her PhD, she isinvolved in a large effort to sequence the DNAfrom 500 oesophageal adenocarcinomas as part ofthe International Cancer Genome Consortium. Thestudy aims to identify recurrently-mutated genesin oesophageal adenocarcinoma with the hopeof identifying novel biomarkers for screening andearly detection.Caryn is also involved in a screening study forBarrett’s oesophagus, the precursor lesion foroesophageal adenocarcinoma. Her role in thisproject is to devise a risk stratification biomarkerpanel that can be applied to cytosponge, anovel non-invasive cell-sampling device. This willhelp identify patients with an increased risk ofdeveloping oesophageal adenocarcinoma.January 2014 13
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