Dr. Thomas Caputo, professor of clinical obstetrics and gynecology, came to Weill Cornell Medicine in 1982 to serve as its first director of gynecological oncology. Over the years, he has seen his patients’ survival rates gradually climb as new treatments became available and minimally invasive laparoscopic surgery has become the norm. But as Dr. Caputo looks forward to retirement, his greatest worry is that there aren’t enough young physicians to follow in his footsteps—not only in the United States but around the world. “Except for breast cancer, women’s cancers are neglected and under-researched,” says Dr. Caputo, also vice chairman for ob/gyn at Weill Cornell Medicine and an attending physician at NewYork-Presbyterian/Weill Cornell Medical Center. “And that translates to a potential shortage of doctors who want to specialize in female cancer.” Studies comparing research dollars with years of life lost, for example, have shown that work on prostate cancer— which only affects men—is funded at six times the rate for uterine cancer and nearly 2.5 times the rate for ovarian cancer.
But hope that patients with these diseases will receive the attention and resources they deserve may lie with young physicians like Dr. Candelaria O’Farrell. In spring 2017, Dr. O’Farrell—then a medical student at the Instituto Universitario CEMIC in Buenos Aires, Argentina—traveled to NewYork-Presbyterian/Weill Cornell Medical Center for an intensive, month-long exploration of the field through the Glickman Fellowship in Gynecologic Oncology. Almost as soon as she arrived, Dr. O’Farrell was scrubbing into a surgery, assisting and observing as doctors removed a benign uterine tumor from a woman in her thirties. Over the next few days, Dr. O’Farrell presented the case in rounds, which meant checking in on the patient each morning as she recovered in the hospital. When the woman returned for follow-up care a few weeks later, she was happy to see the student who had helped tend to her—and the feeling was mutual. “She was really scared going into surgery,” recalls Dr. O’Farrell, who completed her medical degree in December 2017, “but when I saw her again afterward she was so revitalized.”
Forming relationships with patients was new for Dr. O’Farrell, who had little opportunity to follow ongoing cases during her education in Argentina. But it is typical of the experience of Glickman Fellows, whose time at Weill Cornell Medicine offers them an up-close, in-depth look at what it means to specialize in gynecologic oncology. “The students are totally immersed in the service,” Dr. Caputo says. “They take care of the patients on the floor, they go to the operating room every day, they go to the clinics, they go to our private offices and see our patients. They’re totally involved from beginning to end, so they get a complete exposure to everything that encompasses gynecologic oncology.”
Founded in 2009, the fellowship is named for Elenore Glickman, a patient of Dr. Caputo’s who passed away from ovarian cancer in the late 80s. Grateful for her care, her family donated a total of $200,000 to support gynecological oncology training at Weill Cornell Medicine. But Dr. Caputo was concerned that students at other institutions were getting little exposure to the field, so he started the fellowship program to bring young people from around the country and the world to Weill Cornell Medicine for an intensive few weeks. “I hoped that by interesting them in our specialty we would have more bright young people go into gynecologic oncology,” Dr. Caputo says.
The need for young doctors to choose oncology—especially gynecological oncology—is increasingly vital. According to a 2017 report by the American Society of Clinical Oncology, an aging population will require more oncological care, just as more doctors themselves near retirement. There are nearly 40 percent more oncologists aged 64 and older than there are younger than 40, and the median age for gynecologic oncologists—58—is the highest of any oncological subspecialty. “To have these eager young students come here, to see them mature and then go back and share their experiences with other students all over the world—that is one of the most rewarding things I do,” Dr. Caputo says. Over the past nine years, the fellowship has brought more than three dozen students to Weill Cornell Medicine from around the United States and as far away as Germany, India and Australia, including a handful who have gone on to do residencies at NewYork-Presbyterian/Weill Cornell Medical Center. Several have traveled to New York from Weill Cornell Medicine’s Qatar location, including Dr. Ahmed Saleh MD’18, who arrived in February 2017. “I didn’t get to see a lot of gynecologic oncology patients during my core ob/gyn rotation,” he says. “But the fellowship covered the entire spectrum. You get to scrub in and help out with surgery, go on rounds, go to the chemotherapy clinic. It introduces you to the world of gynecologic oncology.”
A native of Egypt who also recently completed a rotation in Tanzania, Dr. Saleh believes that getting to see a variety of cases first-hand during his time in New York was especially valuable for him as a future ob/gyn who plans to pursue a career in global health. In Africa and the Middle East, he notes, there’s still a stigma around women’s cancers, which can translate to delayed diagnoses and more advanced disease when patients do consult a doctor. But while he appreciated seeing how women’s cancers are treated at a top-flight center for gynecologic oncology like NewYork-Presbyterian/Weill Cornell Medical Center, the physicians’ human touch may have made an even deeper impression. “The fellowship teaches you a lot, not just about oncology but also things you’ll need to know no matter what your specialty,” he says. “The doctors at NewYork-Presbyterian/Weill Cornell Medical Center are amazing in the way they talk to patients, the way they explain things to them.”
Witnessing those doctor-patient relationships stayed with Dr. O’Farrell as well. That’s why she credits the fellowship with cementing her decision to specialize in oncology, possibly with a focus on women’s health. “You follow your patients from the first biopsy, when you make the diagnosis, and you are in the clinic or the OR with them,” she says. “You see them through it all.”
— Amy Crawford
This story first appeared in Weill Cornell Medicine, Vol. 17. No. 2