Dr Anees Chagpar and Dr Farin Amersi served on a TKN assignment with the Aga Khan University (AKU) in Karachi for three weeks in September and October this year, in their first visit to Pakistan, to assess the breast cancer programme at AKU.

Both TKN volunteers were well qualified for the assignment, and brought a wealth of experience with them to contribute to the project.

Dr Chagpar is a professor of surgery at Yale University School of Medicine and assistant director, global oncology at Yale Comprehensive Cancer Center. She has also travelled to several countries to help strengthen clinical programmes, research enterprises, and further the education mission of universities.

Dr Amersi is an associate professor of surgery, programme director of general surgery residency and associate programme director of the surgical oncology fellowship at Cedars-Sinai Medical Centre in California. She has also worked with AKU in Nairobi to strengthen faculty research, and helped to improve breast cancer care in Khorog, Tajikistan.

The three major objectives for this TKN assignment were to:
1) Evaluate the AKU clinical programme and lay the foundation for best practice that would enable AKU to achieve national/international accreditation of their programme by the National Accreditation Program for Breast Centers (NAPBC).
2) Understand the capacity and infrastructure for breast cancer research at AKU and invigorate a climate of scholarly activity.
3) Assess educational programmes pertaining to breast cancer surgery at AKU, with particular emphasis on the surgical residency and breast surgical oncology fellowship.

Regarding the clinical excellence objective, Dr Chagpar reflected upon Mawlana Hazar Imam’s desire to see a strong commitment to “best practice” in our institutions. Having served on the Standards and Accreditation Committee and on the Board of Directors for the NAPBC, Dr Chagpar is familiar with what constitutes best practice — particularly relating to breast cancer. NAPBC is administered by the American College of Surgeons and is dedicated to ensuring the highest quality of standards of care for patients with diseases of the breast.

It is Dr Chagpar and the AKU team’s ambition that this breast programme should meet or exceed all required standards for accreditation within one year. The team established a leadership committee to implement guidelines for evaluation and management of patients with benign and malignant conditions of the breast, and to identify and address gaps in current practices.

With over 150 publications to her name, including the investigator-initiated SHAVE trial published in the New England Journal of Medicine, Dr Chagpar wanted to reinforce the spirit of intellectual inquiry at AKU.

“AKU should be on the leading edge of research,” said Dr Chagpar. “We should be generating knowledge that guides best practice for others to follow.” With her guidance, the AKU team organised research meetings to brainstorm project ideas and has already started working on a novel clinical trial to evaluate the use of androgen receptor blockade in triple negative breast cancer.

“This was an incredible experience,” Dr Chagpar said. “If I can help, even in some small way, to contribute towards Mawlana Hazar Imam’s vision for his institutions, this will be a fulfilling TKN assignment.”

Dr Amersi took the lead on evaluating educational programmes at AKU, which include the breast surgery fellowship and the general surgery residency, to determine their strengths and areas for improvement. With her experience as a director of surgical education, she met with AKU medical students, surgical residents and fellows to better understand the strengths and limitations of their educational programmes.

Dr Amersi said, “AKU clearly has the capacity to train future physicians through its excellent clinical education programmes. I will continue to help them in every way possible to advance AKU’s education mission.” She added. “I was extremely impressed with the bright and dedicated AKU medical students and residents I met.”

Dr Gulzar Lakhani, Senior Administrator, AKU Department of Surgery said, “Being an academic and teaching hospital, we are strongly committed to encouraging and investing in clinical best practices, education and research. We were therefore delighted to engage Dr Chagpar and Dr Amersi as dedicated TKN volunteers on this important assignment. We are immensely grateful to them for contributing their extensive knowledge and expertise, and their commitment to remain engaged with AKU.”

Dr Chagpar and Dr Amersi will remain actively involved with the AKU team, as they move forward with the implementation of these three objectives.