Physician to be 1st Ga. fellow in GYN oncology

Augusta University program is one of few in the country.

Dr. Heather Williams is about to become a Georgia pioneer in July when she assumes the state’s first fellowship in gynecologic oncology.

The new program at Medical College of Georgia at Augusta University is one of only 45 in the country, and the fellowship was one of only 55 positions offered in the subspecialty this year, according to data from the National Resident Matching Program. The new program is the only one in Georgia and one of only a handful in the Southeast, according to new fellowship director Dr. Bunja Rungruang, an assistant professor in the Department of Obstetrics and Gynecology.

Just five years out from a similar fellowship herself, it is something she has worked on since coming to Augusta. While new, the program is well-positioned for success, said Dr. Sharad Ghamande, chief of the Section of Gynecologic Oncology.

“We have the necessary volume, we are very busy, we have people with track records, we have a big research base and we have a very good educational program,” he said.

There are fewer than 1,300 certified gynecologic oncologists nationwide and, in Georgia, there are very few outside the Atlanta area, Rungruang said. She and Ghamande can quickly count them off — their practice in Augusta, two practitioners in Savannah, one in Macon that is replaced every few years and one in Columbus.

“We get patients that drive four or five hours easily from Valdosta, Thomasville, Albany,” Ghamande said.

“And there’s not much in South Carolina, either, so we get a lot from South Carolina,” Rungruang said. Those providers also “don’t offer a lot of the things that we offer here, so oftentimes patients will come to us instead,” particularly with clinical trials.

While some of these cancers can be caught early, in this area they most often are already advanced and harder to treat, Ghamande said. Part of that is just a lack of good basic care, Rungruang said.

“The state in general is underserved with general OB/GYN providers, so it makes preventive care to catch things at a precancerous state very difficult,” she said. Even when people have insurance, “we have a culture of not going to a doctor unless you have a problem,” Ghamande said. “So we really don’t emphasize much on prevention.”

Those worse potential outcomes is one reason pursuing this specialty is not easy, he said.

“It’s a tough life,” he said. “You’re in the hospital, you’re dealing with really sick patients. Some of it is lifestyle issues. Some of it is what is just the emotional impact of what you do personally. I think it is always a hard job.”

Unlike many other oncologists, gynecologic oncologists follow their patients throughout their care, performing their surgeries, providing their chemotherapies, but also tending to their other medicals issues like blood pressure, or even dealing with a cold, Ghamande said.

“The best way I can put it is we are a primary care physician for a woman with gynecological cancer,” he said. “It’s a one-stop shop. You really know the patients, you know the family.”

It was that close contact with gynecologic cancer patients and families during the first years of her OB/GYN residency that convinced Williams to pursue gynecologic oncology.

“There was such a reward for taking care of them,” said the fourth-year OB/GYN resident at the University of Iowa. “Even though they should be thinking about themselves in their last weeks or months they had left, they were always thinking about other people, and I was just really humbled by that.”

She also is looking forward to having that “primary care provider role” and accompanying her patients through their care, which Williams believes is better for the patient.

“It’s nice for the patient to have that one point-person that they know is their doctor and is going to see them through this process” from diagnosis to final outcome, she said. “We’re there every step of the way, which I think is very rewarding and also unique to GYN oncology.”

As a native of Arkansas, Williams was also happy to get one of the few slots available in the Southeast.

“It was hard-fought,” she joked.

But having the new program could not only help create more like her in Georgia, but also convince some established in the field to take a new look at Augusta, Rungruang said.

“We’re hoping that training GYN oncologists in the state will help us retain some in the state,” she said. “But it also makes it more attractive to currently practicing GYN oncologists to potentially come to Augusta to join us. Now that we have a fellowship, it elevates our program to a different level in academic GYN oncologists’ eyes.”