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\nDr Basia (Barbara) Lowes
\nObstetrician, Gynaecologist & Laparoscopic Surgeon
\n@dr.basialowes
\nFRANZCOG, MBBS, LLB (Hon), BA, MS (AdvGynaeSurg), MWomHealthMed
\nVMO | Royal Hospital for Women, Sydney, NSW\n\t\t\t\t
Entering independent practice as a gynaecologist – particularly with a focus on laparoscopic or surgical care – is exciting, fulfilling, and challenging. The transition from trainee to consultant brings new responsibilities: clinical decision-making, surgical leadership, professional development, and practice management. The following practical tips are designed to help you build confidence, ensure patient safety, and foster long-term resilience. This list is not exhaustive, but highlights areas consistently important for early-career practitioners.<\/p>\n\t\t\t
Your first consultant role shapes your practice patterns and confidence. Supervision still matters – choose a unit where senior colleagues are approachable, willing to scrub in, and provide guidance. Clarify expectations upfront: operative autonomy, on-call load, theatre access, and private\/public balance. Don’t underestimate culture; a supportive team is often more valuable than a prestigious title.<\/p>\n\t\t\t
Avoid plateauing early or taking on cases beyond your current skill set. Keep a logbook mindset, tracking case mix, outcomes, conversions, and complications. Seek mentorship, surgical coaching, and opportunities to assist in complex cases. For smaller centres, consider attachments at higher-acuity hospitals.<\/p>\n
Engage in cadaveric and skills courses regularly, such as the AGES Laparoscopic Anatomy Pelvic Demonstration (LAP-D) Workshop or Anatomy of Complications Workshop, to practise techniques safely in controlled environments. Deliberate practice accelerates learning while reducing patient risk.<\/p>\n\t\t\t
Strong surgical fundamentals are the backbone of safe practice: port placement, ergonomics, tissue handling, haemostasis, and safe entry techniques. Basics matter more than tackling complex cases prematurely. Learn from surgeons who operate deliberately, manage complications calmly, and explain their reasoning – not just the “how.”<\/p>\n\t\t\t
Preparation and documentation are critical. Review imaging yourself, anticipate anatomical variations, and plan exit strategies, including clear conversion thresholds and assistance needs. Know when to step back: calling for help, converting early, or referring complex cases demonstrates sound judgement.<\/p>\n
Effective documentation – especially of anatomy, decision points, and consent discussions – protects patients and supports medicolegal clarity. Join a reputable medical defence organisation early and engage proactively.<\/p>\n\t\t\t
Understand billing, practice structures, policies, and MBS item numbers. Mistakes can be costly. Consider MBS Billing and Starting Private Practice Workshops to sharpen knowledge of Medicare rules and common pitfalls.<\/p>\n
In private practice, be aware of gap policies, overheads, and theatre list organisation – financial literacy is essential. The Australian Medical Association (AMA) website offers broader guidance for private specialists.<\/p>\n\t\t\t
Surgical care is never delivered alone. A reliable MDT – including anaesthetists, urologists, colorectal surgeons, radiologists, and theatre staff – enhances safety and efficiency. Choose hospitals with ICU backup. Long-term professional relationships are invaluable during complex cases and difficult outcomes.<\/p>\n\t\t\t
Your case mix depends on referrers. Be accessible, courteous, and timely. Write letters that clearly answer the GP’s question, are concise, and follow up after complications or unexpected outcomes. Referrers remember how you make their patients feel – a solid reputation leads to appropriate referrals and sustainable practice.<\/p>\n\t\t\t
Avoid overcommitting. Prioritise tasks and engagements aligned with your clinical focus and wellbeing. Limit the number of hospitals you operate at – reducing travel fatigue and administrative burden. Leave breathing room in your roster; it’s okay to leave sessions unfilled while consolidating skills and maintaining balance.<\/p>\n\t\t\t
Even with growing private practice, stay involved in research, teaching, and quality improvement. Continued engagement keeps your practice evidence-based. Refresh knowledge in areas often overlooked but clinically common: menopause management, vulval dermatology, abnormal vaginal discharge, and libido issues.<\/p>\n\t\t\t
The early consulting months can feel isolating. Protect yourself by setting boundaries, maintaining a non-medical anchor, normalising debriefing after complications, and staying connected with peers. Pay attention to ergonomics, fatigue management, and professional isolation.<\/p>\n
Remember: patients see you, not your CV. Technical skill opens the theatre door, but presence, empathy, clear communication, and calm confidence build trust and define excellent care. Trust is built in the consultation room as much as in the operating theatre.<\/p>\n\t\t\t
Technical skill gets you into theatre, but judgement, professional relationships, and personal development keep your practice safe and sustainable over decades. These ten tips offer practical guidance, but remember: each practitioner’s path is unique. Seek mentorship, prioritise patient safety, and invest in your technical, professional, and personal growth. The early-career years set the foundation for a lifelong, rewarding practice – invest wisely in yourself, your referrers, and your patients.<\/p>\n
Good luck!<\/p>\n\t\t\t
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