2023 | Volume 24 | Issue 5

A commitment to supporting women surgeons in Australia and improving health outcomes in disadvantaged communities is at the heart of plastic surgeon Gillian Farrell’s work.

Associate Professor Farrell has worked tirelessly to help develop a public service at Royal Darwin Hospital and hopes to expand outreach services to improve access to plastic and reconstructive surgery services in the Northern Territory.

It is a far cry from the lifestyle she expected after leaving her private practice in 2021 to enjoy a slower pace.

“Healthcare, education and housing are at the core of significant disadvantage experienced by First Nations people living in the Northern Territory,” she says.

“Nearly 80 per cent of our patients identify as Aboriginal and Torres Strait Islanders, despite comprising approximately 30 per cent of the overall population in the Northern Territory.

“There is significant disparity in health outcomes between different population groups in northern Australia.”

Associate Professor Farrell is the head of Plastic and Reconstructive Surgery at Royal Darwin Hospital and is overseeing the Darwin Workforce Project, which was established by the Australian Society of Plastic Surgeons in 2020.

The program allows for plastic surgeons from across Australia to work at Royal Darwin Hospital for four weeks to six months. This fills an important gap for essential service provision.

However, Associate Professor Farrell would like to see more plastic surgeons permanently relocate to Darwin to make the most of the professional opportunities and embrace the enviable lifestyle from living and working in the Northern Territory.

Plastic surgeons in Darwin are uniquely exposed to a wide range of interesting and unusual presentations including hand injuries, animal bites, tropical infections, and complex lower limb and head and neck reconstructions.

“We have also performed two successful hand replants in Darwin in the last six months, which is extraordinary,” she says.

“The size of the city means that it's very livable, especially compared to somewhere like Melbourne.

“Territorians are known to embrace life outdoors and make the most of exploring surrounding national parks and exquisite cuisine with a strong south-east Asian influence.

“Many locals go camping most weekends during the dry season.”

However, she believes increased funding for local training positions is essential to reduce barriers to recruitment and ensure all team members feel welcome, valued and supported.

Associate Professor Farrell wants to encourage local medical students and junior doctors to apply for plastic surgery training as part of a solution to staffing shortages, with a focus on the rural pipeline.

“The best way to develop the local workforce with a long-term focus on retention is to train those who have been brought up in the Territory, through supporting Indigenous and non-Indigenous Trainees.”

Associate Professor Farrell has a longstanding interest in improving health outcomes and increasing access to surgical services for disadvantaged populations.

She began volunteering in Fiji and other Pacific nations with the Interplast program in the 1990s to provide plastic and reconstructive surgery services for people and communities in need.

In 2003, her family relocated to Fiji for 18-months where she worked as a plastic surgeon servicing the community while her children attended a local school and her partner worked at the Lautoka hospital and Fijian School of Medicine.

She undertook many complex surgical procedures, particularly on burns patients, while also assisting the visiting Interplast teams as a local surgeon.

“My partner and I have always had an interest in working in developing nations,” she says.

“It’s partly because I enjoy going to exotic places and doing different things and partly feeling that being incredibly privileged, we have an opportunity and a responsibility to give back.”

After living in Fiji, she returned to Melbourne with her family and re-established her private practice alongside work at the Peter MacCallum Cancer Centre as a specialist in breast reconstruction and skin cancer.

These formative experiences contributed to three of her four children relocating to Darwin to pursue work in the education, government and the legal sector, with the same desire to work with First Nations populations living in under-serviced regions in northern Australia.

Associate Professor Farrell also has a longstanding interest in supporting women surgeons in Australia.

She founded the Women in Plastic Surgeons (WIPS) group a decade ago to provide women in plastic surgery with support and networking opportunities.

All female plastic surgeons and Trainees in Australia and Aotearoa New Zealand automatically become members if they wish to join.

Group members have gathered at least twice a year (except during the COVID-19 pandemic) since inception to talk, share experiences, and learn from guest speakers in different locations across Australia.

As a mother of four, Associate Professor Farrell is well aware of the many challenges faced by women surgeons in Australia.

There were few mentors and role models for women wanting to pursue a career in surgery when she embarked upon the plastic surgery training program during the 1980s.

She believes that the obstacles have only increased since then—the length of the training program means that women may need to delay motherhood or choose to juggle raising children while working as a registrar and studying for exams.

“Surgery is a challenging profession to combine with having a family or a life outside one’s job, and I am hoping that will change.

“Some things that might help are more group practices, more willingness to share patients with other people and for patients to be prepared to see other doctors, not just their primary surgeon,” she says.

“We need to make surgery more adaptable not just for women, but also other people that are diverse or wish to have a life outside surgery.

“It is a wonderful profession and I feel incredibly fortunate to have had a job that is so rewarding and enjoyable and I would love to encourage other women to consider surgery as a career.”

Associate Professor Farrell has been a strong advocate for greater flexibility during surgical training and opportunities for part-time training either during early parenthood, or to allow Trainees to pursue other interests outside of medicine.

She has plenty of ideas to continue making change, which promise to keep her busy, despite her initial plan to slow down at this point in her career.

Associate Professor Farrell looks forward to a time when she is able to hand over her advocacy work to successors who are equally passionate about improving access to plastic surgery services in the Northern Territory and promoting equality for female surgeons in Australia.

“This work is immensely rewarding because you know that there’s a need and you're meeting that need as much as you can. But I do feel strongly that I need to make myself redundant.”