Dr Rhonda Farrell and Dr Remi Banuelos
Mother and daughter making a difference in women’s health
Where did you grow up?
Rhonda: I grew up in the Sutherland Shire, right on the border of the Royal National Park. My father was the caretaker of the local Sutherland Council swimming pool. My two sisters and I spent a lot of time mucking around in water.
Remi: I feel very lucky to have grown up mostly by the beach in Coogee, Sydney. We also lived in Perth for a short while to follow mum’s training. As a medical student I studied in Sydney and Coffs Harbour in northern NSW, another fantastic coastal town and had some great experiences.
Where do you work?
Rhonda: I escaped the Shire in my early 20’s (quite unusual for most Shire girls) and moved to the Eastern Suburbs after meeting my now husband. My basic training was at the Royal Prince Alfred Hospital, then at the Royal Hospital for Women in Randwick, with terms at Wollongong, Dubbo and Tamworth. I trained in gynae oncology at Randwick, Westmead and Perth. I really enjoyed travelling around to different places during my training, even with young kids, as there were always new places to see and people to meet. Remi and my son Tom developed a love for AFL whilst living in Perth for two years, and they have both been quite successful players. I now work at Chris O’Brien Lifehouse /RPAH as the Director of the Gynaecologic Oncology Department, and at the Prince of Wales Private Hospital.
Remi: I currently work as an O&G SRMO at St George Hospital in Sydney. I did my internship at Royal Prince Alfred Hospital coincidentally like my mum many years ago.
Why did you choose medicine?
Rhonda: I initially trained and worked as a physiotherapist, spending many weekends on the field at rugby games, a game that still doesn’t make much sense to me. I was heading towards orthopaedics but during my intern year I did a term in O and G at the Royal Prince Alfred Hospital after having my first baby (Remi). I was in awe of how strong and resilient women could be when going through life-changing events such as pregnancy, birth, loss of a baby, diagnosis and cancer treatment. I realised that families and society could benefit most if women were given the best chance to stay healthy.
Remi: I first considered medicine because that’s what I knew about. Watching my mum go to work, sometimes sitting at the nurses’ station while she did her weekend rounds or hearing her talk about operating. Then one day, in high school, I think, I realised I couldn’t really imagine myself doing any other job. I’ve always liked sport and science and wanted to know how the human body worked and how it interacted with our environment and other people.
I realised that families and society could benefit most if women were given the best chance to stay healthy.
Remi: Why O&G, in particular?
I’m passionate about women’s health, and that keeping women healthy has a large impact on keeping their families and communities healthy. As a medical student in Grafton, I saw a couple give birth to their first son after eight previous miscarriages, and although she endured complications and a short stint in the ICU, she was very grateful, and I witnessed what an impact we can have on patient’s health and well-being. I also enjoy the mix of medicine with practical and hands-on skills.
Rhonda: What field do you work in and what are you passionate about in your field and why?
I have been a gynaecological oncologist for over ten years. I love how this specialty combines so many facets of medicine and surgery to provide holistic care to women with a serious and often life-changing diagnosis. There is the opportunity to perform complex surgery, learn about a huge array of interesting pathology, provide critical care to sick patients, and work closely with other cancer specialists within a multidisciplinary team. Also, to be involved in translational research and clinical trials, which is now bringing targeted treatments based on molecular and genetic characteristics of a patient’s own tumour directly to that patient, and we are now seeing improved survival outcomes. Gynae oncology is an area where you can follow a woman’s care through from diagnosis, surgery, adjuvant treatments (such as radiotherapy and chemotherapy), ongoing follow-up, and sometimes end-of-life care. You become a friend to your patient and their family, and on a broader level an advocate for their well-being through research, involvement in committees and funding agencies, and through international collaborations with like-minded people.
What does a ‘normal day’ involve?
Rhonda: A normal day is a mix of surgery, seeing patients in the clinic, administration, research, and teaching. I have just finished writing my PhD (on the role of peritonectomy and hyperthermic intraperitoneal chemotherapy for advanced ovarian cancer) which means more time after the workday and weekends to do nice things with the family (perfectly timed, I hope, with the end of lockdown).
Remi: At the moment, a bit of everything. Every day is a mix of outpatient clinics, theatre, delivery suite, and now a lot of telehealth. Often, a lot of ‘normal nights’ are involved working night shift which has its own challenges and rewards.
Rhonda: Your daughter is a DRANZCOG trainee. What advice did you give to her before she embarked on a medical career?
I remember telling her that she can do anything she wants, as long as she enjoys what she does, and it stimulates her brain.
Remi: What advice did your mum give you before embarking on a medical career?
She has always been my biggest supporter for doing whatever I wanted to do, whether that be medicine or anything else in life. In particular, not letting anything get in the way of what I wanted and to keep on trying. She is also a constant reminder that girls and women are smart and strong, and I think subconsciously I’ve always grown up not believing anything else.
Rhonda: What would be your advice to young medical students wanting to enter O&G?
How did both of you end up in surgery together?
Rhonda: I usually have a gynae oncology fellow who assists me on weekends, but the ASGO conference was on that weekend up in Byron Bay and we let all our fellows go to it. Remi had been assisting gynaecologists in her SRMO year at St George, so I thought it would be great to have a day together at work. Secretly I was hoping I could persuade her to become a gynae oncologist!
If doing O and G is really your passion and you are willing to put the hard yards into training, then you will get there. Get as much exposure to different cases as you can. Listen to what the patient tells you. Find mentors throughout your training who you trust and admire and communicate regularly with them. Get involved in research early so you won’t be doing a PhD in your fifties! And be nice to midwives and nurses.
Remi: I’ve always been my mum’s willing assistant! I helped her cook and bake as a kid, then as a medical student I typed up her patient letters for pocket money. The opportunity to be her surgical assistant came up and I was very excited to finally watch her operate and care for her patients. She’s a great and patient teacher, even when she has to remind me again to hold the laparoscope straight.
Challenges? Wins?
Rhonda: I came to research later in my career, so it did not come naturally to me and has been challenging at times. I realised that we could do the same thing to our patients day in / day out, but to really make a difference we need to be thinking ahead, innovating with new treatments, and proving that what we are doing actually makes a difference. Finishing a PhD in my fifties and recently receiving an NHMRC grant for a national multi-centre randomised clinical trial has made it feel like all the effort has been worth it.
Future goals?
Rhonda: There is a huge disparity in resources for prevention and treatment of gynaecological cancers throughout the world, including our closest neighbours. Many women in low-middle income countries do not have access to HPV vaccination and cervical cancer screening, for example. Training of fellows to become gynaecological oncologists in these countries can be very difficult. Becoming a council member for the International Gynaecological Cancer Society and a mentor for junior IGCS members around the world has been a step towards engaging in this space and I would like to continue this. Outside of work, I would love to look after some grandchildren one day.
Remi: In the short term I’m aiming towards completing the DRANZCOG this year. Otherwise, at such an early stage in my medical career I’m happy to take each opportunity as it comes and gain experience in women’s, children’s, indigenous, sexual, rural and all kinds of medicine to become a well-rounded doctor caring for women and their families.
How do you wind down?
Rhonda: Swimming, wine, walking the dog.
Remi: Any form of outdoor activity or exercise. Especially if it involves the beach or my dog, both make me feel relaxed. Catching up with friends and family is also great, whether to chat and debrief about work, or as a distraction and reminder of life outside of hospital.
Rhonda: What activities are you currently engaged with at the College?
We are the College, and the College is us. I have previously been the Chairperson of the CGO Committee and I’m currently a Training Supervisor of CGO fellows. Engaging in RANZCOG activities allows you to have a say in how your specialty functions. I can see how some members become frustrated with College decisions and changes, but if you want to do something about it then get active! By engaging with the College, I’ve been able to secure funding for a fellow at my institution through the Commonwealth Government STP programme. My aim is to improve surgical training of potential CGOs through working in a colorectal/peritonectomy unit. It is hard work but worth it and it would not have been possible without RANZCOG engagement and support. There are many services provided by RANZCOG that you may not be aware of but could help you in your own area.