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Lifelong learning: how Australian specialist plastic surgeons maintain the highest standards

Training, professional development and scrutiny: why choose a specialist plastic surgeon to perform your cosmetic surgery?

Dr David Sharp

Dr David Sharp

Specialist Plastic Surgeon + Registered Medical Practitioner

Article written by Director and Journalist Liz Washington B.Journ, and medically reviewed by Dr. David Sharp, MBBS, FRACS (Plast)

It may come as a shock to patient to realise that not all doctors performing cosmetic procedures such as breast augmentation, facelift and abdominoplasty surgery in Australia are trained, assessed or held to the same standards. There are many reasons why a specialist plastic surgeon is best placed to perform your cosmetic surgery, but this article provides insight into the professional development, training and oversight they undergo behind the scenes, in order to uphold high surgical standards and best practice safety standards. 

It’s a warm mid-week night in Brisbane and your specialist plastic surgeon has just finished a long day of operating at one of Australia’s largest private medical facilitiesl.

He takes the lift to the purpose-built 32-bed plastic surgery ward at Greenslopes Private Hospital to check on one of his patients, who had a large procedure yesterday.

Dr Sharp operating theatre

Before he goes home, he has one final professional commitment for the day; to attend the Greenslopes Private Hospital Plastic Surgery Audit Meeting.

Held at the hospital, the meeting gathers the Unit’s specialist plastic surgeons together after work, for two to three hours, to examine their surgical performance and collaborate on patient care.

Hospital unit meetings also feature professional development topics and enable surgeons to access multidisciplinary input from other doctors, surgeons and specialties. Not all hospitals audit their surgeons routinely in this way, but for those that do, most plastic surgeons attend with keen interest.

Lifelong learning: how Australian specialist plastic surgeons maintain the highest standards - 1

At plastic surgery unit audit meetings, the procedures that all plastic surgeons have performed are examined, breakdowns of operation types – as well as detailed, de-identified case studies of their complications and corrective revisions are prepared and confidentially presented.

Surgeons are asked to speak to their complications, and their colleagues offer questions, feedback and advice.

After your plastic surgeon’s cases of complications are presented (yes, every surgeon has patients who experience complications, from time to time), she or he discusses what they think went wrong, could have been done differently, or factors that still remain unknown or out of their control.

Their colleagues then offer their opinion, advice or questions. These meetings are informative and examine your surgeon’s operating history over the previous six months.

Most surgeons present studied for 12-15 years to achieve their fellowship of the Royal Australasian College of Surgeons and yet they are always grateful for the opportunity to learn from every patient, complication and collaboration with their peers.

If your specialist plastic surgeon is an ASPS member or works at a major Australian hospital, it’s likely that every few months, they too meet with their plastic surgery colleagues to undertake a similar process.

Surgeons who operate in registered licensed hospitals must first complete an accreditation process that includes a series of checks and assessment processes to ensure patient safety.

Surgeons who have not undergone the full specialist training program facilitated by the Royal Australasian College Of Surgeons cannot be accredited for major inpatient hospitals; the type of hospitals that have dedicated plastic wards, such as Greenslopes Private Hospital.

These are also the types of hospitals that are fully equipped with ICUs, emergency departments and multidisciplinary teams. They are the hospitals you want to be at if you are having a long, major procedure or require inpatient care, setting out standards of sterility, clinical consent, respectful workplace behaviours and the surgeon’s training and surgical skills. Ongoing. accredited surgeons are assessed for ongoing suitability to operate at the hospital – and their operating rights can be withdrawn if the hospital deems it appropriate.

Most people are not aware of the rigorous processes that qualified plastic surgeons continue to undergo, long after their training has finished. This involves regular auditing of their surgical results, professional development requirements and collaboration with their local plastic surgery colleagues. Plastic surgeons in Queensland participate in these, on a frequent basis both within their peer group, by their hospitals and their industry bodies. as a condition of their registration as specialists.

Every three months, Queensland’s specialist plastic surgeons gather after a day of operating and consulting, to share dinner, discuss patients and review recent plastic surgery literature, for their quarterly Queensland Chapter of the Australian Society of Plastic Surgeons’ (ASPS) Journal Club meeting.

They discuss patient cases, new research, share ideas and ask questions.

These professional development opportunities and audits take the form of several meeting types that specialist surgeons typically attend, as part of their commitment to lifelong learning, collaborating on patient care, self-improvement and transparent scrutiny of their surgical skills.

They are just one, tiny fraction of what it means to be a member of the Royal Australasian College of Surgeons and a specialist plastic surgeon in Australia; read on to learn more.

ASPS dinner sign

How your specialist plastic surgeon became a ‘real’ surgeon

Becoming a plastic surgeon is an extremely competitive and difficult process, with only one or two plastic surgeons selected into the Plastic Surgery Training Program that is facilitated by the Royal Australasian College of Surgeons (RACS) from hundreds of applicants in Queensland every year.

Once on the training program, plastic surgery trainees spend at least five years in Australia’s busiest, largest public hospitals, learning full time under experienced senior plastic surgeons.

During this period, they spend thousands of hours in theatre, practicing thousands of supervised operations. They perform major trauma and cancer reconstructions, become qualified in microsurgery and undergo regular assessment and performance reviews.

This role is performed as a full time plastic surgery registrar, in addition to participating in approximately 40 hours of (unpaid) professional development or study per week, for a minimum of five years. If it sounds almost humanely impossible – it nearly is. But it provides many years of not only surgical skills practice; but training your surgeon how to focus, take criticism, maintain composure under immense pressure and handle life threatening emergencies or complications.

And after they convocate (graduate) as a fully qualified specialist plastic surgeon, the ongoing learning and assessment of skills never stops.

When a plastic surgeon earns their RACS (Plast) fellowship, ongoing learning, teaching and observation is an essential part of ensuring that they maintain and update their skills, while having their performance monitored.

It is one of many reasons why choosing a surgeon with the letters ‘FRACS (Plast)’ after their name is so important. No other form of plastic surgery training in Australia comes close to offering as much training, experience and oversight when it comes to aesthetic or reconstructive surgery of the face, breasts and body.

Understanding what is means to be a specialist plastic surgeon in Australia

Plastic and Reconstructive Surgery stands as one of the nine critical surgical specialties governed by the Royal Australasian College of Surgeons (RACS) in Australia.

In the current Australian medical landscape, any doctor holding a basic medical degree is legally permitted to conduct surgical procedures.

Dr David Sharp plastic sugeon

However, it is essential to note that only those who are Specialist Plastic and Reconstructive Surgeons have undergone an advanced training program, encompassing at least 12 years of medical and surgical education, including a minimum of 5 years in specialist postgraduate training, specifically in plastic and reconstructive surgery.

The title ‘Specialist Plastic Surgeon’ is exclusively reserved for those who have achieved Fellowship status with the Royal Australasian College of Surgeons (denoted by FRACS Plast), and are specifically qualified in the field of plastic surgery, which encompasses reconstructive and aesthetic or cosmetic surgery.

Defining a Specialist Plastic Surgeon:

A specialist plastic surgeon is an accredited title, formally recognised by the Commonwealth Government to perform both reconstructive and cosmetic surgeries. These surgeons are trained and qualified to operate in various settings, including public and private hospitals, as well as accredited day surgeries. The Australian Medical Board clearly states that only those surgeons approved by FRACS in the recognised field of plastic surgery are entitled to use the title ‘specialist plastic surgeon’. 

‘This is a win for the public and will remove a lot of confusion when patients are making choices about cosmetic surgery,’ AHPRA CEO, Martin Fletcher, said at the time of announcement in 2023. 

However at the same time, the government added to the confusion, announcing that it did not think that doctors need to have RACS accredited training in order to perform surgery. In fact, it intends to let doctors who never completed the RACS training program, to qualify for an ‘endorsement’ from the government, to perform cosmetic surgery and call themselves surgeons. Unfortunately, despite promoting evidence-based decision making, AHPRA did not share the clinical basis upon which it set this significant precedent regarding patient safety. 

The ‘endorsement’ model infers that a patient undergoing cosmetic surgery deserves a surgeon with a lower level of training, oversight and expertise than another surgical speciality – such as orthopaedics or ear, nose and throat – which do not (yet) have unqualified, ‘government-endorsed’ surgeons performing knee replacements or tonsillectomies on patients.

This change further underlines the importance of checking your surgeon’s credentials and ensuring they are a RACS qualified, specialist plastic surgeon

FRACS & RACS: What is the Difference?

The acronym FRACS stands for Fellow of the Royal Australasian College of Surgeons.

This prestigious title is conferred upon specialist surgeons who have completed the aforementioned extensive educational journey, involving at least 12 years of medical and surgical training, with a minimum of 5 years dedicated to specialist postgraduate training. Surgeons who have FRACS (Plast) after their names completed the Royal Australasian College of Surgeons’ (RACS) Plastic Surgery Training Program and are qualified to perform complex reconstructive and cosmetic plastic surgeries.

Why Opt for a Specialist Plastic Surgeon?

In Australia, while the government still somehow believes it is permissible for doctors with basic medical degrees to conduct surgeries, specialist plastic surgeons distinguish themselves through their thorough and rigorous training, which offers unparalleled training in the skills required to perform plastic or cosmetic surgery. Choosing a specialist plastic surgeon also means you have access to private hospital admission if you experience a complication. For example, a patient having facelift surgery with a qualified or unqualified surgeon may experience a complication such as skin necrosis or nerve damage, but a plastic surgeon will be able to admit their patient to a private plastic surgery ward, perform revision or reconstructive surgery using advanced plastic surgery techniques and call upon the expertise of the plastic surgery unit at their hospital to provide the best possible care for their patient. Unqualified surgeons cannot admit their patients to major private inpatient hospitals, so they must be cared for by another surgeon if a complication such as this arises (or if in a public hospital, a trainee surgeon or registrar). Also, unqualified surgeons may not be trained and qualified in reconstructive or microsurgery techniques that are sometimes required to complete a complex procedure, or correct a complication. 

The Path to Becoming a Specialist Plastic Surgeon:

Specialist Plastic Surgeons receive their accreditation from the Commonwealth Governments of Australia and New Zealand, via the Australian Medical Council (AMC) and New Zealand Medical Council (NZMC). Their training journey is extensive, covering a broad spectrum of reconstructive and cosmetic surgical techniques. This includes the rigorous five-year postgraduate Surgical Education and Training Program (SET) in reconstructive and cosmetic plastic surgery, administered by the Royal Australasian College of Surgeons (RACS) and overseen by the Australian Society of Plastic Surgeons Inc (ASPS). Notably, RACS is the sole college in Australia accredited by the Commonwealth Government for delivering specialist surgical training currently, although this may change with the government’s new endorsement model. Upon completing their training, successful candidates are bestowed the title of ‘Fellows’ of the Royal Australasian College of Surgeons (FRACS).

Dr David Sharp plastic surgery Brisbane

About Dr. David Sharp:

Dr. David Sharp is an experienced specialist plastic surgeon in Brisbane, with a special interest in breast, body and facial cosmetic surgery.

With over two decades of experience in medicine, Dr. Sharp has performed over 20,000 surgical procedures in Australia and has an established surgical and non surgical practice in Brisbane.

Read more about Dr Sharp's credentials and expertise here. 

For more information and to schedule an appointment with Dr. David Sharp, please contact our patient support team at 3202 4744 or visit our online booking request form here.

This information is intended for general knowledge and should not replace personalised advice from your surgeon. Always consult with your surgeon for individual care.