Introduction: Surgical practice is unique from other areas in Medicine due to a variety of factors and comes with its own rewards and challenges. Each subspecialty within surgery has different demands and each clinician yet again their own unique style. This talk explores the strengths and weaknesses of setting up ones practice and the different models people pursue.

Background:  Surgical practice in unique due to factors such as rapid turnover, increased procedural nature involved, more complicated administration required and surgeons rarely spend 5 days a week consulting in one set of rooms though encumber the running costs. Compounding that are often long hours and different teams in each work environment. Multiple chains of communication arise whereby efficient systems are critical in reducing risk and avoiding adverse patient outcomes.

Where setting up in an established practice has the advantages of having an established case load, established work practices and trained staff which helps in a seamless transition between being a fellow and a consultant, setting up one’s own practice comes with the challenges of finance, setting new work practices, training new staff, starting a caseload, establishing everything from database of doctors to crafting job contracts. This talk explores the risks and benefits of setting up one’s practice with a focus on the external pressures in life and family that also must be considered while weighing up these decisions.

Conclusion: Setting up a practice can be a risky but rewarding challenge. Clinicians must to weigh up the pro’s and con’s of their decision with respect to their short and long term life and career goals.