In 2023, Dr Reema Kohli was awarded the Brown Craig Travel Fellowship. This article profiles Dr Kohli as she embarks on a six-week placement at Purohit General Hospital and Research Centre in Odisha, India.

Dr Reema Kohli Recipient of the Brown Craig Travel Fellowship 2023

Dr Kohli is a RANZCOG-accredited consultant in obstetrics and gynaecology with a special interest in pelvic floor disorders and minimally invasive surgery. Her career began with specialist training at major tertiary hospitals in Delhi, where she became a board-certified specialist in obstetrics and gynaecology. In 2018, she was awarded membership of the Royal College of Obstetricians and Gynaecologists (UK).

Her passion for pelvic floor disorders led her to complete post-fellowship training in urogynaecology at Gold Coast University Hospital, Varsity Lakes, and Robina Hospitals in Queensland. Following this, she began teaching medical students at Griffith University, Gold Coast. Dr Kohli now works as a consultant obstetrician and gynaecologist at Eastern and Monash Health in Victoria and operates a private practice at Grace Womens in Berwick. She also serves as an examiner on the RANZCOG Board of Examiners.

In addition to her clinical and teaching work, Dr Kohli has presented research on predictors of fetal growth restriction and received awards for developing new techniques to improve urinary tract visualisation during laparoscopy. Her findings have been showcased at both national and international conferences, including the Australasian Gynaecological Endoscopy and Surgery Society Pelvic Floor Symposium and the International Federation of Gynecology and Obstetrics International Conference.

Dr Kohli with Purohit General Hospital and Research Centre Nursing staff

Dr Kohli with Purohit General Hospital and Research Centre Nursing staff

Dr Kohli with a satisfied patient four weeks post-surgery

Dr Kohli’s Experiences from the Brown Craig Travel Fellowship

Through the Brown Craig Travel Fellowship, I travelled to Purohit General Hospital and Research Centre in Odisha, India, to undertake a six-week placement to learn advanced techniques in vaginal hysterectomy for non-prolapse benign indications. The hospital is a regional referral centre offering advanced gynaecological, obstetric, general surgery, and IVF services to the local population.

I had the opportunity to learn the Purohit Technique for vaginal hysterectomy from Dr Ram Krishna Purohit and his team. This widely published technique evolved over the last 20 years and emphasises ergonomic yet safe procedures to minimise visceral injury, using specialised instruments such as the Purohit forceps and a bipolar energy device. The team now applies it to most benign gynaecological indications for hysterectomy.

During my time in Odisha, I deepened my understanding of pelvic floor anatomy and learned to manage complex hysterectomies. I observed how cultural beliefs influence women’s health decisions, with many preferring a hysterectomy over conservative management for conditions like abnormal uterine bleeding once completing their families. I gained hands-on experience, assisting in 25 cases and independently performing six learned techniques for large uteri, previous surgeries, and minimally invasive approaches. I also assisted in vagino-laparoscopic surgery for a hysterectomy on a large 20-week-sized uterus using a minimally invasive approach.

During this placement, I was exposed to a variety of surgical methods that I had not previously encountered (or learned) in Australia. Compared to the robotic and laparoscopic surgery commonly used in Australia, the use of vaginal approaches proved equally effective, safer and more cost-efficient, achieving excellent postoperative outcomes. The collaborative efforts of a highly enthusiastic team of nurses ensures the smooth running of this 24/7 medical centre.

Rewards of the fellowship experience.

One of the most rewarding parts of my experience was meeting satisfied patients after surgery. One example that stands out was a 50-year-old woman who travelled 175 km for her surgery for endometrial hyperplasia. After surgery, she told me her life had changed as she could now concentrate on her handloom business. Before surgery, she had to shut down her business due to irregular, heavy menstrual bleeding which had been ongoing for six months and made it difficult to focus on caring for her family.

I also appreciated witnessing how a health system catering to a large catchment area can function efficiently with limited resources. This experience broadened my understanding of how cultural beliefs affect disease perception and decision-making regarding the management of gynaecological conditions. Many women prefer definitive solutions to their symptoms and, once their families are complete, opt for a hysterectomy over conservative management for conditions like abnormal uterine bleeding due to fibroids. Their decision-making is influenced by both cultural beliefs and logistical barriers to healthcare.

Being awarded the fellowship has enriched my professional and non-clinical skills and provided insights into healthcare resource utilisation in settings where resources are limited. I am grateful to the RANZCOG Women’s Health Foundation and aim to apply these skills in my practice in Australia, fostering continuous learning and innovation.