Guest speaking at the Provincial Surgeons Australia conference in Ballarat was a homecoming for Dr Quade, who is based with Providence Health Service and University of Washington in Seattle.

Dr Quade was keen to return back to western Victoria to share and learn from those operating in regional fields across Australia and New Zealand.

The Loreto College graduate, who grew up in Horsham, said health care was starkly different in the United States and it was interesting to compare, particularly the constraints in regional hospitals thrown up by distance.

It has been in the US that Dr Quade has taken her career to the next level, developing surgical interests in colorectal surgery, robotic surgery, sacral nerve stimulation and colon and rectal cancer as well as pelvic floor disorders on her journey.

First studying nursing at Australian Catholic University in Ballarat, Dr Quade always had a burning desire to go to medical school. Once she secured a Green Card for permanent residency, it was like a ticket to pursue her dream.

Dr Quade studied pre-med in Arizona before going on to her medical degree in Tuscon, Arizona and an internship and residency in general medicine with University of Washington in Seattle.

"Studying medicine is very different there. You don't go straight from school into a medical degree, you have pre-med, which can make it a bit easier to get into," Dr Quade said. "You don't have to be in the top one-per cent or so of students to get started."

Dr Quade honed in on her surgical interests through those formulative university studies. It was in medical school when Dr Quade had her first taste in robotics.

"Healthcare in America is not as government-run as in Australia. There is a lot more privatisation. This can mean we get a lot more access to technologies and that's good and bad," Dr Quade said.

"It's good and bad because the outcomes are not always necessarily proven to be better for the patient. There's not necessarily always the research to show this.

"...It's been a great experience (in Ballarat) understanding and seeing regional surgery contraints and how surgeons work within this."

Dr Quade said it was particularly nice to meet a general surgeon from her hometown Horsham and talking about the resource limitations on his work - and in Horsham he pretty much had to be a surgeon of most trades.

While there are regional hospitals in the United States, Dr Quade said her home state Washington had a population of about 8 million people - about a quarter of the population of Australia.

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