The word governance is essentially used to refer to a set of principles that are used to ensure that the best possible practice in a specific area is implemented. In healthcare this can be seen in areas such as clinical governance, research governance, financial governance, corporate and information governance.

Clinical audit is a process that ensures that healthcare is provided to patients in line with standards set in national and international clinical guidelines. Information from audit informs healthcare providers and patients where the healthcare service is doing well by maintaining standards and shows where further improvement is needed. It is an ongoing process that is repeated once changes have been implemented, ensuring that quality of services is constantly improving and maintained.

Risk management is a process that focuses on improving the quality and safety of healthcare services through a process of identifying the risks and then acting to control and prevent these from happening again. Risk management is an integral part of clinical governance and essential for all healthcare professionals to be aware of.

Defensive medicine may be an instinctive reaction, but like many primeval reactions, it may not come cheaply. And rather than the monetary cost, which is known to all, one refers here to loss of the pleasure of practice, the depersonalization of the patient and the self-destructive constant paranoid deliberating. The honest advice, which comes after 40 years’ experience in the field, is to practice evidence-based medicine and keeping updated with advances in the medical, legal, ethical and technological spheres. Practitioners must take pride in their work and rejoice that they have done well.

Imaging is an indispensable diagnostic tool in gynaecological practice. Transvaginal ultrasound (TVS) is most often used in an office environment as an adjunct to clinical examination. Transabdominal ultrasound is employed in specific applications and often as a first step before TVS by non-gynaecologists, while MRI and CT are used selectively as secondary tests for specific indications. Perioperative imaging is increasingly popular in clinical practice. In the first section, the essentials of the ultrasound technique and image optimization skills will be described as well as professional attributes necessary for safe ultrasound practice. In the clinical section, the prescribed approach was based on presenting symptoms as is the case in clinical practice where patients are referred or present themselves with a complaint. It is critical for ultrasound practitioners to accurately recognize normal features easily and, likewise, in the differential diagnosis of abnormal findings, they should master the salient features that will ultimately establish a diagnosis.

Gynaecological cancers comprise a huge variety of tumours. In the three main organs (endometrium, cervix and ovary), tumours differ in biology and molecular features, explaining the differences in tumour behaviour. However, in all of them, effective treatment options for advanced disease are urgently needed. Immunotherapy could be one such strategy. The goal of immunotherapy is to promote antitumour immune responses by stimulating the host immune system, by enhancing immune response, by relieving immune suppression by the host immune system or by immunomodulation.

Until now, immune checkpoints inhibitors that modulate one of the most important pathways of tumour immune escape presented the most robust efficacy data, but many trials are still ongoing and are expected to provide important knowledge in the coming years.

In future, clinicians will be able to recognize immunotherapy toxicities early on and better deal with them, while appropriate patient selection for these therapeutics will allow a more personalized treatment approach.