Dr Tristan Mehta outlines the five questions to consider before booking a training course
Training is a significant investment in your career in medical aesthetics. Courses can start at approximately £700 for just one day of training, but can go up to £10,000-30,000 for a three year master’s degree.1
There is likely no such thing as ‘the best course’. So, whether you are new to aesthetic medicine, or looking to improve your current practice, the most important question to ask yourself before investing in further education or training is, ‘where will this take me?’ Do you want a broad overview of injectables? Or are you looking to enhance your ability to manage complications? Would you like to deliver medium-depth peels? There are varied education and training opportunities available for all requirements.
Whilst there are many good places to start or advance your training, one of the most common realisations that I see people make after investing in courses is that they did not think far enough ahead into the future and understand what they wanted to get out of it. Those who did not get what they were trying to achieve out of training often find that this easy, yet myopic, mistake has been an expensive one. How can you ensure that you don’t fall into this trap? I would advise that before booking a particular course, you ask yourself the following questions.
This question relates to an often overlooked distinction that we can make between education and training. Whilst training is generally vocational, and therefore provides tangible skills, in some cases education might offer less measurable forms of skill acquisition. Educational courses can tend to centre on improving learners’ more abstract, academic abilities. Short training courses often necessarily neglect the development of these deeper skills in favour of immediately applicable talents. Both approaches have their merits, but it is worth reflecting on your ambitions.
If your interest in a new field of aesthetics is at all academic, then the most appropriate route is likely a master’s degree at a university. Although these are typically relatively lengthy and costly, master’s degrees are not only designed to ensure clinical proficiency, but also to equip you with an ability to critically engage with, and potentially contribute to, aesthetics research in the future.
On the other hand, practical proficiency and continued knowledge can be enhanced through vocational routes such as those offered by independent academies. These options range from weekend courses to distance-learning programmes. If you want to offer a number of core procedures, or update a subset of your overall knowledge, then these may be suited to your needs. Realistically consider whether you want education or training before enrolling on a course. Ideally, however, you should find a way to incorporate them both. This could be through an academic and vocational course, or a course that blends the two.
Some courses may seem to provide a convenient shortcut into the aesthetics industry by implying that if you attend a one-day course then you will be well equipped to perform those procedures independently from then on. However, as the old adage goes, ‘If it seems too good to be true, then it probably is’. How realistic is it that a one-day course will equip you with the skills you need to successfully enter a new medical specialty? To quote some advice from the British Association of Cosmetic Nurses (BACN), “These [one-day] courses usually (and should) only offer certificates of attendance, rather than proficiency, since it is not possible to become proficient within a day.”2
Medical aesthetics is a highly competitive field. Only those who can demonstrate true proficiency, rather than just competency, will succeed in the long run. Short courses might ‘top-up’ your skills with a niche procedure such as treating the tear troughs, provided they take place in small enough groups for in-depth one-to-one feedback. However, those who are completely new to the aesthetics industry should be wary of spending significant amounts of money on one or two-day courses in the hope that it will leave them fully proficient. A foundation of knowledge is the most stable basis for advanced learning. For newcomers it is especially important to find a course that favours depth of learning, with a full theoretical and practical curriculum that includes topics such as dermatology, skin ageing, and the mechanisms of action of any pharmaceuticals such as botulinum toxin type A.
Aesthetics is a specialty typically entered after undergraduate training. So, ensure that your chosen course delivers theoretical and practical training to that postgraduate standard, and provides you with a nationally recognised qualification at the end of it.
You need to know whether your training will withstand upcoming changes to the regulatory landscape. In 2015 and 2016, Health Education England (HEE) laid out the Qualification Requirements for Delivery of Non-surgical Cosmetic Procedures.3 This is one of the most comprehensive guides to what level of training you should be aiming for in order to deliver non- or minimally-invasive cosmetic procedures, from dermal fillers to chemical peels. HEE guidelines were also endorsed by the General Medical Council (GMC) in the recently released guidance for cosmetic doctors.4
Whether you are a new or experienced practitioner, familiarity with the HEE recommendations is essential
Whether you are a new or experienced practitioner, familiarity with the HEE recommendations is essential. HEE signpost what level of training you will be expected to meet in the future. I believe these higher expectations will possibly become the minimum standards for accrediting bodies, as well as for cosmetic insurers, employers at clinic chains, and the general public. Consider some important points outlined for training in botulinum toxin injections:
Qualifications should be at a Level 7 for the administration of botulinum toxins (subject to oversight of an independent prescriber).3
Practical skill requirements: students must perform ‘10 treatments for 10 different patients/clients (observation) [and] 10 treatments for 10 different patients/clients (under supervision) for each treatment type’.3
Training courses must have their own degree awarding powers, or be regulated by the government’s Office of Qualifications and Examinations Regulation, Ofqual.3
HEE gives practitioners until 2018 to meet the new, higher standards.3 So take this opportunity to get ahead of the curve: read the HEE guidelines, and make sure that your chosen course allows you to comply with them.
Practical experience is obviously vital for both confidence and proficiency. With injectable treatments, for example, hands-on training is essential for understanding how to achieve good outcomes and how to minimise the risk of complications. That said, the kind of hands-on practise that is on offer varies wildly. For instance, on a one-day course you may get to partly treat several pre-selected models who are shared between delegates. This means that you get to experience parts of several procedures. Although informative, it is important to distinguish this from what it is like to assess and deliver entire aesthetic treatments in a real clinic. By sharing patients, some teaching methods minimise hands-on time, and fragments the training. This might be useful for the refinement of skills, but for initial training, at least, it is vital to perform entire treatments. By contrast, full treatments include the consultation, treatment planning, entire and uninterrupted procedures, aftercare and follow-up. Before delivering botulinum toxin injections independently, HEE recommend that practitioners observe ten and deliver ten full treatments under expert supervision.3 If you know someone who can supervise you, who has more than three years of experience in the procedure you are learning, then you can gain this clinical experience independently. However, if you do not know someone who is able or willing to supervise you then make sure that your training provider offers real clinical mentoring.
Accreditation is one of the most contentious issues surrounding aesthetic training. This is because, although many courses claim to be accredited, the important question is, ‘who is the course accredited by?’
If you want formal Continued Professional Development (CPD) points then CPD accreditation is useful. However, there are other important accreditations that a course can have. For example, the aforementioned HEE requirements specify that qualifications in aesthetic medicine should be regulated.3 There are only two ways of gaining a regulated qualification in the UK: through a university, or through an awarding body that is regulated by Ofqual. In light of the potential need for compliance with HEE guidelines, my advice would be to check who your course is accredited or regulated by. One useful tool for doing this is the Ofqual register (register.ofqual.gov.uk).5
Other accreditations to look out for include those from independent professional bodies such as the British College of Aesthetic Medicine (BCAM), or the emerging regulatory body the Joint Council of Cosmetic Practitioners (JCCP), which is due to become operational in Spring 2017.6 These accreditations mean that the course meets certain stringent requirements and testify somewhat to the quality of the course, even if they aren’t mandated by HEE requirements.
The JCCP is, in part, being set up to counteract the proliferation of training standards in aesthetics. However, sadly it is still the case that choosing an aesthetic training course can be somewhat of a minefield. Until aesthetic medicine is successfully self-regulating, vigilance is key for prospective students looking to start or continue training.
Fortunately, however, the recent guidelines from organisations like the GMC4 and HEE3 provide a reliable baseline of objective information. By armouring yourself with the facts, examining different courses, and clarifying your aims, you can benefit both yourself and the aesthetics specialty more broadly with wise investments in your education and further training.
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