Starting Out in Aesthetics

By Dr Joanna Hackney / 12 Jul 2021

Dr Joanna Hackney shares her ‘step-by-step’ guide to starting a new career in the aesthetics specialty

As medical professionals, our career path is often mapped out ahead of us – a series of hurdles and hoops to leap over and through – leading us up the well-established ladder of training and role progression. This treadmill can be a comforting ‘box ticking’ exercise, with relatively little autonomy compared with other occupations. Perhaps this is why a change in my career during my senior training years felt like a giant leap into the unknown.

It would appear I was not alone in making the decision to switch careers. In 2018, only 37.7% of Foundation Level 2 doctors continued straight into specialist training programmes,1 sparking a British Medical Journal article to identify ‘why?’2 They received feedback from many junior doctors choosing to leave the NHS and discovered several themes: lack of value, loss of respect, poor training opportunities in favour of service provision, limited pay, and inflexible rotas.

With the strain of the pandemic making working conditions tougher for many, this is a trend which may spiral. Healthcare workers are particularly at risk of ‘burnout’ – a work-related stress syndrome caused by chronic exposure to job stress with approximately one in three physicians experiencing it at any one time.3 Of course, aesthetics is not the only option for those wishing to pursue a different career within medicine, but I believe it to be a great one.

This article is intended to provide a possible ‘step-by-step’ guide on how I believe medical professionals can approach this career junction, as well as some tips that I discovered along the way.

Step 1: Organise your thoughts

This may seem like an obvious place to start, yet this initial step can be surprisingly difficult. Years of programming to follow a certain route without deviation can make objectives, such as your personal goals and desires, difficult to consider. From experience, these are the questions you need to be asking yourself if you are debating a career change:

  • What are my ultimate career goals?
  • What are my interests?
  • What are my skills and values?
  • What do I want to achieve from my job?
  • What are my constraints?
  • Which work style best suits you?
  • What do I need to change in my current role to achieve this?

Creating a list and ranking your top 10 priorities is a useful way of focusing on these answers. They can then be compared against a selection of potential roles you may be interested in to further direct your decision making. I was extremely well supported by my training deanery when discussing my desire for change and embarked on career guidance provided by Health Education England. Whilst this may not be an option for many, accessing similar resources can be an invaluable tool to assist in your decision. Utilising family and friends during this phase can also be a constructive aid to self-analysis and help you hone-in on your priorities.

Step 2: Establish pros and cons

Once you have ascertained that a change is required, you must investigate whether the aesthetic specialty is the correct fit for you. To assist with this, I have compiled a simplified table of some of my personal ‘pros and cons’ of working in aesthetics (Table 1).

This list is not exhaustive and is subjective, so do research the industry yourself and come up with your own unique pros and cons list. I would recommend attending an open day for a training academy or an aesthetic conference, such as the CCR conference in October, or the Aesthetics Conference & Exhibition (ACE) in March, where you can speak with industry professionals established in aesthetics. You should also subscribe to a journal to get a real taste for the specialty and get a feel for the community.

Step 3: Attend a foundation training day

It came as an astonishing revelation, after years of rigorous training in medicine, that all that was required for me to ‘get started’ in aesthetics was a one-day course and a certificate. In reality, for most, this is just the very first step of a longer journey, yet it is a vital one.

Be selective when choosing which training provider to use; consider how you may wish to develop from this point, would you prefer more online or face-to-face contact? Do you feel comfortable practising injecting patients during your first session? Will you be offered support or further training opportunities beyond the initial contact?

Many healthcare professionals which attend foundation training days do not go on to progress in an aesthetics career.4 This, of course, could pertain to many, but when speaking with delegates, I have infrequently found the underlying cause to be a lack of interest. More likely, poor follow through can be explained by not completing steps one and two prior to attending a foundation training day, without the required consideration of the bigger picture.

Step 4: Seek insurance and register with a prescriber

After attending your foundation training day, now is the time to keep the momentum going and ensure you have the necessary processes in place to begin practicing.

Insurance

Become indemnified for the treatments you are now certified to undertake. Your usual occupational indemnity is unlikely to cover you for specialist elective aesthetic work, so seek separate insurance or see if you can extend your current plan. There are many companies providing this, some of which include Cosmetic Insure, Enhance Insurance, Hamilton Fraser Cosmetic Insurance.

Pharmacy registration

Register with a reputable pharmacy or supplier. Some pharmacies that can supply you with your aesthetic products include: Church Pharmacy, Healthxchange, Med-fx and Wigmore Medical.

Prescriptions 

If you are a non-prescribing medical professional such as an aesthetic nurse, or doctor with a provisional GMC registration, you will need to consider how you will be able to ensure your patients can access prescription-only medicines such as botulinum toxin, emergency drugs such as adrenaline, and those for managing complications, such as hyaluronidase, antibiotics, and steroids. The best option is to gain your independent prescribing license; however, I acknowledge this often is not practical for those just starting out so you will need to work closely with a prescriber. Useful sources for connecting with a prescriber are companies like Aesthetics Associates. Furthermore, the British Association of Cosmetic Nurses (BACN) offer excellent guidance on the legal and regulatory requirements here.5

Arranging a mentor or supervisor can be invaluable, and many healthcare professionals within the industry will be happy to offer their guidance

Step 5: Keep on top of training

A foundation training day will introduce you to the basics of aesthetic injectables, which is a good starting point, but you should be building upon this as your experience progresses. I have found there to be generally two pathways once step five is reached. A ‘learn on the job’ approach, with self-led training and development, or a more didactic approach, seeking further formal training, such as completion of a Level 7 qualification in injectables or Master’s. Personally, I chose to undertake more training at the beginning of my career in aesthetics. If undertaking more training, ensure you choose a reputable company, preferably one that complies with the qualification requirements for delivery of cosmetic procedures. The Joint Council for Cosmetic Practitioners (JCCP) has created an ‘Education and Training Provider Register’ and has established strict standards of entry and premise requirements.6

Arranging a mentor or supervisor at this stage can be invaluable, and you may be surprised to discover that despite the high competition levels, many healthcare professionals within the industry will be happy to offer their guidance. The Cosmetic Practice Standards Authority (CPSA) have created a supervision matrix in their bid to promote practitioner networking, move away from ‘lone practice’ and improve outcomes.7

Step 6: Think about your future

Time to organise your thoughts as you decide how you would like to shape your career in aesthetics. Some practitioners choose to set up their own business from the get-go, whereas others prefer to work for someone initially. Either of these options are viable, and are down to individual preference and values, so take your time to consider your predilection. Some considerations to help with this process are:

  • Are you comfortable in business? A business plan is essential, so if this is not your area of expertise, be prepared to outsource or upskill.
  • Ensure that if you work for someone else, their principles are aligned with yours. The GMC, GDC and NMC all have guidelines outlining the standards required from their members and it is important that these are not compromised. The GMC have a document offering guidance for doctors specifically offering cosmetic interventions.8
  • Consider your marketing plan. Building a patient database can take time, so optimise your chances with appropriate marketing and a professional website. Be cautious with advertising, and ensure you adhere to the guidelines provided by the Advertising Standards Authority (ASA).9
  • Optimise your General Data Protection Regulation (GDPR) compliance10 and organisation with a good patient management system from the beginning. Some examples are Aesthetic Nurse Software, Clever Clinic, Cliniko, iCLINICIAN and iRejuvenation.

I would recommend keeping an anonymised ‘logbook’ or portfolio of all the treatments you have performed to demonstrate your competencies when applying for clinic roles.

Step 7: Reflect on your progress

At this stage, if you have completed the previous steps, you will have a reasonable impression of whether aesthetics is an expedient career for you. I would urge you to take some time to return to the work you completed as part of ‘step one’ and reflect on whether you are ticking the right boxes.

I would also offer advice to compare your approach to working within the field of aesthetics to your original medical profession. We must be diligent to remain true to the ethics, codes of conduct, and fundamentals that are so important as healthcare professionals, and alter behaviour which does not stand up to these principles.

Do not be disheartened if you find you are not progressing at the rate you had imagined, and try to not compare yourself to others. It takes years of training to become successful in any medical field, and aesthetics is no different.

A worthwhile specialty

This guide is intended as exactly that – a guide. In my previous career, a methodical, carefully planned approach suited the specialty and my approach to work, and so I hope that this may prove useful for those in the initial phases of their journey into aesthetics. To paraphrase poet Robert Burns, ‘the best laid plans of mice and men often go awry’, so we must adapt, improvise, and overcome. In my experience, it is worth it.

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