The Last Word: NHS and Aesthetics

By Mr James Olding / 25 Jun 2021

Mr James Olding argues why NHS trainees should not be deterred from entering aesthetics and how it’s possible to combine it with their specialist training

Working as an NHS doctor, dentist or nurse brings its unique rewards and challenges. A career in facial aesthetics may take any number of paths, but the rewards and challenges can be just as great. So why do so many NHS health professionals view our specialty as a zero-sum game, feeling like if they were to delve in, they must sacrifice success in one area to achieve it in another?

I am here to debunk the myth that successful progression through NHS specialist training, be that as a doctor, dentist or nurse, is dependent on downplaying your aesthetics achievements. In the NHS, I am a specialist registrar in oral and maxillofacial surgery, this year becoming dual qualified in both medicine and dentistry. In the aesthetics industry, I am the founder and director of the OFQUAL-regulated and accredited, Aesthetics Awards finalist training academy Interface Aesthetics, as well as being a cosmetic injector with a large patient base. Across my roles in clinical practice and training, I hear the concerns that practitioners of all backgrounds have about work in aesthetics and how this could affect appraisals, revalidation and NHS recruitment processes.

Why the bad reputation?

Motivations for forging a new role in non-surgical aesthetics are legion, with the potential for professional fulfilment, remuneration, and greater autonomy among those commonly cited. So why do some individuals perceive there to be a conflict between aesthetics and NHS practice that could lead to negative consequences? As previously one of those individuals, I can talk frankly about my journey from talking down my aesthetics career some years ago, to now championing my non-surgical credentials and experience in every aspect of my NHS career and training.

As a trainee surgeon, I feared being penalised for starting my own aesthetics practice when the time came to apply for jobs. Friends and colleagues in careers as diverse as plastic surgery, general practice and orthopaedics all shared stories and concerns about negative reactions of seniors at appraisals and national recruitment interviews. More concerningly, I knew of outright bans on trainees of certain specialties in certain deaneries on practising non-surgical aesthetics. Despite this backdrop, I decided to proceed with caution, and to my delight discovered a passion for non-surgical aesthetics that has enriched both my personal and professional life.

Negative views of aesthetics arise from many different places. From a senior or supervisory perspective there are valid points concerning time commitments and spreading oneself too thinly; something which I believe can be factored into a professional development plan with appropriate support and mentorship. More pernicious is the idea that aesthetics is somehow less of a specialty, regarded as the ‘easy’ option. This idea is based on valid concerns surrounding regulation (or lack thereof), training and differing expectations around the use of platforms including social media. Nonetheless, misconceptions about the specialty and motivations for entering it abound, and as an NHS doctor working aesthetics, it is important to promote the positives while acknowledging the areas of valid concern.

NHS can coincide with aesthetics

Since starting out in the industry, numerous well-meaning NHS colleagues from various specialties had advised me to downplay my facial aesthetics practice in my surgical portfolio and CV, and to steer interviewers away from the topic during the national recruitment process for my specialist training post as a facial surgeon. I was lucky enough to have a highly supportive consultant mentor within my specialty of oral and maxillofacial surgery; undoubtedly, she helped to create an environment in which both major aspects of my career were able to flourish. As a result, I felt confident in proudly placing my aesthetics practice, teaching and research front and centre; but of course not everyone has had this positive mentorship.

From the perspective of the individual, the potential rewards of entering into the aesthetics field are clear, as are some of the challenges. But I believe that we should be asking ourselves an additional question: namely, what we as individuals can do to contribute positively to this exciting and innovative field? The woeful lack of regulation in non-surgical aesthetics puts patients and professionals at risk daily. This sobering truth requires a collaborative approach across professional backgrounds, private and public sectors, and all levels of training. Advocating for legislation and regulation, participating in training via regulated post-graduate courses, promoting patient awareness through responsible platform use, and contributing to research are just some ways in which an NHS nurse, doctor or dentist is able to take this approach.

I appreciate that effectively having two jobs presents obvious challenges; navigating training alongside growing and running a business has been one the greatest challenges I have faced. This has required excellent time-management, the ability to prioritise, and an unbending commitment to do good for patients; skills and behaviours that we develop and exercise in the NHS on a daily basis. Most of all, having a supportive and understanding mentor within the NHS is fundamental, and I would urge colleagues to seek out this support both as a means of ensuring all aspects of your career link up, while keeping your ideas in step with the differing expectations that we must meet as NHS trainees.

To those colleagues who have reservations, let me be clear; non-surgical aesthetics can and should work synergistically with your NHS training, strengthening your CV and portfolio and providing clear leadership, teaching and research opportunities. In addition to benefiting your NHS career, it could help to bring about the much-needed change required to make the industry safer and better for patients and practitioners alike. Your background and skills make you a leader of the future in this unique area of clinical practice. Do not miss out on joining our growing ranks in this movement; a movement that is literally reshaping our concepts of healthcare, wellbeing and even society itself.

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