Special Feature: Training in Aesthetic Medicine

Looking for the right training options can be a minefield within the aesthetics specialty. With no law on minimum training requirements to practice within aesthetic medicine, it can be hard to choose the right training route. While some providers will give you a brief overview, others are much more in-depth and will put you in a strong position when starting out as an aesthetic practitioner, or further your already flourishing career, with patient safety at the forefront. As detailed on p.17, the recent report published by the All-Party Parliamentary Group on Beauty, Aesthetics and Wellbeing (APPG), highlighted the essential need for high-quality aesthetic training, as well as training standards and qualifications.1 Advanced level nurse practitioner Aine Larkin, academic and clinical director at MAP-IQ training centre, welcomes the report and acknowledges the need for more comprehensive and compulsory training within the sector. “The vulnerable public need to be protected, and this area must be recognised as a specialty only to be carried out by medical practitioners who have regulated qualifications and training in their area of practice,” she says. Miss Priyanka Chadha, joint CEO and founder of Acquisition Aesthetics and recent winner of the CCR Award for Independent Training Provider of the Year at the Aesthetics Awards, states, “There’s so much evidence of all the negatives that have resulted from a lack of regulation and training within the industry, and it feels like not enough is being done. It’s taking risks with the public's health and more needs to be done to improve training and education within the industry.” While there are still no legal requirements to train and practice in the UK, Aesthetics spoke to some of the UK’s leading aesthetic trainers to deliver an overview of the best training options available to ensure patient safety. Where to start “Don’t get into aesthetics at all if what you’re looking for is a quick route to a bigger salary,” says Dr Tristan Mehta, aesthetic practitioner and founder of Harley Academy. “It takes a strong mindset and

commitment to a long-term career in aesthetics. There are no short cuts, and you should choose to get as much knowledge and experience as possible,” he continues. Miss Chadha agrees that it is imperative when starting out in aesthetic medicine that you look at the entire career progression as a whole. “It’s a huge investment of time and money – it’s a subspecialty that takes years, even decades to master,” she explains. If you are unsure whether the commitment required to pursue a career in aesthetics is for you, Mr Adrian Richards, medical director of training academy Cosmetic Courses, suggests doing a few one and two-day courses to introduce yourself to the world of aesthetics. “Aesthetics is a difficult Training in subspecialty,” reiterates Mr Richards, adding, “We only train registered doctors, nurses, and dentists who have already undergone significant training in Aesthetic Medicine their fields, but aesthetics isn’t for everyone, so why not try a one or two-day course in injectables and see how you like it?” Aesthetic trainers explain the different training Depending on the course structure, pre-course theory and modules, e-learning, assessments options available to further develop your career and practical content, the traditional ‘Foundation Training Course’ could be a good place to start, suggests Miss Chadha, “But it’s only a start! A significant course will not be just one day. The practical day will be sandwiched before and after with theory and online learning to cover the basics in aesthetic medicine,” she says. For example, an introduction to the industry, facial anatomy, dermatology, consultations, consent, aftercare, complications, and business tips. “On completion of an appropriate foundation course with all of the relevant modules, assessments and accreditations, practitioners can get the necessary insurance required to start as an injector,” says Miss Chadha. Although there are benefits to short-term training courses, most trainers believe they are not enough as a standalone qualification to enter the field. Dr Mehta believes practitioners should always be striving to achieve their Level 7. “If you complete a few different foundation courses and realise that you are committed to a safe and successful career in aesthetics, then a Level 7 Diploma (sometimes called Certificate) in Injectables for Aesthetic Medicine could be a great next step.” According to Dr Mehta, Harley Academy were the first to launch the postgraduate qualification regulated by Ofqual (The Office of Qualifications and Examinations Regulation) in June 2016. Other training academies have since developed their own Level 7 Diploma, some with and some without JCCP approval. “It’s best practice to look for JCCP approval as they own the original Health and Education England (HEE) guidelines,” he adds, “Typically to gain entry to a Level 7 qualification you will need to have an undergraduate degree in a relevant subject, and most courses are only available to nurses, doctors and dentists.” Each Level 7 qualification will be different, but will typically be made up of various modules, online study, mentoring, practical exercises, and a final examination. Topics often covered include safe use of needles and cannulas, business advice, in-depth knowledge of skin and facial ageing, anatomy and the psychological driving forces, complication management, and issues for patients considering cosmetic treatments. A Level 7 Diploma can take between six and 36

Although there are benefits to short-term training courses, most trainers believe they are not enough as a standalone qualification to enter the field

months depending on a number of factors. “In a severely unregulated industry with consumers who are becoming better informed, a Level 7 can offer a difference between you and less qualified practitioners in an increasingly competitive industry,” argues Miss Chadha.

Larkin also encourages new practitioners to undertake the Level 7 Diploma. “There is currently no other UK qualification at the correct academic level to evidence learner competence in both knowledge and skills. Competence must be validated through an approved process to enable new clinical aesthetic practitioners to start practising in a completely new autonomous clinical specialty,” says Larkin.

The next steps

CPD courses “Following an Ofqual and JCCP regulated Level 7 qualification where the basic modality underpinning knowledge, and skill are taught and assessed, I believe this is where a good continuing professional development (CPD) course comes in,” says nurse Larkin, adding, “CPD courses are there to build on and advance the knowledge and skills of clinical aesthetic practitioners to ensure they remain updated with the scientific evidence base to inform their practice.” The JCCP states that registered practitioners should demonstrate evidence of CPD achievements as required by their professional statutory regulatory body.2 It also specifies that a minimum of 50 hours of CPD must be demonstrated annually by all clinicians on its register, of which a core element is aesthetic-related.

Cadaver training In a 2017 study of 168 aesthetic practitioners in Singapore undergoing a two-day cadaver training course, the results indicated that all four groups showed an improvement in their facial anatomy knowledge based on the comparison of pre-course and post-course test results.3 Mr Richards believes that to fully understand the vascular make-up of the human face, cadaver training is essential. “It’s a way to conduct three-dimensional observation and dissection of human anatomy and an opportunity to see the different layers and structures of the face to enable practitioners to optimise the correct placement of our dermal filler products,” he says, adding, “This essential knowledge not only makes for more effective filler treatments, but also reduces the risk of complications including vascular occlusions.” Arguably, it makes sense to undertake prior training courses, such as multiple foundation courses before you enrol on to a cadaver course, as they can be expensive and require a background in aesthetics to get the most out of it, says Miss Chadha. “In terms of the future of aesthetic training, I strongly believe that cadaver courses should become an essential training opportunity,” she views.

Master’s degree According to Mr Richards an academic master’s degree is similar to a Level 7 and can be a good choice for furthering your academic career, although it can be less practical and more academic, he adds. The university of Manchester, for example, offers a part-time MSc in aesthetics, which incorporates online learning, group work, and written assignments, two five-day residential sessions and a final dissertation over the course of 36 months.4 Larkin explains that MAP-IQ is currently working with regulators and awarding bodies to develop a progression route for those who have successfully achieved a postgraduate Level 7 Diploma to do their MSc in clinical aesthetic injectables. “A Master’s degree can indeed increase your knowledge, personal and professional skills and perhaps even boost your confidence and consequently your employability, such as a move into the regulated education or training sector,” says Larkin, adding, “A Master’s can also help in securing you further funding for your PhD, which you might want to do as a research project in a specific medical topic.”

Becoming a trainer Miss Chadha recommends that experienced practitioners wanting to further their knowledge and improve their practice become teachers themselves. “At Acquisition Aesthetics, we choose our trainers very carefully,” she says, adding, “It can be a great opportunity for seasoned practitioners to pool their expertise, and it can also highlight gaps in your own knowledge. I genuinely believe that becoming a teacher is the best type of training, as you learn from other practitioners and are pushed to always be at the top of your game.” To become an aesthetics trainer, says Dr Tristan Mehta, academies will want to see that you have undertaken as much training as possible, so you have something to offer their students. You can read a previouslypublished article on becoming an aesthetic trainer by Dr Paul Charlson and Dr Vikram Swaminthan for more guidance.5

The future of aesthetic training It is uncertain whether the new APPG report will help to drive muchneeded industry regulation, but it has certainly highlighted the need for excellent training and education for a safe specialty. Larkin concludes, “It’s my view that if practitioners continue to selftitle themselves as aesthetic practitioners without ever evidencing underpinning knowledge and skill competence through a regulated post-graduate qualification, they are continuing to mislead and confuse the public in their search for an appropriately-qualified aesthetic practitioner.” She adds, “I would like to see the Level 7 Diploma become a compulsory benchmark in order for someone to call themselves a practitioner.”

REFERENCES

1. All Party Parliamentary Group on Beauty, Aesthetics and Wellbeing, Inquiry into advanced aesthetic non-surgical cosmetic treatments, 2021 <https://baw-appg.com/> 2. Joint Council for Cosmetic Practitioners, Standards to Enter the JCCP Education and Training

Providers Register, 2018. <https://www.jccp.org.uk/ckfinder/userfiles/files/Education%20and%20

Training%20JCCP%20Standards%20for%20ET%20providers%20V14%20September%202018.pdf> 3. Kumar N, Rahman E, Effectiveness of Teaching Facial Anatomy Through Cadaver Dissection on Aesthetic Physicians Knowledge, [online] 2017 <https://www.ncbi.nlm.nih.gov/pmc/articles/

PMC5522661/> 4. Manchester University, MSc Skin Ageing and Aesthetic Medicine <https://www.manchester.ac.uk/ study/masters/courses/list/09805/msc-skin-ageing-and-aesthetic-medicine/ 2021> 5. Charlson P, Swaminathan V, Becoming an Aesthetic Trainer, Aesthetics Journal, 2020 <https:// aestheticsjournal.com/feature/becoming-an-aesthetic-trainer>