Aesthetic technologies and treatments continue to evolve at a rapid pace. Given the variety of treatments now available and the continued introduction of new products and techniques, “it is imperative that aesthetic practitioners and mid-level providers seek ongoing medical education in order to achieve the best patient outcomes,” says Vic A. Narurkar, MD, director of the Bay Area Laser Institute in San Francisco.
There is a wide assortment of training options available to medical aesthetic providers, including scientific meetings, fellowships, company-sponsored CME and procedure-specific training. On the following pages, we offer an overview of the various options available as well as advice on how to choose the best training programs for you and your staff.
There are a number of national and regional scientific meetings hosted by professional associations. For dermatologists, Girish “Gilly” Munavalli, MD, medical director of Dermatology, Laser and Vein Specialists of the Carolinas in Charlotte, North Carolina, recommends the annual meeting of the American Academy of Dermatology (AAD) and the annual meeting of the American Society for Dermatologic Surgery (ASDS). Both offer hands-on and scientifically based demonstrations. “The ASDS emphasizes relevant anatomy and an interconnection with the latest procedures,” he says. “The demonstrations are very helpful.”
Kenneth Beer, MD, director of Beer General, Surgical and Esthetic Dermatology in West Palm Beach, Florida, regularly attends specialty-specific scientific meetings as
they typically present “best in class” techniques from leading physicians. “Follow this up with a visit to a physician’s office to get the nuances of any procedure,” he says. “Everything looks easy in a Powerpoint presentation, even though that’s not always the case.”
In addition to attending large, national scientific meetings, Dr. Narurkar is a proponent of boutique meetings, which complement the larger meetings. He and Dr. Beer, along with Mary Lupo, MD, a dermatologist in New Orleans, founded the Cosmetic Bootcamp for core specialty physicians. Now in its 11th year, its goal is to educate physicians in science and evidence-based technologies through live injectable and laser treatment demonstrations. The benefit of smaller sessions, according to Dr. Narurkar, is that attendees can interact with faculty, which is more difficult in a meeting with thousands of attendees.
Over the years, the Cosmetic Bootcamp has evolved to offer different levels of meetings for physicians, residents and fellows, and it is offered in multiple cities. “Oftentimes these medical professionals can’t leave their training programs, so we make them convenient,” says Dr. Narurkar.
Most recently, the group has added a practice management meeting (called the Cosmetic Bootcamp Practice Management and Extender Meeting) for physician extenders so
they, too, can learn more about optimal treatment options and scope of practice. “We saw a void in educational offerings at larger meetings, which have become more like trade shows,” says Dr. Narurkar. “Here, attendees can participate in sessions at an intimate level and have the opportunity to ask questions.”
“Physicians do not need to attend every dinner or seminar that is offered in their region, rather they should go to seminars conducted by respected peers in their given field of interest,” says Lisa A. Zdinak, MD, chief surgeon and medical director of Precision Aesthetics in New York. She stays on the forefront of her specialty by attending at least one domestic and one international meeting every year. “This way, I know what is available now domestically and what is on the horizon globally.”
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Fellowships and Preceptorships
Procedural fellowships for core specialty doctors typically last one to two years and provide in-depth training on the most common aesthetic procedures. The most surefire way to obtain a fellowship is to apply for one that is offered formally through an individual discipline. This is an extremely competitive process, primarily for younger physicians proceeding directly from their residency training. It requires formal application, interviews and acceptance by the university. “While this is the only guarantee that you will be taught what you want to know, it can take anywhere from two to three years to complete and the salary is that of a resident with call duties and all that comes with it,” Dr. Zdinak explains.
The American Society of Ophthalmic Plastic and Reconstructive Surgeons, American Society of Plastic Surgeons, ASDS and AAD all offer such fellowships. “A fellowship provides the best overall training, but it requires at least a year of your life at a location that may be far from home,” says Dr. Beer. “For practicing physicians, this is not an option.”
For physicians in practice, there are preceptorship training opportunities that last from one week to one month. The American Society for Laser Medicine & Surgery (ASLMS)
is currently working on structured preceptorships for on-site observation. “This was initiated by the Society’s last president, Jeffrey Dover, MD, and will continue to build momentum,” says Dr. Munavalli.
Another resource is the Women’s Dermatologic Society (WDS), which has offered two-week preceptorships for more than a decade. Through this program, senior dermatology residents and practicing dermatologists can visit and work alongside experienced providers.
If you are unable to take part in a formal fellowship or preceptorship, volunteering to work without pay for a physician in the field offers a less formal but equally valuable educational experience. “Contact physicians in your field of interest and ask if they are willing to take on an unpaid fellow,” Dr. Zdinak advises.
You can also ask sales representatives if their companies offer training programs or if they know a physician who might open his or her doors to you for educational purposes. “Be prepared to travel a few hundred miles to find a physician who is willing to train you in what you want to know,” says Dr. Zdinak, who has trained in five different cities and abroad with hundreds of different physicians to obtain her knowledge base.
Dr. Narurkar recommends asking professional associations such as the AAD, ASDS and WDS for recommendations when seeking a mentor or preceptorship. He notes that smaller meetings also provide an opportunity to find mentors. Attendees of the Cosmetic Bootcamp, for instance, often develop relationships with faculty that, in many instances, evolve into further visits and training.
Scientific meetings, combined with office preceptorships, offer the most valuable training options outside of a formal fellowship, says Dr. Beer.
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Providers who are interested in offering new treatments can obtain reputable, hands-on training through manufacturers. Dr. Narurkar is a faculty member in the Allergan Masters of Injection program and the Galderma Aesthetic Injector Network. These programs train providers in newly launched fillers, such as Voluma XC and Restylane Silk. Training involves patient assessment, anatomy and hands-on injection techniques. These smaller company-sponsored sessions are a great way to learn the nuances of newly launched products.
Many aesthetic companies work with third-party training programs to offer CME-accredited training. “The presented material is offered in an ‘on-label’ fashion with an emphasis on proper techniques,” says Dr. Munavalli. This means that the techniques and training are in line with the FDA-approved indications for the particular product being discussed in the CME session.
Merz Aesthetics is another example of an international pharmaceutical company that offers opportunities for CME training through regional lectures and hands-on demonstrations.
Dr. Beer has found that corporate-sponsored meetings can provide an excellent learning opportunity because they offer hands-on experience, in addition to data from clinical trials to support uses and indications for new products.
Training Options for Mid-Level Providers
Nurse practitioners (NPs), physician assistants (PAs) and other mid-level providers also have a growing variety of training options from which to choose. Dr. Beer advises mid-level staff to affiliate with a leader in the field. “This can be for a period of weeks, months or longer, and provides a context for the procedures learned,” he says. In addition, “There are many excellent meetings that provide the education needed to understand and perform procedures, such as the Cosmetic Bootcamp and injection training at the ASDS annual meeting.”
Dermatologist David A. Goldberg, MD, and Krystie P. Lennox, PA-C, founded the Aesthetic Extender Symposium. Now in its eighth year, the symposium offers educational sessions with live-demonstration laser and injectable workshops geared toward mid-level providers.
The growth of cosmetic medicine has led to the creation of many independent training programs. Key to finding the right program for you and your staff is investigating these opportunities before enrolling. “These institutes typically have established training centers with an affiliation to a medical doctor or group experienced in these procedures,” says Dr. Munavalli. He recommends researching the background of the trainers and faculty speakers, and asking for references before sending a provider for training.
You also want to look at the content of the program: Is it primarily lecture or are there opportunities for hands-on training as well? Dr. Narurkar favors human cadaver dissection courses that highlight facial anatomy and show how to inject a product, and assess the facial compartments involved in aging. He is also a fan of web-based training, as webinars can be archived and reviewed to reiterate teachings.
“Education is never just about being familiar with a product or technique,” he says. “It’s about understanding anatomy, assessment and utilizing multiple venues such as textbooks, web-based programs, academy programs and industry-sponsored events.”
Karen Appold is a medical writer based in Pennsylvania.
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