RSMD equips physicians, nurses and other clinicians to enter or expand in the growing field of medical aesthetics.
Courtesy of Rebecca Small, MD at RSMD
Within the everyday ebbs and flows of a medspa in Capitola, California, Rebecca Small, MD provides hands-on education for medical professionals nationwide. At RSMD, the medical aesthetics studio she founded, healthcare professionals learn injectable protocol, including facial anatomy and artistry. An initiative that started over 15 years ago as small group sessions has expanded into an education initiative with courses, textbooks, videos, conferences and preceptorships.
When Small entered aesthetics, after studying at University of Cambridge and Harvard Medical School, she recounts noticing a gap between textbook knowledge and the skill involved in practice—expertise accomplished by real world examples. She set out to bridge this gap with her medspa, where students can face the trial and error that comes with the artistry and scientific skill of aesthetics in an existing environment, rather than a simulated one.
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Within the everyday ebbs and flows of a medspa in Capitola, California, Rebecca Small, MD provides hands-on education for medical professionals nationwide. At RSMD, the medical aesthetics studio she founded, healthcare professionals learn injectable protocol, including facial anatomy and artistry. An initiative that started over 15 years ago as small group sessions has expanded into an education initiative with courses, textbooks, videos, conferences and preceptorships.
When Small entered aesthetics, after studying at University of Cambridge and Harvard Medical School, she recounts noticing a gap between textbook knowledge and the skill involved in practice—expertise accomplished by real world examples. She set out to bridge this gap with her medspa, where students can face the trial and error that comes with the artistry and scientific skill of aesthetics in an existing environment, rather than a simulated one.
Creating Pathways for Healthcare Professionals Pivoting to Aesthetics
Keeping in mind that the American Board of Medical Specialties does not offer licensure or board certification in aesthetic medicine [1], only dermatology and plastic surgery, Small sought to create an environment where aspiring injectors could refine their technique under expert guidance. In 2022, about 69% of medical directors working in aesthetics came from "non-core" specialties [2]. The reason healthcare practitioners may be increasingly turning to aesthetics, AmSpa speculates, is due to burnout or a desire for a more flexible schedule.
Having trained physicians, nurse practitioners, physician assistants and registered nurses who wish to build or expand their careers in aesthetic medicine, Small’s curriculum includes hands-on training, case-based learning and ongoing mentorship opportunities to support growth for clinicians looking to expand their skills or pivot to a new specialty.
“Many providers were learning piecemeal, through short workshops that lacked precepted hands-on experience, or by trial and error on the job without adequate foundational knowledge or a comprehensive, safety-driven framework,” Small says. “I set out to bridge this gap by combining a rigorous academic foundation, through the textbooks I authored, my courses and case-based learning with hands-on training in my clinic.”
RSMD students progress from safety and anatomy (deconstruct), to functional muscle relationships (reconstruct) and finally to artistry and natural results (contour & lift).Courtesy of Rebecca Small, MD at RSMDA Three-Stage Framework That Guides Practitioners From Safety to Artistry
Zooming into the curriculum for new and evolving practitioners at RSMD, Small says procedures are broken down into three structured frameworks: deconstruct, reconstruct, contour & lift. This enables students to understand anatomy, safety zones and injection technique before layering in artistry and individualized patient goals.
Currently, to administer any injection, healthcare professionals must hold a valid certification for that specific procedure, in addition to their baseline medical degree and specialty. A practitioner can only give Botox or dermal filler injections if they possess a certification, which requires completing the appropriate training courses. These courses cover the fundamentals of botulinum toxins, proper injection techniques and how to manage possible side effects [3]. At RSMD, physicians can receive this training and supervision to obtain a Certificate of Completion and move on to perform these aesthetic treatments on their own.
“Most clinicians complete an initial hands-on toxin and filler training in a one-day course, after which they can continue skill development through advanced courses and ongoing mentorship. While RSMD’s certificate is not a state or board 'license,' it provides recognized, evidence-based training that prepares licensed professionals to safely and confidently perform injections in clinical practice,” Small says.
The deconstruct framework at RSMD specifically targets individual muscles with botulinum toxin—analyzing and visually deconstructing facial movements into component muscles to learn injectable protocol, Small describes. Reconstruct, however, moves on to treat multiple muscles, understanding functional relationships between muscles and how they work in opposition or synergy.
Contour & Lift combines treatments and layers procedures, such as the RSMD Liquid Lift, which combines botulinum toxin with dermal fillers. Within this framework, providers learn techniques for placing fillers safely in different face regions to achieve subtle, natural-looking results, she adds.
“This framework demonstrates a structured pathway for mastering injectables, starting with safety and precision, advancing to muscle relationships and culminating in artistry, balance and natural outcomes."
A Family Medicine Resident at Stanford School of Medicine, who trained at RSMD, said Small helped them to feel more prepared to inject the facial anatomy, adding that they can draw it on themselves, draw it on a friend and feel like they could identify those points for an injection.
Meeting the Growing Demand for Education as More Clinicians Enter Aesthetics
One of the major challenges in creating this training over the last 10 years, Small says, has been meeting the rising demand for education as more physicians, nurses and physician assistants are entering aesthetics from other specialties. Another challenge is helping providers navigate the number of available products, as skincare is an important component to aesthetics, but estheticians and dermatologists typically harness this knowledge. RSMD teaches the science and evidence behind certain ingredients to support informed choices.
Looking forward, given how rapid the aesthetics industry is growing and the amount of professionals looking to pivot to this industry, Small has plans to expand digital education platforms, develop international collaborations and advance training in the latest injectable and device-based techniques so that all healthcare professionals can access education at any stage of their career, from introductory courses to advanced techniques and ongoing mentorship.
“More broadly, I believe the future of provider-led training will focus on raising standards across the field, ensuring consistency and accountability in how aesthetic medicine is taught. By setting a higher bar for education, we can ensure that whether a patient is treated by a physician or nurse, they receive safe, evidence-based care with results that are natural, balanced and aligned with their goals,” Small says.
