Are you considering training in aesthetics? This article serves as a guide to training in botulinum toxins and dermal fillers. You have roughly two options: a very short (1-2 day) course in botulinum toxins and fillers, or a level 7 postgraduate course in cosmetic medicine at a Higher Education institute. This article measures them both against five factors: duration, employment opportunities, hands-on experience, convenience, and cost.
Short courses in botulinum toxins and dermal fillers tend to last just one day. A second day, often called an ‘advanced’ course by the providers, can also be bought to supplement this introductory training. This suits practitioners who are interested in a ‘crash course’ where they can experience the basic techniques and get a feel for how it might be to practice in facial aesthetics.
However, HEE guidelines (Part One) explicitly state that “very short courses, eg 1-2 days in duration, will not meet the requirements for APL/RPL”. In other words, by 2018, these short courses will not be able to be recognised as formal training.
Level 7 Courses
In sharp contrast, Level 7 courses at universities tend to last a number of years. In general:
PGCert: One year
PGDip: Two years
MSc: Three years
Level 7 courses at universities also tend to follow the academic year (September to September) with strict application deadlines in May-June. These may therefore be appropriate most for recent medical graduates and junior doctors who wish to move straight on to aesthetics after their medical degree, and who are more accustomed to strict deadlines.
The level 7 courses in aesthetics training outside of universities are another emerging option. Provided they are regulated by Ofqual, they also meet the latest HEE requirements. Outside of universities, level 7 courses have a more flexible structure. For example, our level 7 course consists of 50-100 hours of e-learning, a series of short essay submissions, and 40 hours of clinical experience, all of which can be conducted in the student’s own time. There are also opportunities to sit the final Objective Structured Clinical Examination (OSCE) day throughout the year, meaning students can graduate at their convenience, and adapt the course to a full-time, part-time, or variable work schedule.
Employment opportunities for Aesthetic practitioners
Even if you are a skilled doctor or a skilled nurse, your employment opportunities will be limited if you have completed only one or two days of training. Short Botox training courses and dermal fillers training courses even at their best only allow you to practice on 2-3 ‘models’, who, unlike real patients in a clinic, have already been consulted for specific procedures. This means that you do not gain the breadth of clinical skills required to work full or part-time in a cosmetic clinic.
Level 7 courses
But will a postgraduate qualification really enhance your chances of aesthetics employment?
There are far fewer medical professionals with a full qualification in cosmetic injectables. A postgraduate qualification in aesthetic medicine, whether from a university or an accredited training academy, is one of the few ways to stand out from the thousands of medical professionals holding non-regulated certificates in Foundation or ‘Advanced’ Botox and Fillers training.
There are currently no regulations over who can perform cosmetic procedures. Hence the aesthetics industry is moderated only by insurance companies, who still accept certificates from short courses as evidence of training. Hence short courses and higher education courses both fulfil the present legal requirements (or lack thereof) for delivery of botulinum toxins and dermal fillers.
However, the first seeds of regulation of the aesthetics specialty were sewn in Health Education England’s Qualification Requirements for Delivery of Non-surgical Cosmetic Procedures (2015, 2016). These clearly state that ‘weekend courses’ will no longer be considered acceptable, with a grace period of three years (until 2018) for current practitioners to upgrade to a postgraduate course of injectables. 2016 GMC guidelines also state that doctors should follow these HEE guidelines for training.
When aesthetics does become regulated, employers will be looking for fully-qualified cosmetic practitioners in their clinics. The longer-term option for those wishing to have a career in aesthetics is therefore a Level 7 qualification that adheres to the latest HEE recommendations for cosmetic training.
Hands-on training in botulinum toxins and dermal fillers is essential for ensuring that you can deliver safe injections and excellent treatment outcomes with minimal bruising, swelling, or more serious complications.
Short courses often allow students to inject a patient, or ‘cosmetic model’, who has already been consulted and consented on their first day of training. This may appeal to those who are already well-versed in needle use, especially to the face.
However, detailed facial anatomy is not assumed clinical knowledge after your typical nursing or pharmacy degree, and is only lightly covered in most medical degrees. Hence the majority of junior doctors, midwives, nurses, and pharmacists may benefit from gradated practice, on synthetic mannequins, cadavers or realistic facial skin substitutes, allowing them to build up facial analysis and injecting skills before delivering botulinum toxins or dermal fillers into real patients.
The average short one-day course will have 1-4 hours of practical hands-on training. Patients are shared between delegates, which minimises hands-on time. This also fragments the training into single injection sites, rather than performing the entire treatment as a continuous whole. It is now recommended by the department of health, Health Education England, and the GMC, that new practitioners observe ten and deliver ten full supervised treatments in each botulinum toxins and dermal fillers prior to practising independently.
Level 7 courses
There are now five Higher-Education courses that train medical professionals in botulinum toxins and dermal fillers, and fortunately, all of these provide comprehensive hands-on training of roughly 40 hours (the minimum required by Health Education England).
Hands-on training time by provider and course:
Queen Mary, London (PGDip/MSc): Four clinical days within the two-year academic period.
University of Northumbia (PGCert): 40 hours of clinical practice.
University of Central Lancashire (UCLAN) (PGDip/MSc): 15 hands-on, “clinical skills sessions” over years one and two.
University of Manchester (MSc): Two compulsory face-to-face 6-day residential sessions during the first 24 months of programme, one in each of the two first years (ratio 1:5)
Harley Academy, London or Liverpool (L7Cert): 40 hours of end-to-end clinical treatments (1:1 for all supervised cases).
Full clinical training is important to allow you to practise botulinum toxin and dermal filler treatments from end-to-end. This means you can become proficient in all of the following stages in a treatment:
- The full cosmetic consultation
- Identifying indications
- Treatment planning
- Informed consent process
- Correct needle aspiration technique
- Injecting in multiple sites
- Injecting with multiple techniques
- Dosage adjustments for each product type and patient needs
- Aftercare instructions
- A wide variety of combined treatment types as requested by real patients in clinics.
As a result, even if you have already completed a weekend course it is important to seek additional hands-on training in a genuine clinical environment.
In terms of theoretical learning, short courses may provide some easy to read notes on the topics covered during the one or two days of training. The theoretical side is therefore convenient, if somewhat incomprehensive.
Face-to-face, hands-on learning is also relatively convenient as short courses often take place over just one or two days in major cities such as London. However, these training environments are often colleges or teaching rooms, rather than clinics.
Why does this matter?
As an example let’s consider the more severe potential complication of dermal fillers: irreversible blindness. Cosmetic training courses that allow untrained delegates to inject patients on their first day of training outside of a clinic, and therefore without emergency care facilities, are putting patients at risk. A non-clinical setting also trivialises these medical procedures and perpetuates the trend towards risky practice in non-clinical situations such as ‘Botox parties’ and home treatments.
Scotland has already started regulating cosmetic clinics, with the rest of the UK expected to follow suit. Thus, it makes more sense to train in the kind of professional environment that you should practice in.
Level 7 courses
Higher Education courses blend the convenience of distance learning with face-to-face learning:
Queen Mary, London (PGDip/MSc): virtual e-learning for module content and assignment submission, interactive forums, the four clinical practice days over 2 years with accompanying lectures.
University of Northumbia (PGCert): a blend of virtual e-learning and face-to-face.
University of Central Lancashire (UCLAN) (PGDip/MSc): 15 face-to-face clinical knowledge study days in the first two years, 9am-5pm, attendance mandatory, and 5 face-to-face study days in year one.
University of Manchester (MSc): virtual e- learning for module content and assignment submission, small group work, interactive forums, clinical debriefs, and mandatory ‘reflections’.
In terms of theoretical learning, Harley Academy provide all of this through distance learning on their custom e-learning system.
Harley Academy (L7Cert): One-day face-to-face foundation training, digital e-learning for all module content, short essays and and a two-hour exam.
The 40+ hours of hands-on training is also far more flexible insofar as students can choose how to coordinate it. Students can book 1:1 training days at the Harley Academy Clinics in London, Liverpool or Manchester. As such, the L7Cert suits both brand new practitioners as well as skilled aesthetic practitioners who wish to certificate their pre-existing experience.
How much does Cosmetic Training Cost?
It is not easy to find out which is the cheapest ‘Botox and fillers’ course. There are over 70 short courses in injectables, so we have limited this article to the next upcoming combined Botox and Dermal Fillers training courses listed on The Consulting Room and followed by the top 3 according to the (quality-indifferent) Google search. For clarity, all prices include VAT.
|Cost (inc. VAT)||Duration||Provider||Location|
|£1,020||One day||Cosmetic Courses||North East/London|
|£995||One day||Skin Viva||Manchester|
|£1,020||One day||Derma Medical||London|
|£900||One day||Harley Academy||London/Liverpool/Manchester|
Level 7 courses
We limited the Level 7 courses that we considered from each HE institution to those that meet minimum HEE guidelines. Prices include VAT, but may be subject to inflation.
MSc: £8,300 (£4,150 per annum)
PGDip: £5,500 (£2,750 per annum)
|PGCert: £6,000||1 year||University of Northumbria||Newcastle|
Year 1 – £10,150
Year 2 – £13,300
Year 3 – £6,960
|3 years (MSc)
2 years (PGDip)
Year 1 – £3,800
Year 2 – £2,800
Year 3 – £1,900
|3 years||University of Manchester||Manchester|
London, Liverpool or Manchester
International student fees are much higher, except for theL7Cert, which is the same price for both international and EU students.
The difference in duration and depth is significant between Higher Education courses and very short courses. Weekend courses might be the perfect introduction to cosmetic procedures, with so much more still to learn in order to meet upcoming regulatory standards it could well be a waste of money to invest only in very short or weekend training.
Harley Academy co-created the only Level 7 Certificate to be regulated by Ofqual, the government’s office of exams and qualifications, that meets all HEE Guidelines.
References and further reading:
- Health Education England Guidelines 2015: What You Need To Know
- Health Education England Guidelines 2016: A Brief Summary
- HEE Guidelines: An Overview
- GMC Rules for doctors delivering Cosmetic Procedures (2016)