The scene

A Foundation Year 1 doctor who was concerned about the financial implications of the proposed changes to the junior doctors' contract called the MDU medico-legal helpline to ask if he was allowed to undertake cosmetic work, specifically botulinum toxin and dermal fillers, in order to supplement his income. He explained that he planned to complete the appropriate training and would ensure he was appropriately indemnified.

MDU advice

The adviser explained that in general terms the GMC advises that doctors are required to recognise and work within the limits of their competence, keep up to date, and work to maintain and improve the quality of their work. If at any point the doctor wished to offer cosmetic treatments, it would therefore be advisable for him to complete appropriate training and take part in appraisal, audit and systems of quality assurance, for example. As the doctor had already identified, he would also need to be appropriately indemnified.

As Foundation Year 1 doctors hold provisional registration with a licence to practise, this limits the services they can provide. The doctor was directed to the GMC’s explanation of provisional registration.

This guidance makes it clear that F1 doctors are only allowed to practise in approved Foundation Year 1 posts. As such, the doctor's registration would not extend to the provision of private cosmetic work.

The doctor asked if he could undertake this work once he had progressed to his F2 training year. The adviser highlighted that even when the doctor holds full registration he would still be required to practise in an Approved Practice Setting (APS). This would require him to maintain a connection with a Designated Body. This restriction would not usually be lifted until the doctor’s first revalidation.

The GMC stipulates that doctors who are on a UK training programme and who wish to practise outside of their substantive employment must make their educational supervisor aware of such work. They would also need to comply with any reporting requirement set by their training body or Responsible Officer (RO). The adviser suggested that the educational supervisor may have some reservations about the doctor undertaking such work and this may prove problematic to his ability to undertake cosmetic work during his F2 placements.

The doctor and the adviser also discussed GMC guidance which specifically states that doctors are not allowed to prescribe cosmetic injectables without a physical examination of the patient and cannot therefore prescribe botulinum toxin or dermal fillers remotely by phone, email, video-link or fax.

Outcome

On balance the member decided to wait until he had completed his foundation years training before considering booking onto any relevant facial aesthetic courses.