Careers in Hair Restoration Surgery
This blog has been written for clinicians, if you are a patient looking to find a BAHRS member please click here.
From the moment one graduates from medical school, in the UK at least, there is a very prescriptive, well defined path ahead of us. The initial two-year foundation training programme offers some variety, but junior doctors are expected to progress rapidly on to the Certificate of Completion of Training programme, which then enables the individual to enter on to the specialist register, or the register of General Practitioners.
How should one then tackle the conundrum of wanting to change one’s vocation, perhaps mid-way through a CCT programme, or even after completing it, to pursue an entirely different career path?
Hair Restoration Surgery is not recognised in the UK as a formal independent branch of either medicine or surgery, and does not have a royal college, therefore nor does it have a formal set of exams and memberships to obtain before being recognised or endorsed as a consultant or even specialist trainee, which makes embarking on this path even more challenging.
The absence of the reassuringly detailed, well planned career trajectory can be unsettling. This article aims to offer some guidance to those interested in pursuing a career in hair restoration.
How do I know if this career is for me?
There are several personal and practical qualities which contribute to the success of the surgeon and are worth evaluating and personally reflecting upon before pursuing the career.
It is of course a pre-requisite that there is a grasp of the pathophysiology and mechanisms involved in hair loss, and an appreciation of the allied therapies for treating hair loss such as medication, laser therapy and platelet-rich plasma therapy. It is imperative that there is an awareness of the differential diagnoses of hair loss and when to seek the expert assistance of a dermatologist colleague. The Cosmetics Practice Standards Authority (CPSA) standards document (referred to later) separates the required knowledge into generic, cosmetic and more specifically hair transplant related knowledge.
One needs to be able to appreciate the aesthetics and artistry involved in creating a natural, age-appropriate hairline. A significant degree of sustained, methodical concentration is required during hair transplant procedures. The surgeries can be lengthy and a degree of resilience and patience is required both with oneself and the team of staff which will also be present. One needs to be happy that they are in complete control of their surgical environment without feeling the compulsion to micro-manage every step. In order to do this, there must be a level of perception on the part of the surgeon in identifying the strengths and weaknesses of their staff and where they are best placed in the flow of the theatre.
Where to begin?
The advice section of this website introduces the Joint Commission for Cosmetic Practitioners (JCCP) and the CPSA. Both of these bodies have worked together to establish Hair Transplant Surgery Standards. This is a comprehensive document encompassing the specific detailed knowledge and skills required, as well as guidance on Ethics, Law, Facilities and Safety. It is highly advisable anyone considering a career in this industry familiarises oneself with this document. There is also reference to the Hair Restoration Surgery part of the JCCP register and the requirements and qualifications necessary to join this.
The International Society of Hair Restoration Surgery (ISHRS) as the main recognised international hair society has a number of useful resources for those starting out- both academic and practical. The various educational offerings and courses provided by the ISHRS, including a ‘Basics’ course which is aimed at complete novices in the industry. It usually precedes the annual ISHRS meeting by a day or two. Along with various other courses and training the ISHRS offers documentation on the core competencies required and advise on the content of an essential core curriculum, which may provide a good starting point. As part of their main annual meeting there is also a newcomer’s reception where each member new to the industry is paired with a senior colleague in the hope of providing support and guidance for the newcomer. There is a listing on the ISHRS website of current educational offerings for members, as well as the opportunity to access the Forum which is a well-recognised publication in the Hair Restoration industry. Recent research, reviews of worldwide educational meetings and developments in equipment are all regular articles within the publication. There are a small number of international fellowship positions which can be applied for through the ISHRS.
The British Association of Hair Restoration Surgery (BAHRS) also offers bi-annual meetings for its members, which is an excellent opportunity for networking with colleagues and peers, and various resources are also listed on this website. There is also a code of conduct which each member signs and attests to, compliance with these standards improves both the quality of the surgery and the safety for patients.
Which qualifications will I need?
The background of doctors within HRS varies enormously, and is not just comprised of surgeons. The ISHRS states that the diversity of the background of its members both in terms of medical speciality and country of origin provides a ‘critical mass’ for innovations in hair restoration. It therefore recognises the contributions that people from a variety of medical and surgical backgrounds provide invaluable contributions not just to its society but also to the industry itself.
Practical training is perhaps the most challenging to acquire. Historically some private practices have been reticent to share and educate newcomers for fear of losing business, whilst others have welcomed visitors on a daily basis for many years, enabling a brief introduction to the procedure and processes involved. However, it is the more enduring daily training necessary to overcome the steep learning curve which may be harder to come by.
At BAHRS we would encourage organisers of training courses / informal fellowships to come forward. One of the key pillars of the ISHRS is collegiality and the BAHRS tries to emulate this also. Although the BAHRS cannot directly endorse individual courses / training programmes or their content, we would like to utilise this platform to share educational and training opportunities. Perhaps you are an established clinic looking to expand your medical staffing and advertising here could also be opportune. Equally there may be clinical space you are interested in sharing with a colleague.
Historically this speciality may appear closed to newcomers, certainly it can be difficult to navigate for new physicians interested in acquiring the practical skills. Through improved collegiality and education from our existing members, hopefully in the future this will change. The future of the profession lies within the integrity of its practising physicians and staff, and part of this responsibility is educating new members, promoting ethical practice and maintaining patient safety at the heart of all that we do.
Author: Dr Rachael Kay, BAHRS Secretary