Evaluating Cosmetic Surgeon Credentials

Cosmetic surgery is elective surgery. If you are considering cosmetic surgery, you should be aware that you can make certain decisions that can minimize the risks and possible complications of surgery.

The most important decision is your choice of surgeon. The vast majority of patients are anxious and uneasy about the process of choosing the right doctor. Many do not know where to start and what to look for. The choice becomes more complicated when they are faced with a myriad of doctors offering cosmetic surgery services. Aside from the legitimate plastic surgeons, one may encounter general surgeons, ENT doctors, ophthalmologists, obstetrician-gynecologists, dermatologists and general practitioners all offering expertise as “cosmetic surgeons”. It is not only in the Philippines that one finds this situation. One can encounter this in almost all countries where cosmetic surgery is being practiced.

In the Philippines, having a medical license allows a doctor to be able to practice a wide range of surgery, including cosmetic surgery, even if the doctor has not had extensive training in this particular field. I surmise that the reason why the law has not been updated or revised is to enable medical practitioners in underserved rural areas to be able to perform life-saving surgery in emergency cases. However in urban areas where one can avail of the expertise of board certified plastic surgeons, it still is the case that patients are not able to distinguish who are the doctors who have undergone legitimate training in cosmetic surgery.

Under current laws governing the practice of medicine/surgery, it is not illegal for any doctor to take a weekend seminar about cosmetic surgery, and then advertise himself as a cosmetic surgeon on the Monday after the seminar. So what constitutes legitimate training in cosmetic surgery?

Surgery training programs in the different hospitals and medical centers in the Philippines undergo an accreditation process by the Philippine College of Surgeons. Under the umbrella of the Philippine College of Surgeons are the different specialty boards that set the standards for the training programs of each specialty. For cosmetic surgery, the relevant board is the Philippine Board of Plastic Surgery.

There are 4 residency programs in Plastic & Reconstructive Surgery which are accredited by the Philippine Board of Plastic Surgery and the Philippine College of Surgeons. These are the training programs of the UP-PGH Medical Center, UST, and the 2 consortium programs approved by the Philippine Board of Plastic Surgery where residents rotate in various hospitals.

Thus the first thing a prospective patient should look for in the credentials of the doctor is whether or not the doctor has completed an accredited training program in plastic surgery. Depending on the institution, this program involves a minimum of 5 years of residency training which consists of 3 years of general surgery and 2 years of plastic and reconstructive surgery.

After a doctor completes an accredited plastic surgery residency training program, he is already equipped with the basic surgical skills and surgical judgment to competently perform both cosmetic surgery and reconstructive surgery, and to start clinical private practice.

Completion of the accredited plastic residency training program enables the doctor to become a “board-eligible” plastic surgeon, meaning that he is qualified to take the written and oral examinations of the Philippine Board of Plastic Surgery. The Philippine Board of Plastic Surgery (PBPS) is the only organization recognized by the Philippine College of Surgeons to grant board certification in the field of Plastic & Reconstructive Surgery in the Philippines. After the doctor passes both written and oral examinations, he becomes a “board-certified” plastic surgeon.

However, the situation has arisen in the Philippines whereby doctors who have not even undergone the accredited plastic surgery residency training process have been able to organize themselves into 2 cosmetic surgery groups, each with its own respective “board” and issuing “board-certification” in cosmetic surgery. Doctors belonging to these groups claim that they are “board-certified in cosmetic surgery” by the boards of their respective association or society. They have claimed cosmetic surgery as their turf and as their field of specialization, and in doing so have come to direct competition with the legitimate plastic surgeons.

If one examines closely the membership of these groups, one will find a motley group of doctors. On one hand, you will have general surgeons, ENT practitioners, and OB-Gynecologists, many of whom may be Fellows of the Philippine College of Surgeons in their respective fields. On the other hand however, one will also find many with limited or no surgical training at all, such as dermatologists and general practitioners.

I would like to emphasize that the issue being discussed is the issue of proper credentialing in cosmetic surgery. Underlying this “turf battle” between the different groups of doctors doing cosmetic surgery is the issue of surgical knowledge, surgical skill and surgical experience. Who can properly lay claim to the practice of cosmetic surgery? I believe that these questions can only be answered in the legal realm. As long as doctors in the Philippines are allowed by the law to practice a wide range of surgery, “turf battles” between the different cosmetic surgery societies will continue to exist.

Until the time comes that a new law will be passed that will regulate the practice of cosmetic surgery, patients should exercise discretion in choosing a cosmetic surgeon. Upon entering a cosmetic surgeon’s office, the first thing a patient should do is to inquire whether the surgeon has undergone the proper accredited residency training program in plastic surgery. This is the most basic requirement in looking for a properly credentialed cosmetic surgeon.

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