The NHS website (NHS, 2020) advises the public that when searching for a cosmetic surgeon only registered doctors can perform cosmetic surgery in England. The NHS also advises that patients should check if someone is a registered doctor or surgeon by searching for the doctor's name with the General Medical Council (GMC) online register (GMC, 2023). The advice goes on to say: ‘you can see if someone is qualified by checking they're registered with a suitable specialist association and trained in the right procedures.’
However, would a prospective patient searching for a surgeon know if the cosmetic surgeon she or he chooses is adequately trained and competent in septorhinoplasty or blepharoplasty procedures simply by searching that online medical register?
It is my view, and one shared by many others, that patients should be signposted towards the GMC specialist register, a register within the medical register. Many patients are not aware of this extra register of specialists and may also be unaware that there are ten surgical specialties to choose from.
As an example, if Mr X chooses a plastic surgeon for his rhinoplasty. He undertakes a GMC online check to see if surgeon A is on the specialist register for plastic surgery, and the surgeon is listed so Mr X appears to have made a wise choice, but has he?
Suppose for a moment that this particular plastic surgeon spends 90% of his clinical time performing breast augmentation and just 2% on rhinoplasty procedures per annum. Consider then, has Mr X been given enough information from the medical register to make an informed choice? I think you would agree with me that the answer to that is probably not.
The Royal College of Surgeons (RCS) has been grappling with the issue of cosmetic surgery provision within its membership since Keogh (2013) made a recommendation that patients must be able to recognise those surgeons who have the appropriate training, qualifications and experience in the area of cosmetic surgery in which they practise. The RCS, along with the three other surgical UK and Irish colleges, have now implemented the Cosmetic Surgery Certificate Scheme (RCS, 2023). The process of certification is open to all surgeons on the specialist registers who wish to obtain the qualification within their area of surgical practice by providing evidence of competence.
This is an important step forward in supporting patient choice, by promoting confidence in the quality of training and practice offered within cosmetic surgery by those surgeons who have the appropriate training and qualifications.
I welcome the Cosmetic Surgery Certificate Scheme; however, patients tell me that they have never heard of it and also that they did not know about the specialist register.
We must make these registers more visible to the public and we should encourage our surgical colleagues to join. I checked this register very recently and found just 130 named surgeons listed.
Nevertheless, as nurses asking for recommendations for surgeons, we must continue to point our prospective surgical patients to the GMC specialist register.