# COMAR Title 10 — Maryland Department of Health

## Subtitle 32 — Board of Physicians

### Chapter 09 — Delegation and Assignment of Performance of Cosmetic Medical Procedures and Use of Cosmetic Medical Devices

#### Regulation .07 Training of Non-Physicians.

*COMAR 10.32.09.07*

A. The physician is responsible for assuring that any individual to whom the physician delegates or assigns the performance of a cosmetic medical procedure or the operation of a cosmetic medical device is properly trained. Training shall include both theoretical instruction and clinical instruction.

B. Theoretical instruction shall include:

  (1) Cosmetic-dermatological indications and contraindications for treatment;

  (2) Identification of realistic and expected outcomes of each procedure;

  (3) Selection, maintenance, and utilization of equipment;

  (4) Appropriate technique for each procedure, including infection control and safety precautions;

  (5) Pharmacological intervention specific to the procedure;

  (6) Identification of complications and adverse reactions for each procedure;

  (7) Emergency procedures to be used in the event of:

    (a) Complications;

    (b) Adverse reactions;

    (c) Equipment malfunction; or

    (d) Any other interruption of a procedure; and

  (8) Appropriate documentation of the procedure in the patient's chart.

C. Clinical instruction shall include:

  (1) Observation of performance of the procedure or use of the device by an individual experienced in performing the procedure; and

  (2) Performing the procedure or using the device under the direct supervision of the delegating physician who is present and observing the procedure a sufficient number of times to assure that the non-physician is competent to perform the procedure without direct supervision.