<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.32.09.07" title_num="10" subtitle_num="32" chapter_num="09" heading="Training of Non-Physicians.">
  <paragraph num="A.">
    <text>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.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Theoretical instruction shall include:</text>
    <paragraph num="(1)">
      <text>Cosmetic-dermatological indications and contraindications for treatment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Identification of realistic and expected outcomes of each procedure;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Selection, maintenance, and utilization of equipment;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Appropriate technique for each procedure, including infection control and safety precautions;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Pharmacological intervention specific to the procedure;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Identification of complications and adverse reactions for each procedure;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Emergency procedures to be used in the event of:</text>
      <paragraph num="(a)">
        <text>Complications;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Adverse reactions;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Equipment malfunction; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Any other interruption of a procedure; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Appropriate documentation of the procedure in the patient's chart.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Clinical instruction shall include:</text>
    <paragraph num="(1)">
      <text>Observation of performance of the procedure or use of the device by an individual experienced in performing the procedure; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
  </paragraph>
</regulation>