Current through Register Vol. 42, No. 11, August 30, 2024
Physicians and delegates involved in the use of LLBDs must
complete a minimum number of procedure/device-specific training hours, a
minimum number of observed procedures, a minimum number of supervised
procedures, and a minimum number of cases under supervision as set forth
below.
(1) Ablative Laser Skin
Resurfacing:
(a) Prior to performing
procedures with any category of LLBD, physicians must complete eight (8) hours
of training in the device or device category, unless the physician received
training on the device in residency, in which case only four (4) hours of
training are required.
(b) Level 1
and 2 Delegates shall not perform these procedures.
(2) Non-Ablative Laser Photorejuvenation:
(a) Physicians must complete eight (8) hours
of training on each device unless he or she received training on the device in
residency, in which case only four (4) hours of training are
required.
(b) Level 1 Delegates
must complete twelve (12) hours of training on each device, which includes
observing the procedure performed by a trained physician and performing ten
(10) cases under the direct supervision of a trained physician. After twenty
(20) cases have been performed with a physician seeing a patient prior to the
procedure, a Level 1 Delegate may treat a patient without a physician seeing
the patient at the initial and each subsequent visit.
(c) A Level 2 Delegate must complete twenty
(20) hours of training on each device, which includes observing the procedure
performed by a trained physician or Level 1 Delegate, and performing fifteen
(15) cases under the direct supervision of a trained physician. After twenty
(20) cases have been performed with a physician seeing a patient prior to the
procedure, a Level 2 Delegate may treat a patient without a physician seeing
the patient at the initial and each subsequent visit.
(3) Intense Pulsed Light (IPL) and Broad Band
Light (BBL):
(a) Physicians must complete
eight (8) hours of training on each device, unless he or she received training
in residency, in which case only four (4) hours of training are
required.
(b) Level 1 Delegates
must complete twelve (12) hours of training on each device, which includes
observing the procedure performed by a trained physician and performing ten
(10) cases under the direct supervision of a trained physician. After
performing twenty-five (25) supervised cases, a Level 1 Delegate may treat
patients for subsequent patient visits without direct supervision by the
physician after the physician sees the patient in consult. After performing
fifty (50) cases, a Level 1 Delegate may treat patients without direct
supervision by the physician for the initial consult and patient
consent.
(c) Level 2 Delegates must
complete twenty (20) hours of training on each device, which includes observing
the procedure performed by a trained physician and performing fifteen (15)
cases under the direct supervision of a trained physician. After performing
twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for
subsequent patient visits without direct supervision by the physician after the
initial patient consult and consent, provided that the physician shall review
the device settings for cases 26 through 50 prior to treatment. After
performing fifty (50) cases, a Level 2 Delegate may treat patients for the
initial treatment visit and subsequent visits without direct supervision by the
physician after the physician has seen the patient in consult and
consent.
(4)
Photoepilation/Laser Hair Removal, Vascular Conditions and Lesions, and
Pigmentary Conditions:
(a) Physicians must
complete eight (8) hours of training on each device, unless he or she received
training in residency, in which case only four (4) hours of training are
required.
(b) Level 1 Delegates
must complete twelve (12) hours of training on each device, which includes
observing the procedure performed by a trained physician and performing ten
(10) cases under the direct supervision of a trained physician. After
performing twenty-five (25) supervised cases, a Level 1 Delegate may treat
patients for subsequent patient visits without direct supervision by the
physician after the physician sees the patient in consult. After performing
fifty (50) cases, a Level 1 Delegate may treat patients without direct
supervision by the physician for the initial consult and patient
consent.
(c) Level 2 Delegates must
complete twenty (20) hours of training on each device, which includes observing
the procedure performed by a trained physician and performing fifteen (15)
cases under the direct supervision of a trained physician. After performing
twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for
subsequent patient visits without direct supervision by the physician after the
initial patient consult and consent, provided that the physician shall review
the device settings for cases 26 through 50 prior to treatment. After
performing fifty (50) cases, a Level 2 Delegate may treat patients for the
initial treatment visit and subsequent visits without direct supervision by the
physician after the physician has seen the patient in consult and
consent.
(d) A solitary pigmented
lesion shall be evaluated by a physician prior to any treatment with an LLBD
device.
(5) Tattoo
Removal.
(a) Physicians must complete eight
(8) hours of training on each device, unless he or she received training in
residency, in which case only four (4) hours of training are
required.
(b) Level 1 Delegates
must complete twelve (12) hours of training on each device, which includes
observing the procedure performed by a trained physician and performing ten
(10) cases under the direct supervision of a trained physician. After
performing twenty-five (25) supervised cases, a Level 1 Delegate may treat
patients for subsequent patient visits without direct supervision by the
physician after the physician sees the patient in consult. After performing
fifty (50) cases, a Level 1 Delegate may treat patients without direct
supervision by the physician for the initial consult and patient
consent.
(c) Level 2 Delegates must
complete twenty (20) hours of training on each device, which includes observing
the procedure performed by a trained physician and performing fifteen (15)
cases under the direct supervision of a trained physician. After performing
twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for
subsequent patient visits without direct supervision by the physician after the
initial patient consult and consent, provided that the physician shall review
the device settings for cases 26 through 50 prior to treatment. After
performing fifty (50) cases, a Level 2 Delegate may treat patients for the
initial treatment visit and subsequent visits without direct supervision by the
physician after the physician has seen the patient in consult and
consent.
(6) Non-Laser
Skin Rejuvenation:
(a) Physicians and Level 1
and 2 Delegates must complete official certifying training by the device
manufacturer or be trained by a physician certified by the manufacturer to use
the device.
(b) Level 1 and 2
Delegates must complete eight (8) hours of training on each device, which
includes observation of five (5) area-specific treatments by a trained
physician and performing ten (10) treatments under the direct supervision of a
trained physician. After completing ten (10) treatments under direct
supervision, a Level 1 or 2 Delegate may complete ten (10) additional
treatments without direction supervision by the physician, provided that the
physician reviews the treatment plan and device settings prior to the
treatment. After performing twenty-five (25) supervised cases, a Level 1 or 2
Delegate may consult, consent, and treat patients without direct supervision by
the physician. Thereafter, treatments may be performed under locally remote
supervision.
(7)
Endovascular Radiofrequency and Laser Ablation (EVLA):
(a) Physicians must complete eight (8) hours
of training on each device within a residency or fellowship program.
(b) Level 2 and 3 Delegates shall not perform
these procedures.
(8)
Laser-Assisted Liposuction (LAL) and Power-Assisted Liposuction:
(a) Physicians must complete eight (8) hours
of training on each device within a residency or fellowship program.
(b) Level 2 and 3 Delegates shall not perform
these procedures.
(9)
Laser-Assisted Surgery
(a) Physicians must
complete sixteen (16) hours of training on each device within a residency or
fellowship program.
(b) Level 1 and
2 Delegates shall not perform these procedures.
Previous Rule .08 was renumbered .07 per certification
published May 31, 2023; effective July 15,
2023.
Author: Alabama Board of Medical
Examiners
Statutory Authority:
Code of Ala.
1975, §§
34-24-50,
34-24-51,
34-24-53.