End of the ‘Direct-to-Practice’ Era? Understanding Taiwan’s 2025 Medical Aesthetics Regulations

A consumer, lured by flashy advertisements, enters a beautifully decorated medical aesthetics clinic. They are greeted by a young doctor, fresh out of medical school. During the procedure, the doctor seems unfamiliar with the equipment, leading to an unexpected skin burn. Subsequent investigation reveals that this doctor, after graduating from medical university, entered the aesthetics industry without any foundational hospital training – a phenomenon known as a ‘direct-to-practice’ physician.

However, by the end of 2025, another consumer experiences a vastly different selection process. They are aware that under the new regulations soon to be implemented by the Ministry of Health and Welfare (MOHW), any doctor performing laser treatments or injections must have completed at least two years of PGY (Postgraduate Year) training. Their sense of security now stems not from advertisements, but from the ‘professional threshold’ established by law.

This regulatory shift from ‘market chaos’ to ‘national team-level’ oversight is the core of the 2025 Taiwan Medical Aesthetics New Regulations. Following several major fatal incidents in the industry, the MOHW is finally pushing forward with critical reforms by the end of this year. This article will delve into this ongoing regulatory revolution – it’s no longer about ‘new equipment,’ but about ‘new safety,’ a fundamental change aimed at ending the ‘direct-to-practice’ malpractice and rebuilding trust between doctors and patients.

Challenges in 2025 Medical Aesthetics Regulations: Why the ‘Old Model’ Failed to Assess ‘Physician Qualification’ Risks?

For a long time, a blurry gray area existed between ‘healthcare’ and ‘commerce’ in Taiwan’s medical aesthetics industry. Existing regulations struggled to keep pace with rapid commercialization, leaving consumers to bear undue risks due to information asymmetry.

The Overlooked ‘Direct-to-Practice’ Phenomenon: The Zero-Time-Lag Risk from Graduation to Procedure

‘Direct-to-practice’ (Chokubi) is a common phenomenon impacting the medical systems in Taiwan, Japan, and South Korea in recent years. It refers to medical graduates who, seeking high salaries and flexible hours, forgo formal specialist training, or even skip the foundational 2-year PGY training, to directly enter aesthetic clinics. The MOHW estimates that nearly 10% of physicians in Taiwan currently lack specialist training. These ‘direct-to-practice’ doctors lack solid clinical experience in managing complications and emergencies, which has been the primary cause behind numerous fatal medical aesthetics accidents in recent years.

The Paradox of the Old Model: The Gray Area Between Medical Practice and Commercial Advertising

Traditionally, non-therapeutic cosmetic procedures were not explicitly included under the scope of the Consumer Protection Act. This created a paradox: aesthetic clinics, essentially ‘medical institutions,’ often employed ‘commercial marketing’ tactics. Although the Medical Treatment Act explicitly prohibits exaggerated, false advertising, discount promotions (like buy-one-get-one-free), or the publication of before-and-after comparison photos, misleading and overly commercial advertisements remain rampant. Consumers, caught in the ambiguous space between ‘medical treatment’ and ‘consumer purchase,’ found their rights inadequately protected.

How the 2025 New Regulations Rewrite the Rules: The Roles of ‘Risk Stratification’ and ‘Mandatory PGY’

Facing the ‘direct-to-practice’ chaos and a continuous stream of accidents, the MOHW officially announced amendments to the ‘Regulations for the Administration of Specific Medical Technologies, Examinations, and Medical Devices’ (referred to as the ‘Regulations’) by the end of 2025. The core of this reform is to control physician qualifications ‘at the source’ and scientifically classify procedures by risk.

New Core Element (1): The ‘Safety Bottom Line’ for Physician Qualifications – Mandatory Two-Year PGY Training

This is the most critical step in the 2025 regulatory update: MOHW Minister Shi Chong-liang has declared the intention to amend the law to ‘eliminate the direct-to-practice phenomenon.’ The new system is expected to be announced and implemented by the end of this year (2025) or early next year (2026). In the future, doctors can no longer ‘engage in medical aesthetics immediately after graduation.’ The new regulations mandate that all physicians providing aesthetic services, regardless of the procedure, must complete 2 years of foundational PGY training. This ‘safety bottom line’ ensures doctors possess basic clinical response capabilities, safeguarding public safety.

New Core Element (2): Medical Aesthetics Risk Stratification – From ‘Unified Management’ to ‘Precise Control’

The second focus of the new regulations is the scientific ‘tiered management’ based on the risk level of aesthetic procedures. The era of ‘any doctor can do it’ is over; future requirements for performing physicians will vary based on risk.

• Low-Risk Procedures (e.g.): Injectables (like Botox, hyaluronic acid), laser and light-based treatments. Physicians must have completed PGY training.
• High-Risk Procedures (e.g.): Liposuction, extensive facelifts, breast augmentation, jaw contouring. Physicians must not only have PGY training but also possess more comprehensive specialist qualifications (e.g., related to general surgery).

This aims to ensure that high-risk, highly invasive surgeries are performed by specialist physicians with rigorous surgical training, preventing ‘expertise’ from falling into the hands of unqualified practitioners.

New Core Element (3): Upgraded Consumer Rights – Future Outlook for Inclusion under the Consumer Protection Act

In addition to the MOHW’s amendment of the ‘Regulations,’ the Legislative Yuan’s Research and Development and Evaluation Commission proposed a key recommendation in its August 2025 report: amending the law to explicitly include ‘non-therapeutic cosmetic procedures’ (such as lasers and injections) under the scope of the Consumer Protection Act. If this forward-looking recommendation is realized in the future, it will increase the legal liability of aesthetic clinics as ‘business operators,’ more effectively curbing misleading advertising and the chaos of an overly commercialized market.

Beyond Qualifications: 4 New Metrics for Measuring the ‘2025 Medical Aesthetics New Standard’

The wave of regulations in 2025 is not just an update of ‘qualifications’ but a comprehensive enhancement of ‘safety’ and ‘quality’ standards. We need a new dashboard to measure whether a clinic meets the standards of this new era.

Core Metric: 2025 Medical Aesthetics Safety Compliance Dashboard

The purpose of this dashboard is to transform abstract ‘regulations’ into ‘safety indicators’ that consumers can review.

Metric Dimension	Measurement Standard (KPI)	Old Model (Pre-2025 Amendment)	2025 New Standard (New Regulations)
Core Metric: Physician Qualification	Completion of PGY Training	Not mandatory (‘direct-to-practice’ physicians could practice)	Mandatory 2-Year PGY Training
Auxiliary Metric: Procedure Risk	High-Risk Surgery Qualification	Vague management; non-specialists could perform	Risk Stratification (High-risk requires specialist qualification)
Key Metric: Consumer Protection	Applicability of Consumer Protection Act	Gray area, not explicitly included	Recommended Inclusion (Increased operator liability)
Future Metric: Innovative Therapies	Cell Therapy Regulations	No legal framework	‘Regenerative Medicine Act’ Passed (Ensuring quality and safety)

Future Trend: Regulation of Regenerative Medicine

Notably, 2025 also marks the inaugural year for ‘regenerative medicine’ in Taiwan. The passage of the ‘Regenerative Medicine Act’ and the subsequent announcement of its supporting regulations (such as those for cell preservation and operational management) this year signify that ‘cell therapies’ (like autologous cell repair) used for aesthetic anti-aging will soon have a legal framework, ensuring their safety, quality, and transparency.

The Future of 2025 Medical Aesthetics Regulations: A Choice Between ‘Professionalism’ and ‘Safety’

The regulatory transformation in 2025 serves as a critical watershed moment for Taiwan’s medical aesthetics industry, moving from ‘wild growth’ towards ‘professional standardization.’ It conveys a clear message: medical aesthetics is primarily ‘medical care,’ and secondarily ‘beauty.’

We must make a choice: Will we continue to be swayed by flashy ‘commercial advertisements,’ placing ourselves at risk with ‘unclear qualifications’? Or will we learn to interpret the new regulations and proactively choose professional physicians who meet the ‘PGY training’ and ‘risk stratification’ standards, making the most responsible decision for our safety and beauty?

This end to the ‘direct-to-practice’ era is not just about physician self-discipline; it’s about the comprehensive awakening of consumer self-protection awareness.