Empire Medical Training is one of the oldest but also the most controversial training organizations in aesthetic training. Dating back to 1998, even before the internet was popular, Empire would send glossy multi-page booklets advertising training courses in aesthetics, wellness, and osteopathic techniques.
Empire was the first to offer memberships allowing candidates to take as many live courses as they wish over a period of time. However, for over 20 years they have been criticized for making it difficult to attend many of these courses because only a few would be offered in a given location requiring a lot of travel. In addition, Empire has been criticized for cancelling courses without notice in the past. Before reading the latest multi-point reviews, one should first read the submissions at Rip-Off Report. Granted many of these are from over 10 years ago, the ownership and management of Empire has not changed during that time. Empire is owned by Stephen Cosentino, DO who is the subject of a number of these reports. As of January 2025, Empire is still owned by Cosentino. These negative reviews abruptly ended in 2014 and even disappeared from the site for a period of time, meaning it was likely that Empire paid the website owner a “reputation management” fee to have the reviews suppressed. However, that appears to have ended and the reviews are live again.
Again, look at their BBB Reviews (a huge volume of complaints and poor communication over just a 2 year period) and look past their paid for “A+ rating” and see the customers comments. This organization has always been one to collect big up front payments in exchange for a promise, and too often that promise is not kept.
They have always offered “training” in a number of fringe applications and niche topics (like exosomes) that really do not require a standalone training program. Others like ultrasound guided injections and butt lifts go way beyond the skill sets that can be safely learned in single day CME.
Also, it cannot be stressed enough that the fake board certification organization AAOPM is wholly Empire Medical Training. It is not an independent board of any kind, nor does it have an jurisdiction or authority in any aspect of healthcare.
Multi-Point Review of Empire Medical Botox Training
Each Category shall receive a weighted score depending on how well the training meets the standard.
Total Score: 19 out of 50 Points.
1. CME Accreditation for MD, DO, NP, PA, RN’s (Score 8 out of 10)
The word “certification” is used prominently by this training program, yet it has no formal legal meaning. It just means receipt of a piece of paper. The standard for post-graduate education is CME or CEU-accredited training that is peer reviewed and backed by an organization called a “joint sponsor” who is authorized to award AMA Category 1 Credits which are the only credits accepted for physicians, NP’s, PA’s and nurses.
Empire appears to use a joint sponsor called AKH who is authorized to award AMA Category 1 level certification for physicians, nurses and PA’s. Not all Empire Courses carry the CME designation, but the most common and popular introductory courses appear to have this CME accreditation. Empire loses 3 points due to a lack of accreditation for their online offerings or for all of their training courses. For example, a basic course like lip fillers should be CME-accredited, but at Empire, it is not.
2. Faculty Qualifications and Transparency (Score 4 out of 10)
Empire has always prided itself in using an all MD and DO faculty. However Empire has a long history of listing people in their faculty bio’s who do not actively teach the training courses month in and month out. Some of these are listed as “Knowledge Leaders” and “Celebrity” physicians which can be misleading for someone interested in signing up for a course in their local area.
It is impossible to know who is teaching any one given Empire Medical Training course offering as they never list the faculty for a given date and location. Therefore you will not know the qualifications of your instructor. Empire has a history dating back 20 years of including faculty who no longer actively teach classes on their faculty list, and exclude some who do. In the past, one exclusion from this list was a person named Bill Horninger who had no medical training at all. He is also addressed in the Rip-Off Report comments and in a lawsuit filed in 2013 regarding him actually injecting filler into a physician at a training class in California. It appears that suit was settled out of court in 2014.
If you plan on registering for an Empire Medical Training class, please contact them first and ask for the name and degree of the instructor.
3. Completeness of the First Level Course. (Score 3 out of 10)
It is difficult enough to calculate the cost of training when factoring in your time commitment and travel. However, when training is incomplete, or you have to purchase the product for hands-on (See Point 4 below), that makes it even harder.
The standard here is to teach everything that is FDA-cleared and off-label indications that work in the level 1 course. Empire’s course outlines for their basic Botox and Fillers courses are low on specifics, so it is very difficult to assess exactly what will be taught in the basic vs the advanced course. Moreover, taking both courses requires additional time off and often travel to a different city where the advanced course will be offered. Looking at the limited information taught in Level 1, and the important basic information reserved for Level 2, it is apparent that their business model is to sell high-priced memberships and force people to take multiple courses (but at a “discount”) instead of being a one stop destination for great comprehensive training on the first contact date. For more information please check out this video.
4. Transparency Regarding Hands-On Product Provided in Tuition Cost. (Score 0 out of 5) DEALBREAKER
Empire’s basic and advanced courses do not guarantee any level of hands-on product to be provided or even that an attendee will be able to do hands-on at all. Buried at the bottom of their course agendas are statements like… “live demonstrations on patients”. A “demonstration” is not hands-on practice required for complete certification that most medical malpractice insurers require. Their basic Botox course, which only meets for 4 hours, also does not guarantee any amount of hands-on practice with real product. They state “some courses will feature anatomical models or live models to enhance the learning experience.” What? The basically say that their Botox Training course might let you practice on a mannequin or maybe not? They also state that the final agenda will be emailed 3 days in advance. This appears to mean that if they make enough money on the class, they might provide more, but don’t count on it.
The industry standard is to provide a certain amount of toxin and filler for hands-on use UP FRONT and include it in the tuition price.
5. Maximum Hands-On Class Size (0 out of 5)
Looking here it appears that the class can be as large as they want it to be with a single faculty instructor. Everywhere are photos of rooms with 10 or more providers in a class, some photos have 20-30. This is too large for a 1-day training.
The standard for a training course should be a cap of around 5-6 providers per instructor for the best hands-on treatment experience. If an organization has more demand, they should open more dates, not cram in additional attendees and dilute your experience for the same tuition cost.
6. Location Transparency (Score 2 out of 3)
Locations are generally hotels, but the locations are listed. This can be an issue since many Empire courses (like butt augmentation) teach sterile procedures which cannot be performed outside of the office setting.
7. No Fake Boards, Fake Society, or Membership Upsells (Score 0 out of 5)
Empire was the first to offer memberships and the first to offer a sham “board certification” organization called AAOPM to scam it’s attendees into overspending out of fear of not knowing enough or being “compliant” with their training. First, a “membership” has zero value. Training does not need to be renewed. Period. Training is not licensure.
Furthermore, there is no Board or true Academy here. That would be made up of diverse individuals who are paid by Empire, but have no interest in Empire, and have trained elsewhere guiding Empire’s leadership with their talents. That is simply not the case. Everything at Empire goes through Cosentino.
Moreover, memberships, renewals and such are not required for any kind of training status over the long-term. Training is training. Aesthetics is not a medical specialty. Empire is not an authority for an industry.
Empire tries to distance itself from fake board certification by referring to AAOPM, but AAOPM was created by Cosentino in the late 2000’s as a sham organization to take up more space in organic search rankings and refer more people to Empire’s memberships. Please watch this for more information on the incestuous relationship between Empire and AAOPM.
8. Offers a Blended Online plus Live Learning Environment (Score 1 out of 5)
Empire offers a “livestream” membership but it is not clear how often each livestream course is actually given and there is no independent CME accreditation for these livestreams.
In addition, Some of Empire’s courses mention reviewing of material through a “portal” prior to attending the live date, but again these courses are not accredited. Only the few hours of live contact time in a limited number of basic courses is CME accredited.
There is no evidence that these online learning modules have any standalone accreditation because when you try to click on one, it takes you to the general course page which only has a live agenda listed. If there was more online course detail or if these on-demand materials are independently CME-accredited, more points would be awarded.
9. No Risk of Paid Models at the Live Training (Score: 1 of 2)
Empire appears to be especially weak for hands-on experience. They do not guarantee any level of hands-on practice for any attendee. However they also state in some course agendas that volunteers may be present for either demonstrations or for actual hands-on. It is unclear if these volunteers are other attendees or patients from the community. However, since they do not publicly recruit patients to pay for treatments like others, they get one point.
10. General Truthfulness and Accessibility (Score: 0 of 5)
Empire lists logos of a number of medical schools which are called “academic venues” with absolutely no explanation of the relationship and none of these universities has ever hosted an Empire course nor do they approve or sanction anything Empire teaches. Empire has simply paid these institutions for access to cadavers for their own for-profit training course. Anyone doing a cadaver course must pay an academic facility to host it. This misleading connection to any accredited academic institution is a scam.
When you enter into a teaching relationship, it should be collegial and not adversarial. Read on past the “WOW Guarantee” which based on our research, Empire has never paid out one single time. The tone and language of the terms and conditions can give you a good idea. In fact, Empire has lost so many chargebacks that they now only allow payment by “echeck” or charge additional for the use of a credit card.
The website is littered with many visuals like ⭐⭐⭐⭐⭐ and unsubstantiated statements like “98% would take this course again”. A few of the testimonial videos look forced. The incredible history of unhappy clients still litters the internet, especially with cancelled courses and failing to deliver on promises after taking the big up-front tuition.
If you spend any money on training up-front, you should get something of value immediately in return, like a CME-accredited online content.
Finally, even their own terms and conditions ends with the statement “I understand that the accuracy and completeness of this data cannot be guaranteed.” Translation: Do not believe anything you have just read on our website.
This organization may have a niche course in the right place at the right time for a certain provider, but trusting your career change to this system has proven to be a poor choice for many providers.
Final Score: 19 out of a possible 50
Final Recommendation… If you see a course that nobody else teaches, then consider Empire for that course only, but be very careful of memberships or getting the quality, small-group training that you will need as a foundation to launch your career. Otherwise, you have better options.
