1. Membership and Professional Standards Committee
Subspecialty Board Certification for Primary Liver Transplant Physicians
Membership and Professional Standards Committee

2. What problem will the proposal solve?
Bylaws require that a primary liver physician must have “current board certification in gastroenterology”
Increasingly common that liver transplant physicians let their gastro boards lapse while maintaining a transplant hepatology subspecialty board certification
Primary liver transplant physician applicants who are otherwise qualified are not approved by MPSC because they no longer have current board certification in gastroenterology
Primary liver transplant physician Bylaws require that these individuals must have “current board certification in gastroenterology.” It has become increasingly common for liver transplant physicians to let their gastroenterology boards lapse while maintaining a transplant hepatology subspecialty board certification. OPTN Bylaws have not been updated to reflect this shift in what board certification is commonly maintained by transplant liver physicians. As such, the MPSC has had to reject otherwise-qualified primary liver transplant physician applicants solely because they no longer possess current gastroenterology board certification.

3. What are the proposed solutions?
Delete current gastroenterology board certification requirement
Replace with requirement that primary liver physician has either:
Current board certification in transplant hepatology
Current pediatric transplant hepatology certification of added qualification
To address this problem, the MPSC is proposing that the current gastroenterology board certification requirement for primary liver transplant physicians be deleted and replaced with a requirement that primary liver transplant physicians must have current transplant hepatology board certification or a pediatric transplant hepatology certification of added qualification.

4. Supporting Evidence
Proposal stems directly from recommendations developed by a Joint Societies Working Group (JSWG)
Collaborative effort between the American Society of Transplantation (AST), the American Society of Transplant Surgeons (ASTS), the North American Transplant Coordinators Organization (NATCO), and the MPSC
Requires board certification that more directly aligns with the functions of a primary liver transplant physician
JSWG members agreed that transplant hepatology board certification is prevalent across liver transplant programs
The recommendations included in this proposal were discussed by a Joint Societies Working Group, and are representative of a collaborative effort between AST, ASTS, NATCO, and the MPSC. Their discussions highlighted that maintaining transplant hepatology board certification more directly aligns with the functions of a primary liver transplant physician, and that this subspecialty board certification is prevalent in the community such that it should be expected of all primary liver transplant physicians.

5. How will members implement this proposal?
No immediate action required of members
Membership applications received on or after the implementation date will be evaluated in consideration of these new requirements
Primary liver transplant physician applicants will be required to have either:
current board certification in transplant hepatology
current pediatric transplant hepatology certification of added qualification
No action will be required of members upon the implementation of these proposed changes. This proposed change will not impact current primary liver transplant physicians; only membership applications received by UNOS on or after the implementation date will be evaluated in consideration of these new requirements. At that time, primary liver transplant physician applicants will be required to have either current board certification in transplant hepatology or a current pediatric transplant hepatology certification of added qualification.

6. How will the OPTN implement this proposal?
Board consideration- December 2016
Programming – No
Federal government must approve updates to membership application forms
Implementation- MPSC will evaluate membership applications in consideration of these new requirements
Transition- changes do not impact current primary liver physicians
New requirements will be used to evaluate applications received on or after the implementation date
If public comment is favorable, this proposal is slated to be considered by the OPTN/UNOS Board of Directors during its December 2016 meeting. Assuming the Board adopts these changes, they would be effective pending federal government approval of updates to the membership application and notice to the membership. No programming is necessary to implement these changes.
There is no monitoring associated with these proposed changes. After implementation, primary liver transplant physician applicants that do not possess current board certification in transplant hepatology or a current pediatric transplant hepatology certification of added qualification will not be approved.
So all are clear, let me reiterate that this new requirement does not impact current primary liver transplant physicians. This new requirement will be used to evaluate primary liver transplant physician applications received on or after the to-be-determined implementation date.

7. Questions? Jeffrey Orlowski, MS, CPTC Committee Chair
Chad Waller
Committee Liaison