1. 1 Addressing the Term “Foreign Equivalent” in OPTN/UNOS Bylaws Membership and Professional Standards Committee Fall 2015

2. 2 What problem will the proposal solve?  OPTN Bylaws term “foreign equivalent” is unclear:  For the MPSC ­ ­­-- evaluating membership applications including board certification or case experience obtained outside U.S.  For members -- determining if certain staff (or staff being recruited) are qualified to serve as transplant program key personnel  Proposed solution:  Delete “foreign equivalent”  Allow Royal College of Physicians and Surgeons of Canada board certification  Add an additional mechanism for individuals without American board certification to qualify as key personnel

3.  Create more definitive key personnel requirements pertaining to board certification and transplant surgery experience obtained outside U.S.  The result :  MPSC has clear and consistent parameters to use when evaluating membership applications involving key personnel changes  Members can assess if certain individuals could be approved as transplant program key personnel before MPSC deliberations What is the goal of the proposal? 3

4.  Deletes the term “foreign equivalent” from OPTN Bylaws  Except OPTN Bylaws Appendix J (Membership and Personnel Requirements for VCA Programs)  Specifically allows Royal College of Physicians and Surgeons of Canada board certification in addition to American board certification How does the proposal address the problem statement? 4

5.  Creates a mechanism to qualify as key personnel for individuals without American or Canadian board certification:  Qualify through the respective clinical experience pathway  Provide two letters of attestation from program directors not affiliated with the applying hospital  Adhere to a continuing medical education plan that at least requires the key personnel applicant to obtain 40 hours of Category I continuing medical education credits with self- assessment every two years How does the proposal address the problem statement? (con’t) 5

6.  No immediate action required  ALL membership and key personnel change applications submitted on or after the implementation date will be evaluated relative to these requirements  Key personnel approved after implementation who are not American or Canadian board certified are responsible for adhering to the provided continuing medical education plan  OPTN will not regularly monitor plan adherence  May request documentation of adherence  Anticipated board review date – December 2015  Anticipated implementation date – March 2016 How will members implement this proposal? 6

7.  Promote the efficient management of the OPTN  Minimize confusion for members and give MPSC clear parameters when evaluating transplant program key personnel  Improve waitlisted patient, living donor, and transplant recipient outcomes  Promote living donor and transplant recipient safety  Bylaws better reflect the training and experience expected of transplant program key personnel How does this proposal support the OPTN Strategic Plan? 7

8. Jonathan Chen, MD Committee Chair jonathan.chen@seattlechildrens.org Regional representative name (RA will complete) Region X Representative email address Chad Waller Committee Liaison chad.waller@unos.org Questions? 8