Addressing the Term “Foreign Equivalent” in OPTN/UNOS Bylaws

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

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. What is the goal of the proposal? • 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

4. How does the proposal address the problem statement? • 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

5. How does the proposal address the problem statement? (con’t) • 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

6. How will members implement this proposal? • 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

7. How does this proposal support the OPTN Strategic Plan? • 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

8. Questions? 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