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Pediatric Transplant Hepatology Certification

Eligibility Criteria for Certification in Pediatric Transplant Hepatology

The American Board of Pediatrics (ABP), in collaboration with the American Board of Internal Medicine (ABIM), will offer a certificate in Pediatric Transplant Hepatology. This document provides the requirements of the ABP. (Note: A candidate who has a primary certificate from ABIM should contact the ABIM office for its eligibility criteria.) Examination registration dates may differ for each board.

ADMISSION REQUIREMENTS

SUBSPECIALTY CERTIFICATION BY THE ABP
A candidate for pediatric transplant hepatology certification must be currently certified in pediatric gastroenterology to be eligible to apply for the pediatric transplant hepatology certifying examination. No exceptions to this policy will be granted. Maintenance of Certification (MOC) in pediatric gastroenterology is required in order to maintain certification in pediatric transplant hepatology. The requirements for MOC can be found on the ABP website. All candidates are urged to ensure that the requirements for MOC will be met in sufficient time to allow acceptance to the subspecialty certifying examination. 

LICENSURE

An applicant must hold a valid, unrestricted allopathic and/or osteopathic medical license in at least one jurisdiction in the United States, its territories, or Canada. If more than one license is held in these jurisdictions, all licenses must meet the requirement of being unrestricted. Temporary or training licenses are not acceptable.

Individuals practicing exclusively abroad, ie, who are not practicing in the United States or Canada, and who do not hold a United States or Canadian license, must provide proof of licensure in the country in which they practice. Applicants for initial certification who intend to practice abroad exclusively must submit a letter stating this fact. In addition, they must submit proof of licensure in the country in which they intend to practice.

TRAINING

One year of fellowship training must be completed in a program accredited in pediatric transplant hepatology by the Accreditation for Graduate Medical Education (ACGME) in the United States.  

Physicians who entered training before January 1, 2011, in a nonaccredited training program must have completed a minimum of 1 year in a pediatric transplant hepatology program associated with a pediatric gastroenterology fellowship program accredited by the ACGME or by the Royal College of Physicians and Surgeons of Canada. The nonaccredited training must have been broad-based and generally consistent with the clinical components outlined in the Guidelines for Training in Pediatric Gastroenterology developed by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) [Journal of Pediatric Gastroenterology and Nutrition 29:S1-26,1999, or the most recent version] as they specifically relate to advanced training for the expert in pediatric hepatology. The training experience must be gained at a UNOS-approved center (for United States trainees) with a qualified pediatric liver transplantation specialist and a qualified liver transplantation surgeon. The trainee should spend a minimum of 6 months on the clinical inpatient liver service, with a weekly continuity clinic for 12 months. The remaining months should consist of other hepatology or transplant-related experience, including involvement in basic or clinical transplant research. The trainee should have direct involvement in pre-, peri-, and postoperative care of at least 10 pediatric liver transplantation patients. The trainee should have direct involvement in outpatient management of at least 20 pediatric liver transplant recipients. Fewer may be adequate or more may be necessary depending on the structure of the program and the involvement of the trainee.

Absences from Training

No continuous absence of more than 1 year will be permitted. Due to the potential for significant changes in medicine over time, the Credentials Committee must review requests for previous credit when a fellow has interrupted fellowship for more than 12 months.

Combined absences/leaves in excess of 1 month during the year of training, whether for vacation, parental leave, illness, and so forth, must be made up. If the program director believes that combined absences/leaves that exceed 1 month are justified, a letter of explanation should be sent by the program director for review by the Credentials Committee.

An applicant must satisfactorily complete all subspecialty training before the first day of the month in which the examination is administered. An applicant whose contracted training period does not expire before the first day of the month of the examination will not be eligible for that examination, even if all formal training has been completed earlier and the remaining time is used only for leave.

No credit will be given for subspecialty training during the core general pediatric residency or a chief residency.

A fellow engaging in part-time training must complete the required training on a part-time basis not to exceed 2 years.

Training as part of the fellowship program in pediatric gastroenterology cannot be used to qualify for the certification examination in pediatric transplant hepatology. An applicant seeking certification in another pediatric subspecialty or a non-ABP specialty (eg, allergy/immunology) on the basis of practice and/or training may not apply the same period of time toward fulfillment of these requirements. 

VERIFICATION OF TRAINING

An applicant will be asked to list the program(s) where fellowship training occurred as well as the name(s) of the program director(s). The ABP will send a Verification of Competence Form to the program director(s) for completion. The role of the program director in the certification process is to verify completion of training and evaluate clinical competence including professionalism.

An applicant must have the Verification Form(s) on file at the ABP in order to be admitted to the subspecialty examination. If an applicant’s training is not verified or if the applicant receives an unsatisfactory evaluation in any of the competencies (with the exception of professionalism alone), the applicant will be required to complete an additional period of subspecialty fellowship training before reapplying. The director of the program where the additional training occurred must complete a separate Verification of Competence Form. If the unsatisfactory evaluation is in professionalism only, the applicant will be required to complete an additional period of fellowship training or, at the program director’s recommendation and at the ABP’s discretion, a period of observation may be required in lieu of additional training. A plan for remediation must be submitted for review and approval by the ABP.

Appeals Process: Applicants who wish to appeal evaluations must proceed through institutional due process mechanisms. The ABP is not in a position to reexamine the facts and circumstances of an individual’s performance.

TIME-LIMITED ELIGIBILITY FOR INITIAL CERTIFICATION EXAMINATION
Beginning with the examinations administered in 2014, the ABP will require that applicants have completed the training required for initial certification in the pediatric subspecialties within the previous 7 years (eg, 2010 or later for examinations administered in 2017). If the required training was not successfully completed within the previous 7 years, the applicant must complete an additional period of supervised practice in order to apply for certification. The subspecialty examinations are offered every other year. Therefore, please note that the pediatric subspecialty examination may not be offered in the year the acceptance expires. The full policy can be found on the ABP website.

CLOSURE OF PRACTICE PATHWAY FOR SUBSPECIALTY CERTIFICATION
The ABP has established a policy for a closure date for the practice pathway for all subspecialties in which a certificate is offered. The certifying examinations for 2010 were the last examinations for which an individual could apply for certification using practice experience accrued by the deadline stated in the original eligibility criteria when the subspecialty was established. Please contact the ABP if additional information is needed.

It should be noted that these criteria and conditions are subject to change without notice. All applicants are advised to contact the ABP to ascertain whether the information they have is current.

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