Eligibility for Certification and Board Policies

The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, February 2015 (pdf), governs ABIM's decision about eligibility for certification. The February 2015 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).

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Transplant Hepatology Policies

The Transplant Hepatology Certification Program is jointly developed by the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP). The examination is administered to candidates from both Boards at the same time in the same testing centers. The American Board of Internal Medicine is responsible for administering the examination.


General Requirements

To become certified in the subspecialty of Transplant Hepatology, physicians must:

  • At the time of application, maintain current, valid certification in Gastroenterology
  • Satisfactorily complete the formal training requirements
  • Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting
  • Hold a valid, unrestricted and unchallenged license to practice medicine
  • Pass the Transplant Hepatology Certification Examination

No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.

Fellowship training taken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience, and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.

To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31st of the year of examination.

Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic, during non-clinical training, is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.

Practice Pathway

Practice Pathways for admission to the Transplant Hepatology Certification Examination were available for the 2006, 2008 and 2010 administrations of the examination. After the 2010 administration of the Transplant Hepatology Certification examination, Practice Pathways were discontinued. All first-time applicants for admission to the examination after 2010 must fulfill the requirements of the Training Pathway below.

Training Pathway

The training pathway involves satisfactory completion of training required for certification in Gastroenterology plus an additional 12 months of satisfactorily completed clinical transplant hepatology fellowship training* which meets the following criteria:

  • Transplant hepatology fellowship training undertaken July 1, 2011 and thereafter must be accredited by the Accreditation Council for Graduate Medical Education (ACGME). Transplant hepatology fellowship training undertaken prior to July 1, 2011 must be conducted in an institution which has an accredited gastroenterology program.
  • Training experience must include meaningful patient care responsibility for perioperative care of 20 liver transplant patients in a UNOS-approved transplant center.
  • Training experience must be consistent with guidelines established by the American Association for the Study of Liver Disease/American Society of Transplantation (AASLD/AST).

* NOTE: Transplant hepatology fellowship training which was credited toward the third year of gastroenterology fellowship training, cannot be used to fulfill requirements for admission to the Transplant Hepatology Exam through the Training Pathway.


Training and Procedural Requirements

The total months of training required, including specific clinical months, and requisite procedures are outlined below.

Minimum Months
of Training
Clinical Months

* For deficits of less than one month in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.

12* 12 Performance of at least 30 percutaneous liver biopsies, including allograft; interpretation of 200 native and allograft liver biopsies; and knowledge of indications, contraindications, and complications of allograft biopsies

Clinical Competence Requirements

ABIM requires documentation that candidates for certification are competent in: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.

Through its tracking process, FasTrack, ABIM requires verification of fellows' clinical competence from the training program director.

As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence and moral and ethical behavior in each of the required years of training. In addition, fellows must receive satisfactory ratings in each of the components of clinical competence and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each component of clinical competence.

Program Director Ratings of Clinical Competence

Overall Clinical Competence
Ratings Fellows (any year)
Satisfactory or Superior Full credit
Unsatisfactory No credit, must repeat year
Moral and Ethical Behavior
Ratings Fellows (any year)
Satisfactory Full credit
Unsatisfactory No credit, must repeat year or, at the request of the program director and at ABIM’s discretion, a successful period of observation can be arranged in lieu of repeating the year to be granted credit
Evaluation of Individual General Competencies*
Ratings Fellows (any year)
* The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.
Satisfactory or Superior Full credit
Unsatisfactory Must repeat year if during final year of required training

Candidates for Special Consideration

ABIM diplomates in internal medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program if they:

  1. Have completed the full training required by ABIM in the subspecialty in another country and have met all current applicable ABIM procedural requirements.
  2. Are a full-time Associate Professor or higher in the specified subspecialty division of the Department of Medicine in an LCME-accredited medical school or an accredited Canadian medical school at the time of proposal.
  3. Have served eight years, after formal training, as a clinician-educator or clinical investigator with a full-time appointment on a medical school faculty.
  4. Possess a valid, unrestricted license to practice medicine in a state, territory, commonwealth, province or possession of the United States or Canada.

Guidelines for proposals are available in Proposing Candidates for Special Consideration.


Certification Using the Research Pathway

The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. The value of the ABIM Research Pathway is that while it requires core clinical training, it concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.

Guidelines for certification using the research pathway are available in Research Pathway.


Information for Candidates Certified by ABP

The policy information above applies only to ABIM diplomates who are seeking admission to the Transplant Hepatology Certification Examination via ABIM. Candidates from the American Board of Pediatrics (ABP) should contact ABP with any questions regarding certification policies or eligibility to apply for admission to the examination.