Since the certification of the initial “class” of board-certified Pediatric Transplant Hepatologists, 89 certificates have been awarded in our subspecialty as of December, 2012.[112] The Accreditation Council for Graduate Medical Education (ACGME) was then responsible for

establishing the criteria for accreditation of training programs Stem Cell Compound Library cell line in transplant hepatology. This ensured that a variety of educational objectives were in place, along with a curriculum, to allow individuals to become adequately trained and monitored. There are currently five ACGME-certified programs in Pediatric Transplant Hepatology in the US. In my opinion the goals and expectations of the AASLD task force, which had the vision of certification of liver disease specialists, have been met. The end result is a thriving clinical and academic subspecialty that continues to attract the “best and the brightest,” carry out high-quality basic and translational research, buy AUY-922 and use innovative strategies to improve patient care. The certification process ensures that those caring for patients of any age with advanced liver disease possess the necessary

knowledge and training. The latter is governed by the high standards set by the ACGME. Buoyed by the success, the trend of “subspecialization” within the broad field of gastroenterology is viewed as likely to continue.[113] It is still a bit unclear as to the optimal process for training the next generation of transplant hepatologists. It this website has been suggested that the current model of a dedicated year of training in Transplant Hepatology after a 3-year fellowship in gastroenterology may be “unworkable and unsustainable.” [114-116] This additional year of postgraduate training may not be a popular option,

a concern predominantly related to the perceived financial disincentives. One proposal emanating from gastroenterology subspecialty groups suggests that subspecialty training such as Transplant Hepatology be incorporated within the 3-year gastroenterology core fellowship. The endpoints for training and the criteria for credentialing might then focus not on process measurement but on the measurement of actual accomplishments or outcomes—the acquisition of competencies within the field.[114] In fact, pilot programs in Internal Medicine are being established that incorporate specialty specific milestones that trainees must attain as they progress.[114, 117, 118] Of course, the ultimate desired outcome is the quality of care provided to our patients. The lessons for me are enduring—focus, persevere, commit. While times may be different, I recall that Bill Schubert fostered independence and that Alan Hofmann was kind enough to take the time to listen to an unknown young fellow. These traits remain key ingredients to successful mentoring/career development of trainees. I also emphasize to trainees the value of dedicating time to work within a community of like-minded individuals.