The AST Election Process

Setting the ballot for the AST’s annual election is a process that is taken very seriously, but is also probably not well understood by many of our members. As Chair of the AST’s Governance Committee, I would like to take a few moments to explain the process that is followed annually in order to set the ballot. It is a thorough and thoughtful process. I hope that this overview is helpful in the interest of transparency.

Anil Chandraker
Chair, Governance Committee 

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Board Structure and Composition

The AST is a complex organization. Board members are responsible for governance and policy setting. The Board focuses on mission, strategic direction, organizational priorities, programs, and financial oversight. Article 4 of the AST Bylaws dictate that the Board includes 14 members: President, President-elect, Immediate Past President, Secretary, Treasurer, and nine Councilors-at-Large. The officers (not including Councilors-at-Large) make up the Executive Committee. Terms for these roles are set in the Bylaws, with Councilors-at-Large serving three-year terms. These are staggered, so three Councilors-at-Large are elected each year. The Secretary and Treasurer each serve two-year terms, with the Secretary rotating on odd years and the Treasurer rotating on even years. The President-elect essentially serves a three-year term, serving in this role for a year, then as President, then as Immediate Past President before leaving the board. The Bylaws also layout a pathway for filling any vacancy of an officer position before the end of a term.

Governance Committee

A governance committee is an essential part of the AST and any non-profit’s leadership, working to develop the board structure. This group is responsible for assessing board composition and identifying areas of need as well as cultivating emerging leaders within the membership. The AST’s Governance Committee is comprised of:

• The current Executive Committee (board officers)
• The two most recent past presidents (that preceded the sitting Immediate Past President)
• The three Councilors-at-Large that completed their terms at ATC

The Immediate Past President serves as the chair of this committee. The group meets by phone throughout the second half of the year, looking at policies and procedures related to the call of nominations and conflict of interest, and determining areas of need on the board based upon positions that will be open, the strategic plan, and upcoming efforts. To ensure that the Board’s composition is balanced and strengthened by differences among members regarding race, gender, age, professional disciplines, institutional affiliations, geographical regions and practice areas, a careful analysis of current members of the board is completed annually by the Governance Committee to determine specific areas of need for the next ballot.

It is this group that is responsible for reviewing all board nominations and recommending a slate to the Board of Directors for final approval before a ballot is presented to the membership.

Board Nominations

Each year, a call for nominations is submitted to the full membership. Nominees may come from individuals or on behalf of the Society’s COPs. All nominees are asked to demonstrate consistent commitment to the AST, and must include specific information confirming this service in their personal statements. An ideal nominee will have:

• AST membership in good standing for a minimum of five years
• Attended AST meetings (including ATC)
• Served in AST leadership positions (e.g. chair of a committee, COP, task force, program planning committee, or advisory council).

For a nomination to be seriously considered by the Governance Committee, the nominee should have had significant involvement in and service to the AST. The nominee should have demonstrated ability to think strategically, commit to working effectively within a collective decision-making body and have knowledge of or experience with governance. The Governance Committee considers nominations in the context of the following:

• Basic leadership skills (not an ability to manage, but to lead).
• At least a three to five-year horizon in thinking/commitment.
• Ability to build teamwork among peers with different needs and interests.
• Demonstrated, not just articulated, leadership abilities.
• Examples of:
  • Moving people and/or an organization in the right direction
  • Ability to cultivate productive teamwork
  • Skillfully and creatively directing resources to accomplish objectives.

• Can they effectively help direct the AST’s resources to achieve its goals and objectives?
• Can they guide the AST in the future?

Two reference letters detailing the nominee’s leadership abilities, as outlined above, are also required to complete a nomination.  Reference letters address each of the leadership questions posed above and include specific examples that demonstrate the attributes espoused by the nominee.

Guiding principles for service on the AST Board of Directors must also be identified and implemented to avoid conflicts of interest. Nominees will be asked to disclose any potential conflicts of interest for review by the conflict of interest committee following submission of their nomination. The Governance Committee will review nominations for the following conflicts of interest:

• Nominees who currently serve on the ASTS, TTS, or CST Councils are not eligible for simultaneous AST Board service.
• Nominees who currently serve as an officer on a professional medical society or transplant regulatory governing body are not eligible for simultaneous AST Board service.
• The Governance Committee will determine, on a case-by-case basis, the eligibility of nominees who currently serve in a non-officer position on a professional medical society governing body.

Setting the Ballot

Once the call for nominations closes, all nominations packets are carefully reviewed by executive staff to ensure that documentation is complete. The Governance Committee is then tasked with carefully vetting potential nominees. This takes place during an in-person meeting.  Each nominee is presented to the committee, highlighting service to the Society, leadership qualities, and other qualifications in detail.

The Governance Committee then works to narrow down the list, identifying individuals that address the specific gaps or needs recognized during its analysis of the current board. Officer openings run unopposed, selected specifically by the Governance Committee. Councilor-at-Large candidates are set up on the ballot in pairs. The Committee strives to put together pairings from similar specialties or backgrounds whenever possible to avoid putting a candidate at a potential numerical disadvantage based upon the representation of his/her specialty within the membership as compared to another. This entire process is managed through as many rounds of votes and discussion as needed for the group to come to agreement in a proposed ballot.

It is important to recognize that a Board of fourteen cannot be specifically inclusive of every specialty currently represented within the Society. As the Society has grown, so too has the number of communities of practice. Great care is taken to recognize the changing needs of the board each year when developing the proposed ballot. This is based upon specific medical expertise or other leadership skills gaps created as members roll off when looking to the horizon at upcoming projects and strategic goals.  The Governance Committee’s primary role is to assure that the next iteration of the board is seated to address these anticipated needs and projects that lie ahead. As a result, some years very qualified individuals may not make the ballot as there is not a pressing need. Of course, any board and committee structure also allows the Board to call upon others for subject matter expertise as needed when it is not specifically represented in its membership.

Once the Governance Committee has finalized a proposed ballot, it is presented to the Board for final approval. At this time, all nominees are individually notified by members of the Governance Committee and told whether or not they have made the final ballot. Finally, the ballot is prepared and opened for voting by the AST membership. Winners are announced at the Town Hall meeting at ATC, and the next iteration of the board begins its work the following day at its first meeting.