- What CHS Certification Actually Is
- Eligibility and Pathway Requirements
- Exam Structure: Part I Written and Part II Oral
- The 11 Content Categories You Must Master
- Fees and Exam Dates
- What the Small Cohort Numbers Mean
- Building a CHS-Specific Study Plan
- Continuing Certification After You Pass
- Who Hires CHS-Certified Surgeons
- Frequently Asked Questions
- CHS is the ABTS Congenital Cardiac Surgery subspecialty certification, not another credential sharing the acronym.
- Initial fees total $4,900: $650 application, $1,750 written exam, $2,500 oral exam.
- Written questions moved to three answer options beginning in 2025, changing how you should practice elimination.
- The 2026 written window is December 7-11, 2026; the oral exam is June 4-5, 2027 in Dallas.
What CHS Certification Actually Is
Certification in Congenital Cardiac Surgery (CHS) is the subspecialty credential administered by the American Board of Thoracic Surgery (ABTS) for surgeons who focus their practice on operative repair of congenital heart disease in infants, children, and adults with congenital anomalies. On the ABTS website it is formally called "Congenital Heart Surgery," but the working shorthand used across the field, and the one this site is built around, is CHS. If you landed here wondering about basic terminology, our companion explainers on What Is CHS?, CHS Meaning, and What Does CHS Stand For? cover the naming conventions in more depth.
This is not a first credential. Candidates already hold primary ABTS certification in general thoracic surgery and are layering on a subspecialty pathway that verifies advanced training and operative experience specific to congenital cases. For a full breakdown of the underlying credential concept, see What Is A CHS? and What Is CHS Certification?
Eligibility and Pathway Requirements
Before you can register for the written exam, ABTS expects candidates to satisfy several concrete prerequisites: current primary ABTS certification, unrestricted medical licensure, completion of qualifying thoracic and congenital cardiac surgery training, verified operative experience logs, and formal endorsement from your training program.
Training requirements tightened for newer trainees. Fellows who began training on or after July 1, 2023 must complete two consecutive years in a single ACGME-accredited program and document at least 150 major congenital cases, with a minimum of 50 of those cases completed in the first year. This case-volume floor is a meaningful planning constraint for fellowship scheduling, not just a paperwork checkbox.
For the complete eligibility checklist, including documentation specifics and program endorsement mechanics, see CHS Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Key Takeaway
If you started fellowship after July 2023, track your case count monthly against the 50-case first-year benchmark rather than waiting until year two to check your total.
Exam Structure: Part I Written and Part II Oral
CHS certification is earned in two sequential stages. Part I is a written, multiple-choice examination administered at Pearson Professional Testing Centers. Beginning in 2025, written questions use three answer options rather than a longer option list, which changes both the guessing math and the way distractors are written - you'll see fewer implausible throwaway choices and more genuinely competitive options.
You must pass Part I before you are eligible to sit for Part II, the in-person oral examination. The oral format tests case-based reasoning: how you work through operative decision-making, complications, and postoperative management scenarios verbally in front of examiners, rather than simply recognizing a correct answer on a screen.
Because the two exams test fundamentally different skills - recall and pattern recognition on Part I versus verbal case synthesis on Part II - most candidates prepare for them somewhat separately, even though the underlying content overlaps heavily. Our CHS Study Guide 2026: How to Pass on Your First Attempt walks through how to sequence preparation for both stages. For scoring specifics, see CHS Passing Score 2026: Exactly What You Need to Pass, and for a broader sense of how demanding the two-stage process is in practice, read How Hard Is the CHS Exam? Complete Difficulty Guide 2026.
The 11 Content Categories You Must Master
ABTS organizes Part I content into 11 categories, drawn from the ABTS Booklet of Information. These are listed as unweighted coverage areas, meaning there is no published breakdown telling you that one category counts more than another on the exam - you should prepare for full coverage across all 11 rather than betting on emphasis.
Domain 1: Septal Defects
Atrial and ventricular septal defects, including anatomic variants, timing of repair, and associated lesions.
- Distinguish repair approaches by defect location and size
Domain 2: Anomalies of Venous Connection
Systemic and pulmonary venous return abnormalities and their surgical correction.
- Know the anatomic subtypes of anomalous pulmonary venous connection
Domain 3: Anomalies of the Aorta, Aortic Arch, and Coronary Arteries
Arch obstruction, coronary anomalies, and their interplay with other cardiac lesions.
- Coarctation repair strategy across age groups
Domain 4: Anomalies of the Tricuspid and Mitral Valves
Atrioventricular valve dysplasia, straddling, and repair versus replacement decision-making.
- Valve-sparing repair techniques and their limits
Domain 5: Anomalies of the Aortic Valve and Left Ventricular Outflow Tract
Left ventricular outflow obstruction, from valvar to subvalvar and supravalvar lesions.
- Ross procedure indications and tradeoffs
Domain 6: Anomalies of the Pulmonary Valve and Right Ventricular Outflow Tract
Right-sided outflow obstruction and reconstruction strategies across staged repairs.
- Conduit selection and reintervention timing
Domain 7: Conotruncal Anomalies
Tetralogy of Fallot, truncus arteriosus, and transposition physiology and repair.
- Arterial switch versus atrial switch decision points
Domain 8: Anomalies of Atrioventricular Connection, Univentricular Heart, and Atrial/Visceral Situs
Single-ventricle pathways, heterotaxy, and staged palliation logic.
- Fontan pathway sequencing and candidacy criteria
Domain 9: Diseases of the Myocardium
Cardiomyopathies and myocardial disease as they intersect with surgical decision-making.
- Surgical versus medical management thresholds
Domain 10: Pre-, Intra-, and Post-Operative Evaluation and Management of Congenital Cardiac Disease
Perioperative physiology, bypass strategy, and postoperative complication management.
- Hemodynamic troubleshooting in the immediate postoperative window
Domain 11: Acquired Cardiovascular Diseases in Infants and Children
Non-congenital cardiac disease presenting in pediatric patients, including infectious and traumatic causes.
- Distinguishing acquired disease from congenital mimics
Each of these categories deserves individual attention rather than a single pass through a review book. Our dedicated resource, CHS Exam Domains 2026: Complete Guide to All 11 Content Areas, breaks down each category further with representative question angles.
Fees and Exam Dates
Budgeting for CHS certification means planning for three separate charges that total $4,900, before travel or study materials:
| Fee Component | Amount |
|---|---|
| Application fee | $650 |
| Written examination (Part I) | $1,750 |
| Oral examination (Part II) | $2,500 |
| Total initial fees | $4,900 |
For a full cost analysis, including how these fees compare across the certification lifecycle, read CHS Certification Cost 2026: Complete Pricing Breakdown.
On scheduling: the 2026 written examination window runs December 7-11, 2026, administered at Pearson Professional Testing Centers. The corresponding oral examination is scheduled for June 4-5, 2027 in Dallas. That roughly six-month gap between written and oral exams is intentional runway - use it deliberately rather than starting oral prep only after your written score arrives. Full scheduling details, including how administration follows the live ABTS calendar, are in CHS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
What the Small Cohort Numbers Mean
ABTS reported 7 passes among 8 written examinees and 4 passes among 4 oral examinees in 2025. These numbers come directly from ABTS's own examination statistics page, but the cohort sizes are small enough that they should be read as a snapshot of a niche subspecialty exam, not a statistically robust trend. A single additional pass or fail shifts the percentage substantially in either direction.
What this means practically: don't anchor your confidence level to a percentage derived from a handful of test-takers. Focus instead on domain mastery and case-based reasoning quality. Our detailed look at these figures, CHS Pass Rate 2026: What the Data Shows, walks through how to interpret small-cohort certification data responsibly.
Building a CHS-Specific Study Plan
Generic study techniques - spaced repetition, timed practice blocks, active recall - work for CHS preparation, but only when mapped onto the actual content categories rather than applied as a one-size-fits-all template. Because the 11 categories are unweighted, a sensible approach is to allocate roughly equal blocks of dedicated time to each, with extra review passes for the categories where your clinical exposure has been lightest (commonly Domain 9, Diseases of the Myocardium, and Domain 11, Acquired Cardiovascular Diseases, for surgeons whose fellowship caseload skewed heavily toward high-volume conotruncal and septal repairs).
Foundational Anatomy Domains
- Domain 1: Septal Defects
- Domain 2: Anomalies of Venous Connection
Outflow Tract and Valve Domains
- Domain 5: Aortic Valve and LVOT
- Domain 6: Pulmonary Valve and RVOT
- Domain 4: Tricuspid and Mitral Valves
Complex Anatomy and Perioperative Management
- Domain 7: Conotruncal Anomalies
- Domain 8: Univentricular Heart and Situs
- Domain 10: Perioperative Evaluation and Management
Lower-Exposure Topics and Oral Simulation
- Domain 3: Aorta, Arch, and Coronary Arteries
- Domain 9: Myocardial Disease
- Domain 11: Acquired Disease
- Begin case-presentation practice for Part II
Timed multiple-choice drilling matters more now that written questions use three answer options: with fewer distractors, you need sharper discrimination between the two most plausible choices rather than the ability to eliminate obviously wrong answers. Practicing under realistic time constraints on our full-length CHS practice tests builds that discrimination skill directly. For a condensed reference to keep nearby during final review, see the CHS Cheat Sheet 2026: One-Page Review of Must-Know Facts.
Continuing Certification After You Pass
Passing Part I and Part II earns initial certification, but CHS maintenance did not stay static. Since January 2024, ABTS continuing certification uses non-time-limited certificates that remain valid conditional on meeting five-year milestone requirements; existing time-limited certificates transition to this model at their expiration date.
Ongoing requirements include unrestricted licensure, active hospital privileges, professional references, 150 Category 1 CME credits per five-year period (with at least 75 specifically related to thoracic surgery), qualifying congenital case activity, an online continuing-certification assessment, and patient-safety and improvement activities. This is a meaningfully different structure from a one-time credential, and it's worth understanding before you commit to the initial certification path - details are covered in CHS Certification.
Who Hires CHS-Certified Surgeons
CHS certification is pursued almost exclusively by surgeons already practicing, or seeking to practice, congenital and pediatric cardiac surgery at academic medical centers, children's hospitals, and regional congenital heart programs. Because eligibility itself requires an ACGME-accredited congenital cardiac surgery fellowship and verified high-volume case experience, the credential functions less as an entry credential and more as formal recognition layered onto an already-narrow surgical subspecialty. For context on how this credential fits into career trajectories and hiring conversations, see CHS Jobs and CHS Training. If you're weighing whether the time and $4,900 investment is worthwhile given your career stage, Is the CHS Certification Worth It? Complete ROI Analysis 2026 and CHS Salary Guide 2026: Complete Earnings Analysis address that question directly.
Key Takeaway
CHS is a subspecialty credential built on top of primary ABTS certification and congenital fellowship training - treat preparation as reinforcing existing operative judgment, not learning content from scratch.
Frequently Asked Questions
No. CHS is a subspecialty certification from ABTS specifically for congenital cardiac surgery, and candidates must already hold primary ABTS certification before pursuing it.
No. Passing the Part I written examination is required before you become eligible to sit for the Part II oral examination.
Initial fees total $4,900, made up of a $650 application fee, a $1,750 written examination fee, and a $2,500 oral examination fee, not including travel or study materials.
Part I is administered at Pearson Professional Testing Centers, while the Part II oral examination is held in person; the 2027 oral exam is scheduled in Dallas.
Since January 2024, ABTS uses non-time-limited certificates for continuing certification, conditional on meeting five-year milestone requirements rather than a hard expiration date.