- Initial CHS fees total $4,900: $650 application, $1,750 written, $2,500 oral.
- The 2026 written window is December 7-11, 2026; oral exam is June 4-5, 2027 in Dallas.
- Written questions have three answer options as of 2025, and are taken at Pearson centers.
- Fellows starting July 1, 2023 or later need 150 major cases with at least 50 in year one.
Quick Facts Snapshot
If you only have five minutes before a call or a case, this section is your anchor point. The American Board of Thoracic Surgery (ABTS) administers Congenital Cardiac Surgery subspecialty certification - referred to on the board's own site as Congenital Heart Surgery, and abbreviated CHS. This cheat sheet consolidates the numbers, dates, and structural facts that matter most for candidates preparing for Part I written and Part II oral examinations. For a deeper narrative walkthrough of preparation strategy, pair this page with the CHS Study Guide 2026: How to Pass on Your First Attempt.
Eligibility in 60 Seconds
Before you touch a single practice question, confirm you actually qualify to sit for the exam. Initial eligibility requires:
- Current primary ABTS certification in general thoracic surgery
- Unrestricted medical licensure
- Qualifying thoracic and congenital cardiac surgery training
- Verified operative experience
- Program endorsement from your training program
For fellows who began training on or after July 1, 2023, the case-volume bar is explicit: two consecutive years in one ACGME-accredited program, with at least 150 major congenital cases overall and at least 50 of those completed in the first year. This case-logging discipline is not a formality - it directly determines whether you can even register for Part I. A full breakdown of the pathway, including documentation nuances, lives in CHS Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Key Takeaway
Start your case log audit early. If you're short on the 50-case first-year threshold, you need to know that months before the application deadline, not weeks before the written exam.
Fee Breakdown
Initial CHS certification carries a total cost of $4,900, split across three components:
| Fee Component | Amount |
|---|---|
| Application | $650 |
| Written Examination (Part I) | $1,750 |
| Oral Examination (Part II) | $2,500 |
| Total (before travel/prep) | $4,900 |
Note that this figure excludes travel to the Dallas oral exam site, lodging, and any preparation resources you invest in. For the complete financial picture, including how continuing certification costs layer on afterward, see CHS Certification Cost 2026: Complete Pricing Breakdown.
Part I and Part II Format
CHS certification is a two-part sequence. You must pass the written Part I before you're permitted to sit for the in-person oral Part II - there's no skipping ahead or attempting both simultaneously.
Part I: Written Examination
- Administered at Pearson Professional Testing Centers
- Multiple-choice format with three answer options per question, a format change that began in 2025
- Covers all 11 content categories drawn from the ABTS Booklet of Information
- Written success is a prerequisite gate for oral eligibility
Part II: Oral Examination
- In-person, case-based oral format
- Held in Dallas
- Only accessible after passing the written component
Because the three-option MCQ format is relatively new, candidates who studied older prep material may find question logic slightly different than expected. If you're weighing how demanding this two-part sequence actually is compared to other surgical boards, read How Hard Is the CHS Exam? Complete Difficulty Guide 2026. And if you want the exact score threshold discussion, check CHS Passing Score 2026: Exactly What You Need to Pass.
The 11 Content Categories
The written exam's coverage areas come directly from the ABTS Booklet of Information and are treated as unweighted categories - meaning no single domain is officially declared "worth more" than another on paper, though clinical frequency and case complexity should still guide your time allocation. For an exhaustive breakdown of each domain with sub-topics, see CHS Exam Domains 2026: Complete Guide to All 11 Content Areas.
Domain 1: Septal Defects
Covers atrial and ventricular septal defect anatomy, physiology, and surgical closure techniques.
- Know timing of repair relative to pulmonary vascular resistance changes
Domain 2: Anomalies of Venous Connection
Includes total and partial anomalous pulmonary venous connection and systemic venous anomalies.
- Master surgical approaches for sinus venosus and TAPVC variants
Domain 3: Anomalies of the Aorta, Aortic Arch, and Coronary Arteries
Covers coarctation, interrupted arch, vascular rings, and coronary anomalies.
- Distinguish arch reconstruction strategies by anatomic subtype
Domain 4: Anomalies of the Tricuspid and Mitral Valves
Includes Ebstein's anomaly, tricuspid atresia, and mitral valve dysplasia.
- Understand valve repair versus replacement decision points in small patients
Domain 5: Anomalies of the Aortic Valve and Left Ventricular Outflow Tract
Covers aortic stenosis, subvalvar and supravalvar obstruction, and Ross procedures.
- Know the surgical ladder from balloon valvuloplasty to Ross/Konno
Domain 6: Anomalies of the Pulmonary Valve and Right Ventricular Outflow Tract
Includes pulmonary stenosis/atresia and RVOT reconstruction options.
- Compare conduit versus transannular patch strategies
Domain 7: Conotruncal Anomalies
Covers tetralogy of Fallot, truncus arteriosus, and transposition physiology.
- Focus on arterial switch timing and coronary transfer patterns
Domain 8: Anomalies of Atrioventricular Connection, Univentricular Heart, and Atrial/Visceral Situs
Includes AV canal defects, single ventricle pathways, and heterotaxy.
- Trace the staged single-ventricle pathway from Norwood through Fontan
Domain 9: Diseases of the Myocardium
Covers cardiomyopathies and surgical implications in pediatric patients.
- Know indications for mechanical support and transplant referral timing
Domain 10: Pre-, Intra-, and Post-Operative Evaluation and Management of Congenital Cardiac Disease
A broad perioperative management category spanning imaging, bypass strategy, and ICU care.
- Expect heavy weighting in case-based oral discussion, not just written recall
Domain 11: Acquired Cardiovascular Diseases in Infants and Children
Covers non-congenital pediatric cardiac pathology encountered by congenital surgeons.
- Don't neglect this domain just because it's not "classic" congenital anatomy
Key Takeaway
Domain 10's perioperative management content tends to resurface heavily in the oral exam's case discussions, so treat it as a cross-cutting theme rather than an isolated topic to review once and forget.
2026-2027 Key Dates
Mark these on your calendar now, especially if you need to coordinate clinical coverage:
- Written examination window: December 7-11, 2026
- Oral examination: June 4-5, 2027, in Dallas
Note the roughly six-month gap between written and oral sittings - plan your oral case-discussion prep as a distinct second phase rather than cramming it alongside written study. For a full scheduling breakdown including registration deadlines, see CHS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Examination Statistics
ABTS reported 7 passes among 8 written examinees and 4 passes among 4 oral examinees in 2025. These cohorts are small, so treat any derived pass rate as directional rather than statistically robust - a single candidate's result shifts the percentage meaningfully. For more context on how to interpret these numbers responsibly, read CHS Pass Rate 2026: What the Data Shows.
Continuing Certification Snapshot
This cheat sheet is built primarily around initial Part I and Part II preparation, but it's worth knowing what comes after you're certified. Since January 2024, ABTS continuing certification uses non-time-limited certificates conditional on five-year milestone compliance. Existing time-limited certificates transition at their expiration. Ongoing requirements include:
- Unrestricted licensure and hospital privileges
- Professional references
- 150 Category 1 CME credits per five-year period, with at least 75 related to thoracic surgery
- Qualifying congenital case activity
- An online continuing-certification assessment
- Patient-safety and improvement requirements
This is a separate assessment track from the initial Part I/Part II process this cheat sheet focuses on, so don't confuse the two when planning your timeline.
One-Week Review Allocation
If you're in the final stretch before the December written window, here's a compact way to allocate a single review week across the highest-yield domains without resorting to generic study gimmicks.
Anatomically Dense Domains
- Domain 7 (Conotruncal Anomalies) and Domain 8 (AV Connection/Univentricular Heart) - these carry the most staged-pathway complexity
Valve and Outflow Domains
- Domains 4, 5, and 6 - tricuspid/mitral, aortic valve/LVOT, pulmonary valve/RVOT
Vascular and Venous Domains
- Domain 2 (venous connection) and Domain 3 (aorta, arch, coronary arteries)
Perioperative and Situational Domains
- Domain 10 (perioperative management), Domain 9 (myocardium), Domain 11 (acquired disease), and a final pass through Domain 1 (septal defects)
This sequencing front-loads the most structurally complex anatomy early in the week when focus is freshest, then closes with the cross-cutting perioperative content that tends to reappear across multiple oral case discussions. For a longer-horizon version of this plan spanning months rather than a single week, see the CHS Study Guide 2026: How to Pass on Your First Attempt.
Who Hires CHS-Certified Surgeons
CHS certification signals to academic medical centers, pediatric heart programs, and multidisciplinary congenital heart teams that a surgeon has met a defined national standard beyond primary thoracic surgery certification. Programs staffing complex single-ventricle pathways, neonatal repair services, and reoperative congenital cases often look for this credential when evaluating candidates for attending or program leadership roles. If you're assessing career impact more broadly, Is the CHS Certification Worth It? Complete ROI Analysis 2026 and CHS Salary Guide 2026: Complete Earnings Analysis go deeper on that question, and CHS Jobs covers what hiring programs typically expect.
Key Takeaway
Because the examinee pool is small nationally, CHS-certified surgeons often stand out distinctly within congenital heart program hiring committees - preparation quality matters more than volume of competing candidates.
Turning This Cheat Sheet Into Practice Reps
A one-page reference is useful for recall, but retention comes from active testing against realistic question formats - including the newer three-option structure. Running timed practice sets that mirror the Pearson center experience helps you build pacing instincts before exam day. You can work through domain-organized practice questions on the main practice test platform to convert this cheat sheet's facts into tested recall, and revisit practice sessions periodically as your written exam date approaches.
If terminology itself is still fuzzy - for instance, distinguishing this credential from other things called "CHS" in unrelated fields - start with foundational pieces like What Is CHS?, CHS Meaning, What Does CHS Stand For?, or What Is CHS Certification? before diving into domain-level study. For training pathway specifics ahead of eligibility, CHS Training is a useful companion read, and the full credential overview is available at CHS Certification.
Frequently Asked Questions
In this article, CHS refers to Certification in Congenital Cardiac Surgery, administered by the American Board of Thoracic Surgery and also referred to as Congenital Heart Surgery certification on the ABTS site.
Initial fees total $4,900, broken into a $650 application fee, $1,750 written examination fee, and $2,500 oral examination fee, not including travel or preparation expenses.
The written window runs December 7-11, 2026, at Pearson Professional Testing Centers. The corresponding oral exam follows on June 4-5, 2027, in Dallas.
The written exam draws from 11 unweighted content categories outlined in the ABTS Booklet of Information, ranging from septal defects to acquired cardiovascular disease in infants and children.
Yes. Written success on Part I is required before candidates are permitted to sit for the in-person Part II oral examination.