- How CHS Certification Fits Into Surgeon Compensation
- Who Hires Congenital Cardiac Surgeons With CHS Credentials
- The Financial Investment Behind the Credential
- The 11 Domains Employers Expect You to Master
- Certification Pathway and Timeline
- Aligning Preparation With Career Payoff
- Continuing Certification and Long-Term Career Value
- Frequently Asked Questions
- CHS certification (American Board of Thoracic Surgery Congenital Cardiac Surgery subspecialty) is a credential, not a salary schedule - compensation is set by...
- Initial fees total $4,900: $650 application, $1,750 written exam, $2,500 oral exam, before travel costs.
- Eligibility requires current primary ABTS certification, meaning CHS sits atop years of prior thoracic surgery training investment.
- Fellows starting July 1, 2023 or later need two consecutive years in one ACGME-accredited program and 150 major congenital cases, with 50 in year one.
How CHS Certification Fits Into Surgeon Compensation
Searching for a "CHS salary" is a natural instinct once you understand what the credential represents, but it's worth setting expectations correctly from the outset. The American Board of Thoracic Surgery does not publish salary data for congenital cardiac surgeons, and no credible source ties a specific dollar figure to holding Certification in Congenital Cardiac Surgery. What CHS certification actually does is signal that a surgeon has cleared a rigorous, board-verified bar of training, operative volume, and examination performance in a narrow subspecialty - congenital heart surgery - that relatively few surgeons pursue.
Compensation for congenital cardiac surgeons is driven by factors like practice setting, geographic market, case complexity, call burden, and institutional reimbursement structures - not by a fee schedule tied to the certificate itself. What this guide will do is walk through the concrete, verifiable facts about the credential - its cost, its domains, its pathway, and its continuing requirements - so you can reason clearly about the career and earning trajectory it supports rather than relying on invented numbers.
Who Hires Congenital Cardiac Surgeons With CHS Credentials
Congenital cardiac surgery is one of the smallest and most specialized surgical subspecialties in existence. Surgeons pursuing CHS certification are typically already practicing - or about to practice - at institutions with dedicated congenital heart programs: freestanding children's hospitals, academic medical centers with pediatric cardiac surgery divisions, and regional congenital heart centers that handle the full spectrum of defects, from simple septal repairs to complex single-ventricle palliation.
Because eligibility requires current primary ABTS certification, unrestricted medical licensure, and program endorsement, holding CHS status functions as a gatekeeping credential for leadership and staff-surgeon roles at these programs rather than a general-market qualification. Hospital credentialing committees, congenital heart program directors, and academic search committees use it as a verification point during hiring and privileging. If you're mapping out what a career built around this credential actually looks like day to day, our overview of CHS Jobs breaks down the practice settings and roles where the certification carries the most weight.
Key Takeaway
Treat CHS as a credentialing prerequisite for congenital heart program roles, not a stand-alone salary lever - its value shows up in eligibility for positions, not in a posted pay premium.
The Financial Investment Behind the Credential
Before evaluating any return, it helps to understand exactly what the credential costs to obtain. Initial ABTS fees for Certification in Congenital Cardiac Surgery total $4,900, broken down as:
- $650 application fee
- $1,750 written examination fee (Part I)
- $2,500 oral examination fee (Part II)
These figures do not include travel, lodging, or preparation resources - the oral examination is administered in person in Dallas, so candidates should budget for travel separately. For a full line-item breakdown of every fee and how they compare against the time investment required, see CHS Certification Cost 2026: Complete Pricing Breakdown.
The written examination (Part I) is administered at Pearson Professional Testing Centers, and as of 2025 uses multiple-choice questions with three answer options rather than the traditional four or five. Written success is required before a candidate is permitted to sit for the in-person oral examination - meaning the $2,500 oral fee is only relevant once Part I is cleared. Candidates preparing for the 2026 cycle should note the written window runs December 7-11, 2026, with the corresponding oral examination held June 4-5, 2027 in Dallas. Full scheduling detail is available in CHS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
| Cost Component | Amount | When It Applies |
|---|---|---|
| Application Fee | $650 | Submitted with eligibility documentation |
| Written Exam (Part I) | $1,750 | Pearson Testing Centers, December window |
| Oral Exam (Part II) | $2,500 | In-person in Dallas, after written pass |
| Total Initial Fees | $4,900 | Excludes travel and prep materials |
The 11 Domains Employers Expect You to Master
Because CHS certification exists to verify clinical competence in congenital heart surgery, the content categories tested on Part I are effectively a map of what a congenital heart program expects a staff surgeon to handle independently. These are drawn from the ABTS 2025 Booklet of Information and treated as unweighted coverage categories - no single domain is disproportionately emphasized over another:
Domain 1: Septal Defects
Atrial and ventricular septal defect anatomy, physiology, and repair strategy - foundational cases in most congenital programs.
Domain 2: Anomalies of Venous Connection
Systemic and pulmonary venous return anomalies, including surgical planning for anomalous drainage.
Domain 3: Anomalies of the Aorta, Aortic Arch, and Coronary Arteries
Arch reconstruction and coronary anomaly management, often intersecting with other structural repairs.
Domain 4: Anomalies of the Tricuspid and Mitral Valves
Atrioventricular valve pathology distinct from full AV canal defects.
Domain 5: Anomalies of the Aortic Valve and Left Ventricular Outflow Tract
Left-sided obstructive lesions and valve-sparing versus replacement strategies.
Domain 6: Anomalies of the Pulmonary Valve and Right Ventricular Outflow Tract
Right-sided obstructive and regurgitant lesions, conduit selection and reintervention planning.
Domain 7: Conotruncal Anomalies
Tetralogy of Fallot, transposition physiology, and related outflow tract malalignment defects.
Domain 8: Anomalies of Atrioventricular Connection, Univentricular Heart, and Atrial/Visceral Situs
Single-ventricle pathways and heterotaxy-associated surgical planning.
Domain 9: Diseases of the Myocardium
Cardiomyopathies and myocardial disease processes relevant to surgical decision-making in children.
Domain 10: Pre-, Intra-, and Post-Operative Evaluation and Management
Perioperative decision-making across the full congenital cardiac disease spectrum.
Domain 11: Acquired Cardiovascular Diseases in Infants and Children
Non-congenital cardiovascular disease presenting in the pediatric population.
Program directors evaluating candidates - and candidates evaluating their own readiness - should treat this list as a checklist of operative and cognitive competence, not just an exam outline. A full walkthrough of how these categories interact and where candidates commonly underprepare is available in CHS Exam Domains 2026: Complete Guide to All 11 Content Areas.
Certification Pathway and Timeline
Understanding the pathway matters for career planning because it clarifies how long the "investment" period actually is before certification - and the earning trajectory it supports - is realized. Initial eligibility requires:
- Current primary ABTS certification
- Unrestricted medical licensure
- Qualifying thoracic and congenital cardiac surgery training
- Verified operative experience
- Program endorsement
Fellows starting their training on or after July 1, 2023 must complete two consecutive years in a single ACGME-accredited program and log at least 150 major congenital cases, with a minimum of 50 completed in the first year. This is a meaningfully structured requirement - it means the case-volume clock starts early and does not allow the two years to be split across programs. Full eligibility detail, including how program endorsement works, is covered in CHS Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Once eligible, candidates sit the written Part I exam, and only after passing move to the in-person oral Part II exam. ABTS reported 7 passes among 8 written examinees and 4 passes among 4 oral examinees in 2025 - small cohorts that should be read cautiously rather than as a stable predictor. For more context on how to interpret these numbers, see CHS Pass Rate 2026: What the Data Shows and How Hard Is the CHS Exam? Complete Difficulty Guide 2026.
Aligning Preparation With Career Payoff
Because the written exam must be passed before the oral exam is even scheduled, the highest-leverage use of preparation time is treating Part I as the gatekeeper it functionally is. Rather than studying all 11 domains with equal intensity in a generic rotation, map preparation weeks to where your own case exposure is thinnest - a surgeon with heavy conotruncal (Domain 7) experience from fellowship should weight study time toward domains like venous anomalies (Domain 2) or myocardial disease (Domain 9) where clinical reps are naturally fewer.
Anatomic Foundations
- Domains 1, 2, 3 - septal defects, venous anomalies, arch and coronary anatomy
Valve and Outflow Tract Pathology
- Domains 4, 5, 6 - AV valve, LVOT, and RVOT anomalies
Complex and Single-Ventricle Physiology
- Domains 7, 8 - conotruncal anomalies and univentricular pathways
Perioperative Management and Review
- Domains 9, 10, 11 plus full-spectrum practice questions
This kind of domain-anchored scheduling, rather than a generic study calendar, is covered in more depth in CHS Study Guide 2026: How to Pass on Your First Attempt. If you want a fast final-week reference once your content review is complete, the CHS Cheat Sheet 2026: One-Page Review of Must-Know Facts and practicing timed questions on our practice test platform can help confirm readiness before exam week. Understanding exactly what constitutes a passing performance also matters for pacing your review - see CHS Passing Score 2026: Exactly What You Need to Pass.
Continuing Certification and Long-Term Career Value
The earning trajectory tied to CHS certification isn't a one-time event - it depends on maintaining the credential over a career. Since January 2024, ABTS continuing certification uses non-time-limited certificates that remain valid conditional on compliance with five-year milestones, with existing time-limited certificates transitioning at their expiration date. Maintenance requirements include:
- Unrestricted licensure and active 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 structure means the certificate holder must remain actively practicing and educating throughout their career to retain the credential - which, in practical terms, keeps CHS-certified surgeons continuously eligible for the leadership and staff roles that depend on active certification status. For candidates still early in the process, understanding this full lifecycle - not just the initial exam - is part of deciding whether to pursue the credential at all; revisit Is the CHS Certification Worth It? Complete ROI Analysis 2026 for that fuller picture, and CHS Training for how fellowship structure feeds into this continuing-certification cycle.
Key Takeaway
CHS certification's career value compounds through continuous maintenance - non-time-limited status tied to five-year milestones - not through a single exam pass.
Frequently Asked Questions
No. ABTS publishes exam fees, eligibility requirements, and pass statistics, but does not publish salary or compensation data for congenital cardiac surgeons. Any specific salary figure you see elsewhere is not sourced from ABTS.
Initial ABTS fees total $4,900, covering a $650 application fee, $1,750 written exam fee, and $2,500 oral exam fee. This excludes travel to the Dallas oral exam and any preparation resources.
Yes. Eligibility requires current primary ABTS certification, unrestricted medical licensure, qualifying thoracic and congenital cardiac surgery training, verified operative experience, and program endorsement.
Written success (Part I) is a prerequisite for sitting the in-person oral examination (Part II). Candidates cannot schedule or attempt the oral exam until they have passed the written exam.
Since January 2024, ABTS uses non-time-limited certificates conditional on five-year milestone compliance, including CME credits, qualifying case activity, and a continuing-certification assessment - so it requires ongoing maintenance rather than a single pass/fail event.
Whatever your reason for researching CHS certification - career planning, program hiring decisions, or simply understanding what the credential represents - the underlying facts matter more than any unverified salary claim. For a broader orientation to the credential itself, start with What Is CHS? and CHS Certification, and when you're ready to test your domain knowledge directly, explore practice questions modeled on the ABTS content categories.