- What Does CHS Stand For?
- Who Administers CHS and Where It Fits
- The 11 CHS Exam Domains
- How the CHS Exam Is Structured
- CHS Fees and Registration Mechanics
- Eligibility and Training Requirements
- Upcoming CHS Exam Dates
- What the Pass Numbers Show
- Who Pursues CHS Certification
- Mapping Preparation to the Domains
- Frequently Asked Questions
- CHS stands for Certification in Congenital Cardiac Surgery, administered by the American Board of Thoracic Surgery (ABTS).
- Total initial fees are $4,900: $650 application, $1,750 written, $2,500 oral, excluding travel.
- Part I written questions moved to a three-option multiple-choice format starting in 2025.
- The 2026 written window runs December 7-11, 2026, with the oral exam June 4-5, 2027 in Dallas.
What Does CHS Stand For?
In the world of thoracic surgery credentialing, CHS stands for Certification in Congenital Cardiac Surgery (sometimes written as "Congenital Heart Surgery" on the certifying board's own site). It is the subspecialty certification offered by the American Board of Thoracic Surgery (ABTS) for surgeons who focus specifically on operating on children and adults with congenital heart disease. This is not a general cardiac surgery credential, and it is not related to any other certification that happens to share the same three letters in a different field. If you have landed on this page after seeing "CHS" used elsewhere, it is worth double-checking which credential you actually mean - for a full breakdown of the terminology, see CHS Meaning and What Is CHS?.
CHS sits on top of an already-completed general thoracic surgery certification. In other words, a surgeon does not walk into CHS as a first credential - it is layered onto an existing ABTS primary certification, after additional congenital-specific fellowship training and case experience. That distinction matters enormously for anyone trying to understand what the letters actually represent: CHS is a subspecialty mark of advanced, focused expertise, not an entry-level surgical license.
Who Administers CHS and Where It Fits
The American Board of Thoracic Surgery is the sole certifying body for CHS. It is the same organization responsible for general thoracic surgery certification, and CHS functions as one of its defined subspecialty pathways. Candidates must already hold current primary ABTS certification before they are eligible to sit for CHS - the subspecialty is built explicitly on top of that foundation, not as a replacement for it.
Within the certification pathway, CHS has two components that candidates need to prepare for in sequence:
- Part I (written examination): A multiple-choice exam administered at Pearson Professional Testing Centers.
- Part II (oral examination): An in-person case-based oral exam that can only be attempted after passing the written portion.
This article focuses on what CHS means and how the credential is structured for initial certification - not on the separate continuing-certification assessment that certified surgeons complete later in their careers to maintain their credential. If you are trying to understand the full certification journey end to end, CHS Certification and What Is CHS Certification? walk through the broader pathway in more detail.
The 11 CHS Exam Domains
The content of the CHS written exam is organized around eleven congenital cardiac surgery topic areas. These categories are reproduced from the ABTS Booklet of Information and function as unweighted coverage areas - meaning candidates should not assume any one domain carries more exam weight than another, and should instead prepare broadly across all eleven.
Domain 1: Septal Defects
Covers atrial and ventricular septal defect anatomy, physiology, and surgical repair strategies across age groups.
- Timing and technique of closure
- Associated lesions and hemodynamic consequences
Domain 2: Anomalies of Venous Connection
Focuses on anomalous pulmonary and systemic venous return and their surgical correction.
- Partial vs. total anomalous pulmonary venous connection
- Sinus venosus defects and baffle techniques
Domain 3: Anomalies of the Aorta, Aortic Arch, and Coronary Arteries
Encompasses arch obstruction, interrupted arch, and coronary anomalies requiring surgical management.
- Coarctation repair approaches
- Anomalous coronary origin and reimplantation
Domain 4: Anomalies of the Tricuspid and Mitral Valves
Tests knowledge of atrioventricular valve dysplasia, regurgitation, and repair versus replacement decision-making.
Domain 5: Anomalies of the Aortic Valve and Left Ventricular Outflow Tract
Covers left-sided obstructive lesions including subaortic stenosis and aortic valve disease.
Domain 6: Anomalies of the Pulmonary Valve and Right Ventricular Outflow Tract
Addresses right-sided obstructive disease and outflow tract reconstruction options.
Domain 7: Conotruncal Anomalies
Includes tetralogy of Fallot, transposition, and truncus arteriosus repair strategies.
Domain 8: Anomalies of Atrioventricular Connection, Univentricular Heart, and Atrial/Visceral Situs
Covers single-ventricle pathways, heterotaxy, and staged palliation.
Domain 9: Diseases of the Myocardium
Focuses on cardiomyopathy and myocardial disease relevant to surgical decision-making in children.
Domain 10: Pre-, Intra-, and Post-Operative Evaluation and Management of Congenital Cardiac Disease
Tests perioperative judgment across the full care continuum, not just operative technique.
Domain 11: Acquired Cardiovascular Diseases in Infants and Children
Covers non-congenital cardiovascular disease processes that present in pediatric patients.
For a deeper, standalone breakdown of each domain with study emphasis, see the CHS Exam Domains 2026: Complete Guide to All 11 Content Areas.
How the CHS Exam Is Structured
Understanding what CHS "means" also means understanding how the exam actually tests candidates. Part I is a written, multiple-choice examination delivered at Pearson Professional Testing Centers. A key format detail for anyone preparing: beginning in 2025, written questions use three answer options rather than the traditional four or five. That narrower option set changes how distractors are written and how quickly a well-prepared candidate can move through the exam, which is worth building into your practice strategy.
Passing Part I is mandatory before a candidate is permitted to sit for Part II, the in-person oral examination. The oral format shifts from recognition-based multiple choice to case-based discussion, where candidates are expected to talk through diagnosis, operative planning, and management decisions the way they would with a colleague in a real clinical scenario.
Key Takeaway
Because the three-option format is a recent change, older practice materials written for four- or five-option questions may not reflect current exam mechanics - verify that any prep resource accounts for the 2025 format update.
For a detailed look at how tough this two-part structure is in practice, and how the written and oral components compare in difficulty, see How Hard Is the CHS Exam? Complete Difficulty Guide 2026. And if you want a clear target for how the exam is scored and what "passing" actually requires, CHS Passing Score 2026: Exactly What You Need to Pass covers that specifically.
CHS Fees and Registration Mechanics
Initial CHS certification carries a total cost of $4,900, broken into three separate payments tied to the stages of the process:
| Fee Component | Amount |
|---|---|
| Application fee | $650 |
| Written examination (Part I) | $1,750 |
| Oral examination (Part II) | $2,500 |
| Total | $4,900 |
This total does not include travel, lodging, or preparation materials - the oral exam is held in person, so candidates should budget separately for getting to and staying in the host city. For a full cost breakdown, including how to plan around these payments, see CHS Certification Cost 2026: Complete Pricing Breakdown.
Eligibility and Training Requirements
CHS eligibility is not open to any thoracic surgeon. Initial eligibility requires:
- Current primary ABTS certification
- Unrestricted medical licensure
- Qualifying thoracic and congenital cardiac surgery training
- Verified operative experience
- Formal program endorsement
Training requirements were formalized further for newer trainees: fellows who began their programs 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 at least 50 of those cases required in the first year alone. This structure is designed to ensure a concentrated, continuous immersion in congenital case volume rather than a fragmented or interrupted training path.
For the complete eligibility checklist, including how program endorsement and case logging typically work in practice, see CHS Requirements 2026: Eligibility, Prerequisites & How to Qualify, and for how fellowship programs prepare candidates for these thresholds, CHS Training covers the training side specifically.
Upcoming CHS Exam Dates
Exam scheduling for CHS follows a fixed annual cadence set by ABTS. The written window for 2026 is scheduled for December 7-11, 2026, administered at Pearson Professional Testing Centers. Candidates who pass that written window then move to the corresponding oral examination, scheduled for June 4-5, 2027 in Dallas.
That roughly six-month gap between the written pass and the oral exam is significant for planning purposes - it gives successful written candidates time to shift their preparation from broad domain recall toward case-based oral reasoning. For the full current calendar and registration deadlines, see CHS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
What the Pass Numbers Show
ABTS reports small examinee cohorts for CHS, which is expected given how specialized the credential is. In 2025, 7 of 8 written examinees passed, and 4 of 4 oral examinees passed. These numbers should be read cautiously - with cohorts this small, a single additional pass or fail shifts the percentage dramatically, so year-to-year comparisons are not statistically reliable in the way they might be for a high-volume exam.
Key Takeaway
Small cohort sizes mean CHS pass numbers should be treated as directional context, not a precise predictor of individual outcomes - preparation quality matters more than population-level statistics here.
For more context on how these numbers have been reported over time and what they do and don't tell candidates about difficulty, see CHS Pass Rate 2026: What the Data Shows.
Who Pursues CHS Certification
CHS is pursued by surgeons who have already completed general thoracic surgery training and certification and who intend to practice specifically as congenital cardiac surgeons - operating on infants, children, and adult congenital patients rather than a general adult cardiac caseload. This typically means surgeons working in dedicated pediatric heart centers or academic congenital programs where case volume and program endorsement requirements can realistically be met.
Because the credential signals a narrow, high-stakes surgical focus, it tends to matter most to hiring committees and program leadership at congenital heart centers rather than to general cardiothoracic recruiters. If you're weighing whether pursuing CHS makes sense for your career trajectory, Is the CHS Certification Worth It? Complete ROI Analysis 2026 and CHS Salary Guide 2026: Complete Earnings Analysis look at that question in more depth, and CHS Jobs covers where the credential tends to open doors.
Mapping Preparation to the Domains
Because the eleven CHS domains are unweighted, an efficient study plan spreads attention across all of them rather than betting heavily on a subset. A simple way to structure early preparation is to pair anatomically related domains in the same study block - for example, reviewing Domain 5 (Aortic Valve and LVOT) alongside Domain 6 (Pulmonary Valve and RVOT) since outflow tract reasoning transfers between the two, then moving to Domain 7 (Conotruncal Anomalies) once outflow tract fundamentals are solid.
Foundational Anatomy
- Domain 1: Septal Defects
- Domain 2: Anomalies of Venous Connection
Outflow and Vascular Anomalies
- Domain 3: Aorta, Arch, and Coronary Arteries
- Domain 5 and Domain 6: Left and right outflow tracts
Complex Anatomy
- Domain 7: Conotruncal Anomalies
- Domain 8: AV Connection, Univentricular Heart, Situs
Valves, Myocardium, and Perioperative Care
- Domain 4: Tricuspid and Mitral Valves
- Domain 9, 10, 11: Myocardial disease, perioperative management, acquired disease
Practicing with exam-style questions before test day is one of the most reliable ways to get comfortable with the three-option format and the pacing it demands. You can work through domain-organized practice questions modeled on the current CHS structure at CHS Exam Prep, and return to the main practice test hub as you cycle through each domain in your study plan.
Frequently Asked Questions
CHS stands for Certification in Congenital Cardiac Surgery, a subspecialty credential offered by the American Board of Thoracic Surgery for surgeons who focus on congenital heart disease.
No. CHS is a subspecialty layered on top of an existing primary ABTS certification and requires dedicated congenital fellowship training, not a standalone general certification.
Initial certification totals $4,900, split into a $650 application fee, a $1,750 written exam fee, and a $2,500 oral exam fee, not including travel costs.
The written Part I is given at Pearson Professional Testing Centers, with the 2026 window set for December 7-11, 2026. The Part II oral exam follows in person, with the corresponding 2027 sitting scheduled for June 4-5 in Dallas.
Yes. Written success on Part I is required before a candidate is permitted to sit for the in-person Part II oral examination.