- What CHS Certification Actually Is
- Who Administers CHS and Why It Exists
- The Two-Part Certification Pathway
- The 11 Content Categories
- Eligibility Requirements
- Fees, Dates, and Logistics
- Who Pursues and Holds CHS Certification
- Building a CHS-Specific Study Plan
- Maintaining Certification After You Pass
- Frequently Asked Questions
- CHS is the American Board of Thoracic Surgery's Congenital Cardiac Surgery subspecialty certification, distinct from primary ABTS certification.
- Initial fees total $4,900 across application, written, and oral examination charges.
- Part I written exams now use three-answer-option multiple-choice questions, administered at Pearson Professional Testing Centers.
- Candidates must pass Part I before sitting the in-person Part II oral exam.
What CHS Certification Actually Is
CHS Certification refers to the American Board of Thoracic Surgery's Congenital Cardiac Surgery subspecialty certificate, sometimes labeled "Congenital Heart Surgery" on the ABTS website. It is a subspecialty credential layered on top of primary thoracic surgery certification, intended to formally recognize surgeons who have completed dedicated congenital heart surgery training and who operate on patients across the full spectrum of congenital cardiac disease, from neonates to adults with congenital lesions.
Because the acronym "CHS" is used by several unrelated credentials in other fields, it's worth being precise here: this article, and this entire site, is about the ABTS Congenital Cardiac Surgery certification only. If you landed here trying to confirm exactly what CHS is or what CHS stands for in this context, the short answer is that it is a surgical subspecialty board certification, not a general health or fitness credential.
Who Administers CHS and Why It Exists
The American Board of Thoracic Surgery administers CHS certification as part of its subspecialty offerings. Congenital cardiac surgery involves anatomy, physiology, and operative techniques distinct enough from adult acquired cardiac surgery that ABTS created a dedicated pathway to verify a surgeon's competence in this narrower, high-stakes domain. Holding primary ABTS certification is a prerequisite, not a substitute, for CHS.
For readers who want the plainest possible definition before diving into logistics, see What Is CHS Certification? or the related explainer on what CHS stands for. If terminology is your main question rather than exam mechanics, What Is A CHS? and What Does CHS Mean? cover that ground directly.
The Two-Part Certification Pathway
CHS certification is earned through two sequential components:
- Part I - Written Examination: A multiple-choice exam administered at Pearson Professional Testing Centers. Starting in 2025, questions use three answer options rather than the more common four or five, which changes both guessing strategy and how tightly distractors are written.
- Part II - Oral Examination: An in-person case-based oral exam. Candidates must pass Part I before they are eligible to sit for Part II, so the written exam functions as a gatekeeper for the oral component.
This sequencing matters for scheduling. A candidate cannot bank an oral exam date until the written result is confirmed, so preparation timelines typically treat the two parts as connected but staged efforts rather than simultaneous ones. Our CHS Study Guide 2026 walks through how to structure preparation across both stages, and CHS Exam Dates 2026 lays out the current testing windows in more detail.
Key Takeaway
Treat Part I as the higher-priority near-term goal - you cannot register for or benefit from oral-case rehearsal until the written exam is behind you.
The 11 Content Categories
CHS Part I content is organized into 11 categories that mirror the topics published in the ABTS Booklet of Information. These are unweighted - ABTS does not publish a percentage breakdown for how heavily each category is tested - so candidates should treat coverage as comprehensive rather than prioritized by point value.
Domain 1: Septal Defects
Covers atrial and ventricular septal defect anatomy, physiology, and repair strategies across age groups.
- Distinguishing defect types and their hemodynamic consequences
Domain 2: Anomalies of Venous Connection
Includes anomalous pulmonary and systemic venous return and their surgical correction.
- Recognizing variant venous drainage patterns on imaging and at the table
Domain 3: Anomalies of the Aorta, Aortic Arch, and Coronary Arteries
Spans coarctation, interrupted arch, and coronary anomalies relevant to congenital repair.
- Arch reconstruction technique selection
Domain 4: Anomalies of the Tricuspid and Mitral Valves
Addresses atrioventricular valve dysplasia, Ebstein's anomaly, and repair versus replacement decisions.
- Valve-sparing repair indications
Domain 5: Anomalies of the Aortic Valve and Left Ventricular Outflow Tract
Covers aortic stenosis, subaortic obstruction, and Ross procedure considerations.
- LVOT obstruction staging and intervention timing
Domain 6: Anomalies of the Pulmonary Valve and Right Ventricular Outflow Tract
Includes pulmonary stenosis/atresia and RVOT reconstruction options.
- Conduit choice and reintervention planning
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
Covers single-ventricle pathways, heterotaxy, and staged palliation.
- Fontan pathway sequencing and complications
Domain 9: Diseases of the Myocardium
Cardiomyopathies and myocardial disease relevant to pediatric surgical decision-making.
- Surgical versus medical management thresholds
Domain 10: Pre-, Intra-, and Post-Operative Evaluation and Management of Congenital Cardiac Disease
Perioperative care spanning workup through postoperative complications.
- Bypass strategy and postoperative hemodynamic management
Domain 11: Acquired Cardiovascular Diseases in Infants and Children
Non-congenital cardiac conditions that present in pediatric surgical practice.
- Differentiating acquired disease from congenital presentations
For a deeper breakdown of each area with study emphasis and cross-references, see the CHS Exam Domains 2026 guide.
Eligibility Requirements
ABTS restricts CHS eligibility to surgeons who already hold current primary ABTS certification and unrestricted medical licensure. Beyond that baseline, candidates must complete qualifying thoracic and congenital cardiac surgery training, accumulate verified operative experience, and secure endorsement from their training program.
A specific structural rule applies to newer trainees: fellows starting 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 cases required in the first year alone. This case-volume threshold is one of the more concrete gatekeeping mechanisms in the pathway, and it's worth mapping against your own case log well before applying.
Full detail on documentation, endorsement, and case-logging mechanics is covered in CHS Requirements 2026.
Fees, Dates, and Logistics
Initial CHS certification carries a total cost of $4,900, broken into three components:
| Fee Component | Amount |
|---|---|
| Application fee | $650 |
| Written examination (Part I) | $1,750 |
| Oral examination (Part II) | $2,500 |
| Total | $4,900 |
These figures exclude travel and preparation costs, which candidates should budget separately since the oral exam requires in-person attendance. For the 2026-2027 cycle, the written examination window is scheduled for December 7-11, 2026, and the corresponding oral examination will be held June 4-5, 2027 in Dallas. Part I is administered at Pearson Professional Testing Centers rather than at a single central location, which gives candidates some flexibility in choosing a test site.
A full pricing breakdown, including how these fees compare across the pathway stages, is available in CHS Certification Cost 2026, and the exact registration windows and deadlines are detailed in CHS Exam Dates 2026.
Who Pursues and Holds CHS Certification
CHS certification is pursued almost exclusively by cardiothoracic surgeons who intend to practice congenital heart surgery, typically after completing a dedicated congenital cardiac surgery fellowship. Because primary ABTS certification is a prerequisite, candidates are already board-certified thoracic surgeons before they even begin the CHS-specific eligibility process.
Academic congenital heart programs, children's hospitals, and combined pediatric-adult congenital heart centers are the primary employers looking for this credential, since it signals verified subspecialty training and operative volume beyond general cardiothoracic certification. If you're evaluating career impact rather than exam mechanics, CHS Jobs and CHS Salary Guide 2026 address hiring context and compensation considerations, while Is the CHS Certification Worth It? weighs the credential's value against the time and cost investment described above.
Building a CHS-Specific Study Plan
Generic exam-prep methodology only goes so far here - CHS candidates are experienced surgeons, not first-time test-takers, so the real preparation challenge is organizing 11 broad content categories into a schedule that fits around clinical duties. A practical approach is to block preparation time by domain cluster rather than by generic study techniques: group Domains 4 through 7 (valve and conotruncal anomalies) together since they share overlapping repair logic, and treat Domain 8 (univentricular pathways) as its own block given its staged, multi-decision-point nature.
Septal, Venous, and Arch Anomalies
- Review Domains 1-3 with emphasis on anatomy variants and repair selection
Valve and Outflow Tract Anomalies
- Work through Domains 4-6, comparing repair versus replacement decision criteria
Conotruncal and Single-Ventricle Pathways
- Focus on Domains 7-8, including staged palliation sequencing
Myocardial Disease and Perioperative Management
- Cover Domains 9-11 with attention to perioperative decision-making scenarios
Because Part I now uses three-answer-option questions, practice with materials that reflect this format matters more than it did under prior formats - narrower answer sets change how confidently you can eliminate distractors. Once Part I is behind you, shift preparation toward oral case presentation, since Part II tests judgment and communication under a different format than the written exam. Our practice test platform is built around this exact domain structure, letting you drill each content category before moving to the next cluster, and you can revisit weak areas using the same practice test platform as a diagnostic tool rather than a one-time review.
For candidates who want a condensed reference during final review, the CHS Cheat Sheet 2026 consolidates must-know facts across all 11 domains into a single page.
Maintaining Certification After You Pass
Earning CHS certification is not the end of the process. Since January 2024, ABTS continuing certification uses non-time-limited certificates that remain valid conditional on meeting five-year milestone requirements, with existing time-limited certificates transitioning to this model at expiration. Maintenance requirements include unrestricted licensure, hospital privileges, professional references, 150 Category 1 CME credits per five-year period (at least 75 of which must relate to thoracic surgery), qualifying congenital case activity, an online continuing-certification assessment, and patient-safety/improvement components.
This article intentionally focuses on the initial Part I and Part II pathway rather than the continuing-certification assessment, since the preparation approach, content emphasis, and stakes differ meaningfully between earning the credential and maintaining it.
Key Takeaway
Budget for ongoing CME and case-tracking obligations from day one - continuing certification is a five-year cycle, not a one-time renewal.
Frequently Asked Questions
No. CHS is a subspecialty certification that requires current primary ABTS certification as a prerequisite. It verifies additional training and operative experience specific to congenital cardiac surgery.
Part I (written) must be passed before a candidate is eligible for Part II (oral). The written exam is administered at Pearson Professional Testing Centers, while the oral exam is held in person.
Initial certification totals $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 preparation expenses.
Yes. Fellows starting on or after July 1, 2023 need two consecutive years in one ACGME-accredited program and at least 150 major congenital cases, with a minimum of 50 in the first year.
Since January 2024, continuing certification uses non-time-limited certificates that remain valid as long as five-year milestone requirements, including CME credits and case activity, are met.