PATHWAY TWO: SUBSPECIALTY CERTIFICATION FOR CANDI­DATES TRAINED PRIOR TO JULY 1, 2008

Admission to the ABTS Congenital Heart Surgery subspecialty certification process for those whose training began prior to July 1, 2008 is based on train­ing and current experience, case volume and distrib­ution, primary ABTS Board certification, contribu­tions to the specialty and professional accomplishments, duration of active participation in a congenital heart surgery-related field, and partici­pation in continuing medical education. Applicants are expected to conform to and maintain high moral and ethical standards.

GENERAL REQUIREMENTS

Subspecialty certification in congenital heart surgery by the ABTS may be achieved for surgeons who began congenital heart surgery training prior to July 1, 2008 by fulfillment of these requirements. The candidate must:

1. Apply, become approved, and sit for written examination by no later than 2012.

2.  Have achieved primary certification by the ABTS and be in current good standing with a valid certificate and current with the annual certification maintenance fee.

3.  Hold a currently registered, full and unrestricted license to practice medicine granted by a state or other United States jurisdiction. The license must be valid at the time of application for admission to examination and maintained until the Subspe­cialty Certificate is granted by the ABTS. A tem­porary and/or limited license such as an educa­tional, institutional, or house staff permit is not acceptable to the Board.

4.  Hold full and unrestricted inpatient hospital admit­ting, inpatient care, and consultative privileges in congenital heart surgery at an institution accred­ited by the JCAHO or other organization judged acceptable by the ABTS.

5.  Meet the operative case criteria volume and distri­bution described in the Booklet of Information during each of the 2 years preceding application, not including cases performed during residency training.

6.  Provide evidence of continuing medical education (CME), including the accumulation of at least 30 hours of Accreditation Council for Continuing Medical Education (ACCME)-approved Category I CME during each of the 2 years as an attending physician immediately preceding the application. At least 15 of the 30 hours each year must be in the broad category of congenital heart surgery.

7.  Provide evidence of significant contribution to the profession of congenital heart surgery, which may include affirmation from the community that the applicant is recognized as a specialist and con­sultant in a congenital heart surgery-related disci­pline, congenital heart surgical service in a med­ically underserved area, or service to the American Heart Association in an area of congen­ital heart surgery.

8.  Possess an ethical standing in the profession and a moral status in the community that are accept­able to the Board.

9.  Pass a closed-book, secure, written examination.

Candidates with special circumstances should include a letter of full explanation with their applica­tion for review by the ABTS Credentials Committee.

After August 15, 2012, all candidates for subspe­cialty certification in congenital heart surgery by the ABTS will be required to have successfully com­pleted an ACGME-approved residency training pro­gram in congenital heart surgery that began on or after July 1, 2008.

OPERATIVE CASE CRITERIA

A broad education and adequate operative expe­rience in congenital heart surgery are essential, irre­spective of the area of congenital heart surgery in which a candidate may choose to practice. The operative experience requirement of the ABTS has two parts. One is concerned with the intensity or volume of cases, and the other with the distribution of cases (index cases).

1. Surgical Volume (Intensity)

The Board’s operative experience requirements include 75 major congenital heart operative proce­dures performed as an attending, primary surgeon during each of the 2 years immediately preceding the application. The operative procedures performed during training will not apply. Teaching faculty for thoracic surgery and/or congenital heart surgery resi­dency training programs can count “teaching” pro­cedures for which they are the primary physician only when actively taking a resident or fellow through the procedure.

The application of any candidate whose operative experience fails to meet the requirement of 75 major congenital heart operations per year as primary sur­geon will be referred to the Board’s Credentials Committee for review.

2. Index Cases (Distribution) Index Cases are full credit, primary surgeon cases only.

The application of a candidate whose operative experience does not include the required number of Index Cases as listed below will be sent to the Cre­dentials Committee for review. The ABTS Creden­tials Committee is authorized by the Board to reject a candidate if the operative experience is considered to be inadequate in volume and/or intensity depth and/or breadth. The number of index cases required to meet the minimal acceptable standards in the vari­ous areas are:

Index Cases

Operative experience must include a minimum of 75 major congenital cases in each of 2 years and must reflect depth and breadth in the scope of prac­tice. In order to ensure an appropriately diverse dis­tribution of cases, the applicant’s case log cannot exceed a maximum of the specified number for the following cases in each year: 

5   Secundum Atrial Septal Defect/Patent Foramen Ovale closure

5   Patent Ductus Arteriosus ligation or division

5   Pulmonary Artery banding 10 Right Ventricle-to-Pulmonary Artery Conduit insertion/replacement; Pulmonary Valve replace­ment

5  Other valve repair or replacement (patients 18 years of age or under, only) 

EXAMINATION

The written examination is designed primarily to assess cognitive skills. The content of the questions on this examination represents uniform coverage of all aspects of the congenital heart surgery specialty. Candidates who began training prior to July 1, 2008 should apply, achieve an approved application, and sit for examination no later than 2012. Candidates who began training prior to July 1, 2008 and who successfully pass the ABTS written examination for Congenital Heart Surgery will not be required to take an oral examination. Applications for candidates who began training prior to July 1, 2008 will not be accepted after August 15, 2012.

Candidates must request an application in writing to the Board office. Specific formatting is required for operative case log reporting. Applications must be postmarked no later than August 15. No applica­tion will be considered for the current year when postmarked after August 15.

After a candidate’s application is approved and the candidate is declared eligible for the written examination, he or she must pass the examination within four (4) years. Candidates who fail an exami­nation may be eligible to take the examination the following year.

Candidates who fail the examination 3 times, or who do not pass the examination within the allotted time period, will be required to complete an addi­tional congenital heart surgery educational program, which must be approved in advance by the Board, before they will be permitted to retake the examina­tion. The required additional training must be com­pleted within the succeeding two (2) year period after losing eligibility for the written examination. Candi­dates who complete the required additional training must have their eligibility for examination reviewed by the Executive Director and/or the Credentials Com­mittee of the Board. Candidates will be given two more opportunities to pass the examination within the succeeding two years.

Candidates who fail the examination a fifth time will be required to complete an approved, full con­genital heart surgery residency before they will be eli­gible to re-apply for examination by the Board.

FEES

2010 Registration fee (not transferable or refundable) ...........$   475

2010 Part I (Written) Examination fee..................................$1,500

No applications will be accepted after August 15 each year. Candidates who do not appear for their sched­uled examination or who cancel less than 60 days prior to the examination may forfeit their examination fee.

The Board is a non-profit corporation, and the fees from candidates are used solely to defray actual expenses incurred in conducting examinations and carrying out the business of the Board. The Direc­tors of the Board serve without remuneration.