Primary Certification Part I (Written) Examination


The Part I (Written) Examination has been designed primarily to assess a candidate's cognitive skills. The content of the questions on this examination represents uniform coverage of all aspects of the thoracic surgery specialty, including general thoracic, adult cardiac, congenital cardiac, and cardiothoracic critical care. The diagnosis and treatment of both common and rare conditions will be assessed on this examination. The examination is chosen from among this broad list of topics.

Although the Board uses SESATS as a basis for its Maintenance of Certification (MOC) Exam, the Board does not consider it a primary reference guide for the Part I (Written) Exam. The Board encourages candidates to consider preparing for the Written Exam by using more formal reference materials, such as cardiothoracic textbooks, journals, and courses.

Exam Blueprint

This table provides the general subject topics and a range of their relative weight (based on the past several years) of the entire exam.

Category Components Overall Exam Composition Range %
Cardiac   ~50%
  Acquired Heart Disease  25-35% 
           Valvular heart disease   
           CAD w/other combined disease   
           Disease of great vessels, tumor,
          trauma, critical care 
  Congenital Heart Disease   5-10%
  General Management   10-20%
           Extracorp circulation/life support   
           Postop care/arrhythmia surgery  
General Thoracic*   ~50%
  Lung 20-30% 
  Trachea/Bronchi  3-10% 
  Pleura  5-10% 
  Mediastinum  5-10%

Esophagus  5-10%
  Chest Wall/Diaphragm  1-8% 
  *Each General Thoracic component will include questions examining:   
            Neoplasms: Benign & Malignant   
            Special Operative Techniques   
            Postop & Critical
            Non-Operative Management   

The exam is composed of 250 multiple-choice questions covering all areas of thoracic surgery. The questions consist of a brief statement, case history, possible graphic or picture, followed by a question and a list of possible answers.

The exam is given on a single day each year in an electronic format at Pearson Professional Testing Centers located throughout the United States. By using a computer-based format, candidates will have the opportunity to select the testing center in which they would like to take the exam. Please note that not every Pearson Testing Center is available on the day of the Written Exam. Candidates need to be flexible when selecting a testing center location.

The exam is given in two equal parts that last 2 hours, 45 minutes each, for a total of 5 1/2 hours. The Written Exam is given once a year to candidates whose applications have been approved. The exam is usually administered in late November or early December.


The exam results are mailed to the candidates approximately 6-12 weeks after the examination. No results are released over the phone, by email or via the Internet. 

2023 Written Exam Format Video


Part I (Written) Exam
The ABTS will be using the 8th edition of the American Joint Commission on Cancer TNM staging system.

2023 Written Exam Update

The American Board of Thoracic Surgery will be pretesting questions within the December 2023 Qualifying Exam (QE).  The questions will not be identifiable to the examinee.  These pilot questions will not be counted toward the examinees’ overall examination performance.  The purpose of pretesting these questions is to gather statistical data for the construction of future examinations. Sample pilot questions can be found HERE .

Pearson Testing Center

To learn more about the test taking experience at Pearson Testing Centers, please Click Here.