Pathway One

Subspecialty Certification for Candidates Trained on or After July 1, 2008

The factual knowledge and technical skills needed to treat patients with congenital cardiac conditions are developed in a Congenital Cardiac Surgery fellowship program that is approved by the Review Committee on Thoracic Surgery (RC-TS) and is accredited by the ACGME. The highest educational standards are best achieved in fellowship programs in which close supervision and instruction as well as progressive individual responsibility for operative and postoperative care are possible.

The ABTS realizes that a written examination primarily tests the acquired factual knowledge and the candidate’s ability to reason. However, the limitations of an examination as the only assessment of clinical competence are well recognized. Therefore, an important part of the responsibility for determining clinical competence rests upon the Program Director of each Congenital Cardiac Surgery fellowship. For this reason and others, only applicants who successfully complete an ACGME-accredited Congenital Cardiac Surgery fellowship program and are recommended by their training Program Director are considered for examination for the ABTS Congenital Cardiac Surgery Subspecialty. It is during the period of the fellowship program that the trainee’s judgment, technical skills, ability to cope with a wide variety of clinical problems, and ethical and moral character can be most accurately assessed. Thus, the endorsement of the candidate by the Program Director is required to complete eligibility for certification by the ABTS.

A current, valid, and compliant primary thoracic certification from the ABTS is required for all applicants for the Congenital Cardiac Surgery subspecialty certificate.

The required route to subspecialty certification in Congenital Cardiac Surgery is as follows: successful completion of an ACGME-accredited thoracic surgery residency, followed by successful completion of Congenital Cardiac Surgery fellowship training in an ACGME-accredited program, primary thoracic surgery certification by the ABTS, and successful completion of ABTS Congenital Cardiac Surgery Written (Part I) and Oral (Part II) examinations. The Congenital Cardiac Surgery examination process must begin within 2 years of successful congenital fellowship program completion or meet the additional requirements noted below. The Congenital Cardiac Surgery written and oral examinations are constructed and administered by the Board with consultation and assistance in developing the examinations, and in analyzing the results, obtained from content experts, psychometricians, and others. The validity and reliability of the examination process and content are scrutinized continually.

A candidate is eligible for Board Examination for Subspeciality Certification in Congenital Cardiac Surgery during the first 2 years following completion of a congenital ACGME-accredited training program. If the candidate has NOT achieved primary ABTS certification within the 2 years following completion of congenital cardiac surgery training, the individual must provide additional information regarding congenital cases performed and CME obtained between the completion of congenital training and the application for subspecialty certification before such application can be considered.

To enter the examination process, a candidate must apply by submitting an online application to the ABTS that includes the specifics of the Congenital Cardiac Surgery operative experience during the Congenital Cardiac Surgery fellowship and the attestation by signature of the Program Director indicating satisfactory performance and satisfactory completion of the Congenital Cardiac Surgery fellowship training. Eligible applicants must then submit to and achieve a passing score on both the Congenital written and oral examinations, acknowledging that the candidate possesses sufficient training, experience and judgment necessary for competence in Congenital Cardiac Surgery.

The procedures for establishing a candidate’s qualifications will be reviewed by the Board periodically and revised, when appropriate, in a continuing effort to provide public assurance that congenital cardiac surgeons granted a subspecialty certificate by the ABTS have been adequately trained and educated in, and are competent to, practice the specialty of Congenital Cardiac Surgery.

General Requirements

Subspecialty certification by the ABTS may be achieved for Congenital Cardiac Surgeons who began their training on or after July 1, 2008 by fulfillment of these requirements:

  1. Successful completion of an ACGME-accredited fellowship in Congenital Cardiac Surgery at a single institution.
  2. Operative case experience, verified by the Congenital Cardiac Surgery Program Director, to meet or exceed current minimum requirements shown on pages 10-12 and the Appendices in the 2025 Congenital Cardiac Surgery Booklet of Information.
  3. Entry into the Congenital Cardiac Surgery examination process within 2 years of successful completion of an ACGME-accredited congenital cardiac surgery program, or through the process listed on pages 13-16 in the 2025 Congenital Cardiac Surgery Booklet of Information.
  4. Current, valid primary thoracic surgery certification by the ABTS.
  5. Good standing with the ABTS, including current with Continuing Certification, annual dues, and all fees.
  6. 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.
  7. Ethical standing in the profession and a moral status in the community that are acceptable to the Board.

Congenital Cardiac Surgery Fellowship Program Requirements

Candidates must have fulfilled and successfully completed all of the fellowship training requirements of an ACGME-accredited Congenital Cardiac Surgery training program that are in force at the time that their Congenital Cardiac Surgery training program begins.

The fellowship Program Director must approve the application form certifying that the candidate has satisfactorily completed the fellowship in Congenital Cardiac Surgery, and must endorse each candidate’s qualifications by written evaluation. Supervisory Congenital Cardiac Surgery faculty are also required to provide written evaluation of the candidate.

Operative case logs required for application for certification by the ABTS must be entered in the ABTS format directly in the ABTS online application platform; ACGME logs do not satisfy this requirement. Applicants enter the required case logs directly into the ABTS system.

Candidates for subspecialty certification who started their Congenital Cardiac Surgery fellowship training prior to July 1, 2023, must have completed 12 consecutive months of Congenital Cardiac Surgery fellowship training in a single program accredited by the ACGME. The Operative Case Criteria for these applicants are listed in this Booklet.

Candidates for subspecialty certification who started their Congenital Cardiac Surgery fellowship training on or after July 1, 2023 must have completed 24 consecutive months of Congenital Cardiac Surgery fellowship training in a single program accredited by the ACGME. This is as mandated by the ACGME. The Operative Case Criteria for these applicants are listed in this Booklet.