Certified Cardiovascular Knowledge Examination

Welcome to the Certified Cardiovascular Knowledge Examination (CCKE) Information Page!

Thanks to everyone who completed the May CCKE!
Score reports will be available in 2 – 3 months and will be delivered via the Exam HUB.

Congratulations to the physicians who successfully completed ACC's December 2022 exam!

Applications for the December 2023 CCKE will be accepted on Monday, June 12.

Demonstrate your clinical knowledge and commitment to cardiovascular excellence by taking and passing ACC's Certified Cardiovascular Knowledge Examination (CCKE). Open to physicians practicing outside the U.S., successful participation allows you to:

  • Validate your clinical knowledge
  • Uphold standards of excellence in patient care
  • Achieve global recognition
  • Gain competitive advantage and elevate your status in the field
  • Demonstrate your commitment to optimizing cardiovascular care and outcomes
  • Increase professional accomplishments for career advancement & enhance professional reputation
  • Earn credit towards your path to becoming an FACC

Click the arrows below to learn more about the exam.

Applicants must be licensed physicians qualified to practice CV medicine within countries outside the United States. Applicants must also have completed training equivalent to:

  1. Graduation from medical school, and
  2. Successful completion of a training program that allows them to practice CV medicine.

ACC recognizes that training pathways and practice patterns differ greatly around the world. Applicants whose training and experience do not fit into the above criteria, but who nonetheless feel that they are qualified to take the examination, may notify ACC via email at ccke@acc.org explaining their training and experience. Such applications will be formally reviewed by ACC leadership.

Individuals who pass the Certified Cardiovascular Knowledge Examination will be listed on ACC's website for a minimum of three years. After that, they will need to demonstrate continuous competency to continue to be listed. Details will roll out over the next few years.

  1. Validate your eligibility for participation in the Program by reviewing the list above.
  2. Apply for the Program online and submit proof of eligibility. You'll learn if your application has been accepted in approximately 4 weeks.
  3. Prepare for your exam.
  4. Verify that your system is compatible with ACC's exam delivery system by taking a brief practice test.
  5. Take the exam.
  6. Learn your score 2 – 3 months after the exam.
  7. Celebrate your success!

This exam will be offered twice a year:

Exam Date Application Deadline
May 7 - 8, 2023 April 10, 2023
December 2023* October 2023*

*exact dates TBD

What Do I Need to Submit When I Apply For the CCKE?
Application fee $25
Exam Registration Fee
Member $335
Nonmember $420

The CCKE is administered online twice a year during a two-day testing window. The exam may be taken from your home or office; there is no need to travel to a testing center. More than 7.5 hours are allocated for the exam: there are 30 questions with three minutes per question. There are five sections and you are allotted 24 hours of break time which can be taken between sections. The 2023 CCKE will open on May 7 and close on May 8. This is a global exam so the exam window for testing is 66 hours to ensure all time zones are open on May 7 – 8, 2023.

To take the CCKE, you must have:

  • A private space that is free from disruptions for the time allotted for the assessment.
  • Reliable internet access.
  • The devices and browsers outlined in the table below:
  Do Use Do NOT Use
Device Laptop
Browser Chrome

This exam is administered in English.

This exam covers the field of cardiovascular medicine. The list below shows the specific topics that are covered and their relative weight on the exam:

Arrhythmias 15%
Coronary Artery Disease 12%
Acute Coronary Syndromes 11%
Valvular Disorders 15%
Congenital Disorders 5%
Pericardial Disorders 4%
Aorta/Peripheral Vascular Disease 6%
Hypertension/Pulmonary Disorders 12%
Systemic Disorders Affecting the Circulatory System 3%
Heart Failure 17%

This exam is designed to evaluate your knowledge and clinical judgment in areas where a cardiovascular specialist should demonstrate a high level of competency. The majority of questions are based on patient scenarios. Exam questions are designed to require you to draw from a variety of sources to reach the correct conclusion, including training, education, practical experience in the health care environment, as well as textbooks and scholarly journal articles. Some questions involve interpretation of images.

Overview of the Exam

  • The Certified Cardiovascular Knowledge Examination consists of 150 multiple-choice questions covering the field of cardiovascular disease. You have up to 7.5 hours to answer the exam questions. Many examinees finish the exam in 4 – 5 hours.
  • All questions are designed to test your clinical judgment with patient vignettes.
  • Once you start the exam, you will have a total of 7.5 hours to answer questions. The CCKE has 5 sections that consist of 30 questions. You have 3 minutes per question or 1.5 hours per section. You are allocated 24 hours of break time that can be taken between the exam sections.
  • The exam is delivered online so you can take it from your home or office; you do not need to visit a testing center.

The Certified Cardiovascular Knowledge Examination is developed, evaluated and approved by subject matter experts and psychometricians to ensure that each examination provides a reliable estimate of proficiency.

Prior to the examination, questions are written by cardiovascular subject matter experts trained in effective question writing. The questions undergo a rigorous review process to ensure that each question is fair, clinically accurate, and culturally relevant. The questions selected for inclusion on the examination must be of good quality and meet statistical and content specifications.

Following each exam administration, questions are evaluated based on their statistical properties. Questions that do not meet statistical criteria are reviewed by a committee prior to scoring the exam. Any question deemed as flawed or inappropriate is removed from scoring. The final scoring of the exam is based on the number of questions and correct answers that have been accepted as suitable.

Candidate Score

Candidate scores are determined by the number-correct formula where a correct response will count as one and an incorrect response will count as zero.

While ACC strongly recommends that candidates attempt to answer every question, failure to complete every question does not immediately imply you will not pass the exam and there is no penalty for guessing.

Passing Score

The passing score is determined based on the results of a content-based standard-setting study process along with a review and approval of the recommended passing score by ACC's Board of Continuous Cardiovascular Competence.

The standard-setting study is conducted by cardiovascular subject matter experts invited by ACC to participate as a standard setting panelist. Panelists are representative of physicians outside of the U.S. and reflect diversity in age, geographic location, and years of experience. All panelists must spend at least 50% of their clinical time in direct patient care.

ACC uses the standard setting method known as the modified-Angoff. Selected panelists review each question to determine the basic level of knowledge or skill that is expected. Under the guidance of a psychometrician, the recommended passing score is based on the panel's estimated difficulty ratings for each exam question. The recommended passing score from the standard-setting study is then reviewed and approved by ACC's Board of Continuous Cardiovascular Competence. The passing score for the exam represents the minimum score needed to identify individuals with an acceptable level of knowledge and skill.

Passing the Exam

The CCKE is a criterion-referenced test meaning that exam outcomes are a result of comparing a candidate's score to the passing score standard. If the candidate's score is equal to or higher than the passing score, then the candidate has passed the exam. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

Score Report

A score report showing the candidate's score and the passing score will be available 2-3 months after the examination test window. ACC will notify candidates by email when scores are available.

Reliability is the extent to which the CCKE accurately measures the core components of cardiovascular medicine. The reliability of the examination can be affected by the uniformity of the questions, the length of the test, as well as the quality of questions. The reliability of the CCKE will be estimated using internal consistency methods such as Cronbach's alpha once we have gathered sufficient data.

ACC is committed to helping you on your knowledge certification journey and offers an outstanding resource to help you prepare.

ACCSAP, ACC's Adult Clinical Cardiology Self-Assessment Program, covers the entire field of cardiovascular medicine and is used by cardiologists in the U.S. to prepare for their initial certification or maintenance of certification exams. With ACCSAP, you can:

  • Perfect your knowledge of CV medicine. Use ACCSAP to identify your knowledge gaps, reinforce your existing knowledge, and learn new information.
  • Prepare for the Exams Covering the Field of CV Medicine. ACCSAP has everything you need to:
    • Practice with hundreds of exam-style questions that include rationale, references, and links to related text
    • Learn from educational text and lectures
    • Simulate taking a certification exam
    • Identify your knowledge gaps so you can plan additional study.

Click here to learn more.

Additional FAQs

The American College of Cardiology provides reasonable accommodations to examinees with documented needs for special accommodation. Examinees wishing to request accommodation should submit a completed request form and supporting documentation at least 60 days prior to the exam date. Submit requests to ccke@acc.org.

For more information, click here.

Your exam fee covers the cost of one exam; if you take the exam a second time, you will need to pay a second fee.

You may take the exam multiple times, but not consecutively. If you take the December 2022 exam and do not pass, then you must skip the Spring 2023 exam and try again the following Fall. If you take the May 2023 exam and do not pass, then you must skip the Fall 2023 exam and try the following Spring.

Pricing/Refund Policy/Cancellation Policy

Application fee: $25

Exam registration fee:

  • Member: $335
  • Nonmember: $420
  • The CCKE application fee of $25 is nonrefundable.
  • The CCKE exam registration fee is refundable if you request a refund at least 30 days prior to the exam.
  • The exam registration fee allows you to take one (1) CCKE exam. If you do not pass an exam and wish to take it a second time, you must pay a second exam registration fee.

ACC will release pass/did not pass information and score reports 2 – 3 months after the exam.

The passing score is determined based on the results of a content-based standard-setting study along with a review and final approval by ACC's Certification Governance Work Group.

* A passing score on the Certified Cardiovascular Knowledge Examination (the "Program") solely demonstrates that a medical professional has met the particular standards and criteria of the Program. Neither the American College of Cardiology Foundation, nor the Program itself, guarantees or warrants anything beyond a medical professional's ability to meet such standards or criteria. A passing score is not a license to practice medicine, nor is it a substitute for formal medical training. The American College of Cardiology Foundation makes no representations, warranties, or guarantees as to, and has and assumes no responsibility for the proper performance of medical services or care provided by those individuals who achieve a passing score under the Program.