Certified Cardiovascular Knowledge Examination

Welcome to the Certified Cardiovascular Knowledge Examination Resource Page!

Taking the December 4 – 5 CCKE?
If you are taking the exam and have a question,
use the live chat icon for assistance. Live Chat Icon To Look For For additional questions, email CCKE@acc.org.

Prepare for the exam using resources and tools in the Exam Hub.

Applications accepted for May 7 – 8, 2023 CCKE on December 15, 2022.

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
December 4 – 5, 2022 November 1, 2022
May 7 – 8, 2023 March 2023*

*exact dates TBD

Application fee $25
Exam Registration Fee
Member $335
Nonmember $420
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 fail an exam and wish to take it a second time, you must pay a second exam registration fee.

The Certified Cardiovascular Knowledge Examination 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. Seven hours are allocated for the exam: 5 hours to answer questions and 2 hours for breaks. The 2022 CCKE Exam will open open on December 4 and close on December 5. You may take the exam within that window of time.

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.
  • This exam is open book. You may use any resource except another person.
  • The devices and browsers outlined in the table below:
  Do Use Do NOT Use
Device Laptop
Browser Chrome
Internet Explorer

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 146 multiple-choice questions covering the field of cardiovascular disease. The exam will take up to 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 hours to complete it (5 exam sessions of up to one hour each, plus 2 hours to take breaks between exam sessions).
  • 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 carefully developed, measured and evaluated by subject matter experts and psychometricians to ensure that each examination provides reliable estimates of proficiency.

Prior to the examination, questions are written by cardiovascular subject matter experts trained in effective question writing. The questions are reviewed multiple times to assess clinical accuracy and relevance. The questions selected for inclusion on the examination must be of good quality, meet statistical properties and have acceptable levels of difficulty.

Following an exam administration, questions are evaluated again based on their statistical properties. If any question fails to correlate with examinee performance or if any incorrect multiple-choice options were selected by a substantial group of examinees, the questions are evaluated by a committee. In some cases, such questions may be removed from consideration for final scoring if, after careful consideration, they are deemed flawed or inappropriate. The final scoring of the exam is based on the number of questions and correct answers that have been accepted as suitable.

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 is estimated using internal consistency methods such as Cronbach's alpha. High levels of internal consistency indicate that a physician's performance on the examination would generalize well to cardiovascular medicine, that the test is of sufficient length, and that the test is generally free of technical flaws. Reliability also allows for the reporting of confidence intervals for interpretation of an individual score.

Candidate Score

Candidate scores are determined by the number of questions answered correctly. While ACC strongly recommends that candidates attempt to answer every question, failure to complete every question does not immediately imply failure of 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. First, the standard-setting study is performed by panels of cardiovascular subject matter experts using the modified Angoff. Panelists carefully review each exam 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 established difficulty ratings for each exam question. Subsequently, 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.

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.

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

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

The passing score will vary from year to year based on the relative difficulty of the questions on the test. Each year's passing score will be published in that year's Score Report.

ACC will release pass/fail information and score reports 2-3 months after the exam.

* 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.