Medical residents are exposed to increasing numbers of adults with congenital heart disease (ACHD). While inadequate ACHD knowledge may lead to inappropriate practice, this educational deficit has not been investigated. Our aim was to analyze residents' attitudes, perceived ability, and knowledge of ACHD medicine.A single center, multiprogram cross-sectional study was conducted in 2015 using an electronic survey to assess 472 medical residents' perceived knowledge and self-assessed skills related to ACHD medicine. Demographic data obtained included age, gender, level of training and program type.The survey was completed by 25% of surveyed residents (N = 116, median age 29.5 years, 39% male). Responses were received from Family Physician (FP; 8.5%), Internal Medicine (43%), Pediatrics (34%), Internal Medicine-Pediatrics (IM-P; 7%), and Transitional residents (4%). There was no difference between ACHD knowledge and year of residency (P = NS). IM-P residents were more confident in their knowledge and assessment of ACHD patients (P < .05). Those with prior cardiology elective during residency (59%) demonstrated a significant correlation with ACHD knowledge (P < .05) and confidence in ability to assess ACHD patients (P < .05). Overall, knowledge and confidence in ACHD assessment trended towards a positive correlation (P = .061, gamma statistic = 0.8). Residents' learning preferences included ACHD lectures (81.6%) and web sites (60.2%).Most residents in this study lacked ACHD knowledge or comfort level required to care for adults with complex defects. Still, residents remain interested in teaching venues to improve examination skills. Residency programs should include routine cardiology electives to prepare residents to care for this complex group of patients.