FLS is a comprehensive web-based education module that includes a hands-on skills training component and assessment tool designed to teach the physiology, fundamental knowledge, and technical skills required in basic laparoscopic surgery. The goal is to provide residents, fellows, and practicing physicians an opportunity to learn the fundamentals of laparoscopic surgery in a consistent, scientifically accepted format; and to test cognitive, surgical decision-making, and technical skills, all with the goal of improving the quality of patient care.
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is the non-profit organization that offers FLS. Visit the FLS website to download an order form to purchase the didactic access and testing voucher.
FLS includes a multimedia presentation of didactic content and “watch and do” exercises that focus on manual skills training. The content is available in a web-based format accessed online.
You must provide your FLS certificate to ABOG by either uploading the document directly to your ABOG portal or emailing it to residency@abog.org.
Download an order form on the FLS website and return it with payment by check or credit card.
For FLS pricing information, please access the order form on the FLS website.
A test voucher is the “admittance ticket” needed to take the FLS exam. Each voucher has a unique identification number and can be redeemed one time only. All test vouchers, including retest vouchers, have an expiration date printed on the upper right corner, and tests must be completed by this date. The test must be completed within 12 months of the voucher purchase. If the FLS test is not successfully completed, a “retest” voucher may be purchased within 18 months of the original exam date.
The exam includes two assessments: a computer-based multiple-choice cognitive assessment and a performance-based manual skills assessment consisting of five skills performed on the FLS Trainer Box. Those who successfully complete both components will have demonstrated the knowledge, judgement, and technical skills fundamental to the performance of basic laparoscopic skills.
The manual skills assessment consists of the five simulation exercises reflecting skills uniquely required in laparoscopic surgery such as ambidexterity, depth perception, hand-eye coordination and controlled movement of instruments, and efficacy of movement. The task performance is scored on both efficiency (time) and prevision (accuracy).
The cognitive assessment consists of multiple-choice questions, some of which include visuals and clinical scenarios. It is computer-based and designed to test the understanding and application of the fundamentals of laparoscopy with as much emphasis as possible on clinical judgement or intra-operative decision-making.
If you fail one or both parts of the assessment, you must retake whatever part was not completed successfully within 18 months of your original exam date. If one or both are still not passed after the first retake, then the participant must wait six months for the next retake (again, this must occur within 18 months of your original exam date). After three retakes or 18 months, a new registration process is required, and both assessments must be undertaken anew, even if one had been passed previously.
The didactic portion of FLS can be completed online. To take the examination, you must go to an FLS testing center. There are 85 testing centers throughout the United States and Canada. Over 70% of the current ACGME-accredited OB GYN programs are within one hour of a testing center. Find the testing center nearest you.
You will have 90 minutes to complete the multiple-choice cognitive assessment. The manual skills assessment includes five designated skills administered on the FLS Trainer Box and lasts approximately 30-45 minutes. Both are administered by a trained FLS proctor.
To practice the skills needed for the FLS examination, you will need to use an FLS Trainer Box or a different trainer box or simulator. FLS Trainer Boxes are available in many residency programs and institutions that have simulation centers.
All general surgeons who desire to become certified by the American Board of Surgery are required to take FLS prior to taking their QE. If there is a general surgery residency program at your hospital, it is very likely that the program or institution has a trainer box. If there is not a trainer box at your institution, one can be purchased here. Other laparoscopic skills trainer boxes can be used to practice and for formative feedback in training, but you must use the FLS Trainer Box and proctored examination to meet the ABOG requirement.
Anyone is eligible to review the curriculum, but the FLS certification is limited to medical residents, fellows, practicing general surgeons, obstetricians and gynecologists, urologists, surgical oncologists, and other physicians.
Scores will be emailed approximately three weeks after the testing date. For privacy reasons, scores will not be transmitted by telephone. Those who successfully complete both the educational and assessment components will also receive a certification of completion confirming that they have demonstrated the knowledge, judgement, and technical skills fundamental to the performance of basic laparoscopic surgery.
All FLS certificates expire 10 years from the date of issue.
For questions regarding OB GYN certification requirements, please email ABOG at residency@abog.org. For questions regarding the FLS curriculum or testing, please visit the FLS website or email fls@sages.org.