Trends and results of the first 5 years of Fundamentals of Laparoscopic Surgery (FLS) certification testing

Allan Okrainec, Nathaniel J. Soper, Lee L. Swanstrom, Gerald M. Fried

Research output: Contribution to journalArticlepeer-review

88 Scopus citations


FLS is an educational program developed by the Society of American Gastrointestinal and Endoscopic Surgeons and endorsed by the American College of Surgeons. The goal of the FLS program is to teach and assess the basic cognitive and psychomotor skills required to perform laparoscopic surgery. The purpose of this study is to review the results from the first 5 years of FLS certification testing. Methods: FLS test data were prospectively collected for all participants taking the FLS certification examination since its inception. Deidentified data were reviewed and analyzed using standard descriptive statistics. Results: The FLS examination was taken by 2,689 participants between October 2004 and December 2009. There was a yearly increase in the number of individuals seeking FLS certification. Complete demographic information was available for 1,882 participants: 12% were junior residents (PGY 1-3), 69% were senior residents (PGY 4-5) or fellows, and 19% were attending surgeons. A breakdown of participants by specialty revealed that 88% were general surgeons, 4% were gynecologists, 2% were urologists, and 6% were labeled as "other." The mean (standard deviation, SD) score on the cognitive examination was 519 (157), with a 93% pass rate. The mean score on the technical skills examination was 525 (117), with a 92% pass rate. After combining both scores, the overall FLS certification pass rate was 88%. Conclusions: The FLS certification examination has gained widespread acceptance among laparoscopic surgeons in training and practice, with a marked increase in testing since the American Board of Surgery mandate for certification was announced. The overall pass rate of 88% on the examination approaches the target pass rate of 90% established during the test-setting process.

Original languageEnglish (US)
Pages (from-to)1192-1198
Number of pages7
JournalSurgical endoscopy
Issue number4
StatePublished - Apr 2011
Externally publishedYes


  • Education
  • Fundamentals of Laparoscopic Surgery
  • Laparoscopy
  • Simulation

ASJC Scopus subject areas

  • Surgery


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