Data-based self-study guidelines for the fundamentals of laparoscopic surgery examination

Surg Endosc. 2012 Dec;26(12):3426-9. doi: 10.1007/s00464-012-2357-6. Epub 2012 May 31.


Background: In preparing for the fundamentals of laparoscopic surgery (FLS) exam, residents usually adopt a self-learning strategy where practice time can be managed with more flexibility. However, with this self-learning strategy, there is a lack of direct supervision from experts and residents risk understudying for this high-stakes exam. Our objective is to determine study goals for effective self-guided practice for the FLS manual skills tasks that will result in passing the examination.

Methods: FLS manual skills data for all PGY-5 residents during 2009-2010 was supplied by the FLS administrative office. Descriptive statistics were performed, and data were regrouped by the pass/fail results of the exam. The minimum practice time requirement for passing each manual skills task is reported in order to guide practice.

Results: 1,047 proctored FLS exams were completed by 2009-2010 residents. Mean task time achieved by all residents was 84 ± 31 s for peg transfer, 139 ± 54 s for pattern cut, 78 ± 29 s for endoloop, 158 ± 66 s for extracorporeal suturing, and 168 ± 77 s for intracorporeal suturing. In the pass group (n = 988), mean time to complete each task was 80 s for peg transfer, 134 s for pattern cut, 75 s for endoloop, 148 s for extracorporeal suturing, and 160 s for intracorporeal suturing. Calculations suggest a self-study goal for each task of 53 s for peg transfer, 50 s for pattern cut, 87 s for endoloop, 99 s for extracorporeal suturing, and 96 s for intracorporeal suturing. If a resident can reliably achieve these results during self-study, they have an 84% chance of passing the exam.

Conclusions: Residents preparing to take the FLS exam can refer to data presented in this study to set practice goals. Referring to these data-based practice goals will help residents to improve their chances of passing this high-stakes exam.

MeSH terms

  • Clinical Competence*
  • Guidelines as Topic
  • Internship and Residency*
  • Laparoscopy / education*
  • Programmed Instructions as Topic*