The FLS Exam Consists of 25 Multiple-Choice Questions

The Fundamentals of Laparoscopic Surgery (FLS) written exam includes 25 multiple-choice questions covering core topics like laparoscopic instrumentation, physiology, and surgical principles. Test-takers have 50 minutes to complete it, with a passing score typically set at 70% or higher. The exam is paired with a hands-on skills assessment.

FLS Exam Structure Breakdown

  • Question count: 25 multiple-choice (single-best-answer format).
  • Time limit: 50 minutes (≈2 minutes per question).
  • Topics covered:
    • Laparoscopic equipment and energy sources.
    • Patient physiology (e.g., pneumoperitoneum effects).
    • Surgical techniques and complication management.
    • Ergonomics and operating room setup.
  • Passing score: Usually 70% (18/25 correct), but may vary by administration.
  • Skills test: Separate from the written exam (5 tasks, 1.5-2 hours).

FLS Exam vs. Other Surgical Assessments

Exam Question Count Time Limit Passing Score Skills Component?
FLS Written 25 50 minutes ~70% Yes (separate)
FES (Fundamentals of Endoscopic Surgery) 50 90 minutes 72% Yes (integrated)
ATLS (Advanced Trauma Life Support) 40 90 minutes 80% No (practical stations separate)

Key Tips to Pass the FLS Written Exam

  1. Study the manual: Focus on the FLS Manual (2nd Ed.), especially chapters on instrumentation and physiology.
  2. Practice time management: Aim for <1.5 minutes per question to allow review time.
  3. Master high-yield topics:
    • Trocar placement and port sites.
    • Complications of laparoscopy (e.g., gas embolism, thermal injury).
    • Electrosurgery principles (monopolar vs. bipolar).
  4. Use online question banks: Prioritize exams with explanations for incorrect answers.
  5. Simulate test conditions: Take timed practice tests to build endurance.

Common Mistakes to Avoid

  • Overlooking basic concepts: ~30% of questions test foundational knowledge (e.g., insufflation pressures).
  • Ignoring negative-marking: Guess strategically-no penalty for wrong answers.
  • Skipping diagrams: Questions often include images of instruments or anatomy; study visual aids.
  • Underestimating the skills test: The written exam is only half of FLS certification.

How Long to Prepare?

Most candidates need 4-8 weeks of focused study (1-2 hours/day) if familiar with laparoscopic basics. Beginners may require 10-12 weeks. Combine reading with hands-on practice for the skills test.