Fundamentals of Laparoscopic Surgery Exam: A Cross-Sectional Survey of in-Training Obstetricians and Gynecologists

STUDY OBJECTIVE: Physicians seeking specialty certification in Obstetrics and Gynecology are now required to successfully complete the Fundamentals of Laparoscopic Surgery (FLS) exam in order to meet the American Board of Obstetrics and Gynecology (ABOG) certification requirement. We conducted a survey of U.S Obstetrics and Gynecology physicians in training in an attempt to assess their laparoscopic surgical training and perceived barriers and limitations to successfully obtain FLS certification. DESIGN: Observational. SETTING: Internet-based survey of United States Obstetrics and Gynecology residency programs. PATIENTS OR PARTICIPANTS: U.S Obstetrics and Gynecology residents. INTERVENTIONS: Participants were asked to self-evaluate their confidence in conducting laparoscopic procedures. MEASUREMENTS AND MAIN RESULTS: Of the 237 U.S Obstetrics and Gynecology programs, 146 residents responded. Seventy-one (48%) respondents completed the FLS exam and reported a 93% pass rate. All those who did not pass reported poor performance on the manual skills portion. Sixty-six (93%) respondents felt the laparoscopic box trainer was most helpful in preparation for the FLS exam. Fifty-five (79%) respondents felt the cognitive portion of the exam was not at all or slightly representative of subjects taught in residency. Thirty-three (47%) respondents felt the skills portion was moderately reflective of laparoscopic skills needed in gynecologic surgery. Thirty-eight (54%) respondents felt preparing for this exam was not at all or slightly helpful in clinical or surgical practice. CONCLUSION: The laparoscopic box trainer appears to be most useful in preparation for the FLS exam. Most respondents agree the skills portion of the exam represents skills required in Obstetrics and Gynecology. Concern remains whether the cognitive portion of the exam is applicable to Obstetrics and Gynecology residents or if residency programs need to broaden their laparoscopic education. Alterations likely need to be made to the exam to more specifically evaluate fundamental laparoscopic surgical skills in gynecologic surgeons.