The FLS assessment component is a two-part, proctored exam that covers cognitive knowledge and manual skills.
The cognitive component is a timed multiple-choice exam administered via computer. It is designed to test the understanding and application of the basic fundamentals of laparoscopy with emphasis on clinical judgment or intraoperative decision-making.
FLS is currently phasing in a new on line testing process to administer this component. If you’re test center is currently using the on line process please download the following instruction manuals:
Online Testing: Test Center User Guide * For test centers only*
Online Testing: Test Taker Registration Guide
The manual skills component evaluates skills based on efficiency (speed) and precision (accuracy) of the surgeon’s maneuvers using the FLS Laparoscopic Trainer Box. The test consists of five non-procedure specific simulation exercises incorporating most of the psychomotor skills necessary for basic laparoscopic surgery.

