FLS exam — how to split prep time between skills lab and the written portion
I'm a surgery resident prepping for the FLS and trying to figure out how to split my limited time between the manual skills portion and the cognitive exam. I have about 8 weeks before my scheduled date and can realistically get in 45 minutes per day on the skills box and another 30-45 minutes on knowledge review. Is that enough, or am I setting myself up to fail the skills section specifically?
The cognitive test feels manageable — I've been scoring around 75-80% on practice questions covering laparoscopic principles, energy sources, and patient positioning. The skills portion is a different story. My peg transfer time is around 95 seconds and I need it under 60 to score well. The precision cutting task is even messier — I'm too slow and losing points on dropped pieces.
My program director says most residents who fail do so on skills, not the written, so I'm trying to shift my ratio toward box training. But I'm nervous that 45 minutes per day isn't sufficient for the coordination improvements I need in 8 weeks. Does motor learning actually work on that timeline, or do I need to find more time somewhere?
For those who've passed — what did your skills box practice actually look like day-to-day? And did you use the official FLS kit or a generic trainer?
Daily short sessions beat weekly long ones for motor learning. I did 30 minutes every single day for 10 weeks and brought my peg transfer from 110 seconds down to 48. Consistency matters more than volume on any given day.
Get the official FLS kit if you can — the peg dimensions and instrument resistance are calibrated to match exam day. Generic trainers can build slightly off habits.
The cognitive portion is straightforward if you've done your basic surgery training. Focus 80% of your remaining time on the box. Your scores show you don't need more written review right now.
I failed my first attempt because I spent 70% of prep on the cognitive exam, which I was already passing, and not enough on precision cutting. If your written scores are 75%+, redirect that time to the box immediately.
The endoloop and intracorporeal suturing tasks have the steepest learning curves and also the highest point values. If you're 8 weeks out, prioritize those over peg transfer even though peg transfer feels easier to improve quickly.
My co-resident practiced suturing 20 minutes every morning before rounds and went from failing to 89th percentile in 7 weeks.