Proficiency-based preparation significantly improves FES certification performance

  • Angela A. Guzzetta
  • Joshua J. Weis
  • Sara A. Hennessy
  • Ross E. Willis
  • Victor WilcoxJr.
  • Brian J. Dunkin
  • Deborah C. Hogg
  • Daniel J. Scott



The Fundamentals of Endoscopic Surgery (FES) certification has recently been mandated by the American Board of Surgery but best methods for preparing for the exam are lacking. Our previous work demonstrated a 40% pass rate for PGY5 residents in our program. The purpose of this study was to determine the effectiveness of a proficiency-based skills and cognitive curriculum for FES certification.


Residents who agreed to participate (n = 15) underwent an orientation session, followed by skills pre-testing using three previously described models (Trus, Operation targeting task, and Kyoto) as well as the actual FES skills exam (vouchers provided by the FES committee). Participants then trained to proficiency on all three models for the skills curriculum and completed the FES online didactic material for the cognitive curriculum. Finally, participants post-tested on the models and took the actual FES certification exam. Values are mean ± SD; p < 0.05 was considered significant.


Of 15 residents who participated, 8 (53%) passed the FES skills exam at baseline. Participants required 2.7 ± 1.3 h to achieve proficiency on the models and approximately 3 h to complete the cognitive curriculum. At post-test, 14 (93%, vs. pre-test 53%, p = 0.041) passed the FES skills exam. 14 (93%) passed the FES cognitive exam and 13/15 (87%) passed both the skills and cognitive exam and achieved FES certification.


Our traditional clinical endoscopy curricula were not sufficient for senior residents to pass the FES exam. Implementation of a proficiency-based flexible endoscopy curriculum using bench-top models and the FES online materials was feasible and effective for the majority of learners. Importantly, with a modest amount of additional training, 87% of our trainees were able to pass the FES examination, which represents a significant improvement for our program. We expect that additional refinements of this curriculum may yield even better results for preparing future residents for the FES examination.


Fundamentals of Endoscopic Surgery Resident endoscopy training Endoscopy simulation FES 



The authors gratefully acknowledge the funding provided by the Society of American Gastrointestinal and Endoscopic Surgeons in the form of discounted test vouchers.

Compliance with ethical standards


Drs. Angela A. Guzzetta, Joshua J. Weis, Sara A. Hennessy, Ross E. Willis, Victor Wilcox Jr., Brian J. Dunkin, Deborah C. Hogg, and Daniel J. Scott have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2018_6190_MOESM1_ESM.pdf (1.6 mb)
Supplementary material 1 (PDF 1664 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Angela A. Guzzetta
    • 1
  • Joshua J. Weis
    • 1
  • Sara A. Hennessy
    • 1
  • Ross E. Willis
    • 2
  • Victor WilcoxJr.
    • 3
  • Brian J. Dunkin
    • 3
  • Deborah C. Hogg
    • 1
  • Daniel J. Scott
    • 1
  1. 1.University of Texas Southwestern Medical Center at DallasDallasUSA
  2. 2.University of Texas Health Sciences Center at San AntonioSan AntonioUSA
  3. 3.Houston Methodist HospitalHoustonUSA

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