FES (Fundamentals of Endoscopic Surgery) Resident Guide

1️⃣ Understand the Requirement

• Why: Required by ABS as part of the Flexible Endoscopy Curriculum.

• When: Often completed during or after your endoscopy rotation.

• Components:

• Didactic: Online modules (cognitive knowledge)

• Skills: Virtual reality simulator tasks

• Exam: Written + simulator-based skills test

2️⃣ Register for the Program

• Go to the FES Website and read the user guides and forms

• Purchase FES access (covered by our program, so please get your voucher code from your coordinator).

3️⃣ Complete the Didactic Modules

• The FLS didactics have moved and are now available to everyone, free-of-charge, at www.sages.org/owls.

  • Create a login and sign in to OWLS

• Modules cover:

  • Module 1: Technology 

  • Module 2: Patient Preparation 

  • Module 3: Sedation & Analgesia 

  • Module 4: Upper Gastrointestinal Endoscopy 

  • Module 5: Lower Gastrointestinal Endoscopy 

  • Module 6: Performing Lower GI Procedures 

  • Module 7: Small Bowel 

  • Module 8: Diagnostic Endoscopic Retrograde Cholangiopancreatography (ERCP) 

  • Module 9: Hemostasis 

  • Module 10: Tissue Removal 

  • Module 11: Enteral Access 

  • Module 12: Endoscopic Ultrasound 

  • Module 13: Advanced Imaging 

4️⃣ Practice on the Simulator

• FES uses a GI Mentor or equivalent VR simulator.

• Core skills include:

  • Scope navigation

  • Targeting & retroflexion

  • Biopsy & polypectomy

  • Hemostasis techniques

• Practice until you meet or exceed proficiency benchmarks.

5️⃣ Schedule Your Exam

• Follow the guide found here: Step 3: Schedule Your FES Test Appointment - Fundamentals of Endoscopic Surgery 

  • Direct link to registration guide: Fundamentals Exam Registration Guide - Google Drive 

  • Our residency programs is a certified testing center, and the testing happens up on the 12th floor in the sim lab.

• Exam parts:

• Written: multiple-choice questions (~1.5 hours)

• Simulator: Timed and scored performance of core endoscopic skills

6️⃣ Test Day Tips

• Bring a photo ID and your FLS voucher code to the test.

• For simulator: keep movements smooth, avoid excessive insufflation, and follow the task prompts exactly.

• For written: focus on clinical decision-making and complication management.

7️⃣ After the Exam

• Results are typically immediate for simulator; written scores may take a few days.

• Submit your certificate to your program coordinator.

• Didactic Content - Fundamentals of Endoscopic Surgery 

  • Register/Sign in at: Welcome to OWLS! - SAGES and navigate to the FES didactic modules

• Upper Endoscopy - The Operative Review Of Surgery 

• Upper Endoscopy – Complications - The Operative Review Of Surgery 

• Lower Endoscopy - The Operative Review Of Surgery 

• Lower Endoscopy - Bowel Preparation - The Operative Review Of Surgery 

• Lower Endoscopy - Polypectomy - The Operative Review Of Surgery 

• Lower Endoscopy – Complications - The Operative Review Of Surgery 

• Respiratory Endoscopy - The Operative Review Of Surgery 

Scenarios are made up, and any similarity to real cases is by coincidence only. 

Pre-Lab Preparation

• Equipment & Environment Setup:

  • Ensure all endoscopic simulators and necessary tools are available and functioning.

  • Verify that the lab space is arranged for hands-on skill stations.

• Program Materials:

  • Confirm resident access to the FES didactic website and training materials.

  • Ensure residents have reviewed the didactic material prior to the lab simulation. 

Lab Orientation

• Introduction to FES Program:

  • Present an overview of the FES program, its purpose, and exam relevance.

• Goals & Objectives Overview:

  • Clearly state the lab goals: introduction, hands-on practice, and certification preparation.

  • Review the specific objectives: skill development (navigation, injection, snaring, loop reduction), self-study enhancement, and friendly competition.