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Introduction: SILS has emerged as a promising way to perform laparoscopic surgery. However, it is more technically challenging than standard laparoscopy (LAP), and is not currently part of the Fundamentals of Laparoscopic Surgery (FLS) curriculum. We hypothesize that SILS-specific training is superior to LAP training in improving SILS performance.Methods: First and second year medical students with no prior LAP or SILS experience were recruited and baseline tested on tasks from FLS (peg transfer and circle cutting) using LAP and SILS techniques. LAP was performed on a standard, three-port, FLS box-trainer with standard LAP instruments. SILS was performed using an FLS box-trainer modified to accept a Covidien SILS Port ™ with two ports for Covidien Roticulator™ instruments and one port for a 30-degree 5mm laparoscope. After baseline testing, subjects were randomized to either LAP or SILS training (four practice sessions over a 4-6 week period). After completing the training, subjects were retested on LAP and SILS platforms. Scores were calculated using standard time and accuracy metrics, normalized to previously published FLS scoring criteria used to distinguish competent (>54%) and non-competent surgeons (<54%). Repeated measures analysis of covariance was used to measure the effect of time and training regimen on score improvement, while controlling for differences in baseline score. A p-value of < 0.05 was used to denote a significant difference.Results: 14 subjects performed LAP (n=8) or SILS (n=6). Baseline scores were similar in both groups, except for SILS circle (p = 0.014) and overall SILS score (p=0.012) which were higher in the LAP group. All scores improved significantly over time (p < 0.001). Improvement of LAP scores was similar between groups. However, the SILS group had superior improvement of SILS peg (F(1,11) =12, p = 0.005) and overall SILS scores (F(1, 11) = 23, p = 0.001).Conclusion: SILS-specific training is superior to standard LAP training in improving SILS score. SILS-specific training does not adversely affect acquisition of LAP skill. SILS-specific training should be incorporated into existing LAP training curriculums.