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PREPARATION
FOR THE PART I MRCOG |
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SYLLABUS
FOR PART I MRCOG |
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PREPARATION
FOR THE PART II MRCOG |
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SYLLABUS
FOR PART II MRCOG |
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[Most of the information
provided in this section can also be accessed from the College
website i.e. www.rcog.org.uk]
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The Royal College
of Obstetricians and Gynecologists is a Post Graduate Institute
for Doctors specializing in the Medical Specialty of Obstetrics
and Gynecology. It is not a University or a Hospital. |
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The College does not
train people directly, but rather administers examinations,
approves hospital training programmes, organizes scientific
meetings and short courses. |
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PREPARATION FOR THE PART I MRCOG: |
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Any medical graduate
(M.B.B.S.) from a recognized university is eligible
to give the Part I MRCOG examination. |
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The Membership
of the Royal College of Obstetricians and Gynecologists
(MRCOG), is not a hurdle race, but a marathon. Each
milestone is to be covered with good planning and preparation
and should not be attempted in spurts of energy. |
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It is a good
plan to take the MRCOG Part I exam after having started
your Post graduate training in Obstetrics and Gynecology,
for at least one year. A preparatory period
of six months must be anticipated. This is
an examination that seeks to assess your knowledge of
basic sciences as applied to OBSTETRICS & GYNECOLOGY. |
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The examinations
are held in March and September
each year.
It consists of two multiple choice question papers covering
300 questions and lasting for 2 hours. |
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The examination
covers all subjects that are part of the undergraduate
training. It can be attempted at any time after passing
the M.B.B.S and the number of attempts that
one can take is unlimited. Exemption from the
MRCOG Part I examination was applicable to Medical graduates
of some countries. This exemption is no longer
applicable from January 1, 2007. |
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All candidates,
who wish to appear for the MRCOG Part II examination,
must pass the MRCOG Part I examination. Please go through
the syllabus carefully, identify the recommended books
in each subject and read as many as possible, as there
is no single book that covers all the subjects.
It is a good idea to use the books which you have read
as an undergraduate and are likely to be familiar with
the language and style. Familiarity saves time. Use
the latest editions as the information must be up to
date and factually correct. |
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Any list of topics
is only a general guide to the information upon which
the questions will be based. The list is not intended
to be comprehensive and therefore questions will be
asked, the answers to which require applied knowledge
as relevant to the practice of OBSTETRICS & GYNECOLOGY. |
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Give yourselves
three months to read through all the basic sciences,
studying for four to six hours daily. The next three
months are spent reading the text book of basic sciences
in OBSTETRICS & GYNECOLOGY by De Swiet and Timchard.
These books will cover all the required subjects from
the point of view of the Gynecologists. For e.g. in
Pharmacology, Cardiac drugs may not be relevant, though
anaesthetics may be important. |
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| MULTIPLE CHOICE QUESTIONS : |
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Multiple choice
questions in MRCOG Part I follow a format wherein there
is a basic (root statement) and five stems for each
questions. Each time, read the root statement separately
with each stem. Together they form a separate question
and the stems are not related to each other. Similarly
one statement does not follow from the other. Take your
time to read each question carefully, try and understand
the entire statement and do not be in a hurry to mark
your answer. |
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Multiple choice
questions are an accurate judge of a candidate’s
knowledge of a topic. They test not only facts but also
understanding and reasoning ability. It is important
to know your subject thoroughly. Reading small comprehensive
texts are better than exhaustive textbooks on a particular
subject. Read as many MCQs as possible to understand
the nuances of the English language. |
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The statement
may contain absolute negatives such as never, or absolute
positives such as always, which are seldom true in medicine.
Such questions should be read carefully as they are
usually false. |
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Pairs of words
such as “Not uncommon” means “Common”
or “Not unlikely” actually means “Likely
to happen”. These can be confusing and hence careful
attention to the wording of the statement is important.
There is no negative marking in the paper. Hence all
questions must be attempted. Even if you do not know
the answer, logical guess work will give you 50% chance
of success. If you do not answer any question however,
it will definitely fetch you no marks at all. |
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Having solved
a particular set of MCQs, now is the time to re-read
certain relevant topics. The student gets an idea about
the important and frequently asked questions in each
subject and can concentrate on these during revision.
The College publication of past papers contains a question
bank without answers. These must be discussed with other
candidates attempting the exam. Such discussions help
build confidence and arrive at consensus statements.
It helps one to identify your weak areas and take necessary
steps to overcome the same. |
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The standard
of the examination is high. There is no limit to the
attempts one can take to pass the exam. Most candidates
do not pass the exam in the first attempt. However,
there is no disgrace in failure. If a candidate is unsuccessful,
they will receive an analysis of their paper and marks
obtained in each section from the Royal College. This
helps them to identify problem areas and take remedial
measures. |
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secret of passing the exam is wanting to pass the exam.” |
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One must make
it a goal to be achieved within a time frame of six
months. It is not a difficult examination, but involves
a lot of preparation, precise knowledge of facts and
figures is required. At the same time, a broad base
of reading is necessary to deal with questions that
can be multidisciplinary. |
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The MRCOG
examination appears to be more popular than ever. There
are several reasons for this, but the bottom line appears
to be that it is still highly regarded world wide as
a relevant test of clinical competence and a bench mark
even in countries having their own examination board
and systems. |
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| The numbers sitting both part I and
part II of the examinations have increased by around 50%
in the last ten years. Asian students and especially Indians
do rather well in the MRCOG Part I examination. Willingness
to concentrate, hard work and perseverance are major factors
in achieving success in this examination. |
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| SYLLABUS FOR PART I MRCOG: |
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A
detailed knowledge of the gross structure, ossification
and landmarks of the pelvic bones and their associated
joints and muscles. |
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Shape and dimensions of the
normal female pelvis and its commoner variants. |
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Relationship between pelvic
architecture and reproductive functions. |
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Anatomy of the thoracic,
lumbar and sacral spine with special emphasis on its relation
to the spinal cord, meninges, nerve roots, vascularity and
surface anatomy. |
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A detailed knowledge of the gross and mic
anatomy of pelvic structures, the vulva and perineum. |
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Topographical anatomy
of all intra abdominal structures, including the vascular,
lymphatic and nerve supply of all intra abdominal organs.
A detailed knowledge of the structure and nerve supply of
the abdominal wall. |
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Gross and mic anatomy. |
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Gross and mic anatomy of the adrenal glands,
hypothalamus, pituitary and their relations. |
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Gross anatomy of the larynx, trachea, main
bronchi, pericardial and pleural cavities and heart. |
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A knowledge of the anatomy of the male genital
tract. |
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A knowledge of the
major sensory and motor pathways within the central nervous
system with particular regard to the nervous connections of
the pelvic organs and the lumbo sacral plexus. The autonomic
nervous system related to pelvic viscera and the genital tract. |
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A knowledge of the histology of the female
genital tract including the placenta. |
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Structure and function of the normal
cell. Cell ultra structure and methods of its investigation.
Function of nuclei, mitochondria, endoplasmic reticulum
etc and relationships of one cell to another.
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Transfer of substances
across the cell membrane, including active and passive
transport mechanisms. |
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Protein and steroid hormone receptors
and their action on appropriate cells. Receptor assays
and their significance. |
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Principles of genetic code, RNA and
DNA metabolism. |
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Mitosis and meiosis. The cell cycle. |
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Cyto genetics including techniques
of cell structure. |
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Chromosome constitution
and the anomalies associated with common abnormalities
of the karyotype. |
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Mechanism of inheritance of genetically
determined abnormalities. |
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Features associated with cell damage
including those associated with ionizing radiation, hypo
and hyperthermia and cytotoxic agents. |
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The candidate should
be able to understand the common terminology and methods used
in obstetrics and gynecology literature. |
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Measurements
of central tendency, mean, mode, median. Measurements
of dispersion. Normal and skewed distribution, standard
deviation and variance. |
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Measurements of proportions and percentages. |
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Concepts of probability, survey, experiment,
random error, tautology and experimental control. |
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Rates,
prevalence, incidence, morality and perinatal mortality. |
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Standardization – particularly
age standardization as a means of eliminating the effects
of age from a comparison of rates between the populations
or time. |
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Oogenesis and spermatogenesis.
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Fate of spermatozoa
in the male and female reproductive tracts. |
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Ovulation, transport of the ovum and
sperm, fertilization and implantation. |
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Blastula and trophoblast development. |
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Development, structure and function
of the placenta. |
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Development of amnion, chorion and
yolk sac. The origin, transfer, contents and function
of the amniotic fluid. |
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The general
pattern and timing of organ genesis in the foetus. |
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The factors concerned in the determination
of sex. The effects of drugs, infections, radiation and
other deleterious agents of embryo development. |
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Development of Mullerian and Wollfian
duct systems, the gonads, proctodeum and coelomic cavity. |
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Hypothalamic releasing hormones.
Hormones of the anterior and posterior pituitary gland
and control of their secretion.
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Pineal gland. |
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Ovarian hormones.
An understanding of the basic pathways involved in their
synthesis. The control of ovarian steroid metabolism
and feedback mechanisms. The action of ovarian hormones. |
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Feto-placental
steroid hormone metabolism: placental hormones, adrenal
gland. The action of ACTH, aldosterone, cortisone and
catecholamines. A general understanding of the metabolic
pathways involved in the production of these hormones. |
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Pancreas. A detailed knowledge of
the pancreatic hormones, their effects on carbohydrate/lipid
metabolism. |
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Thyroid. Control, secretion of thyroid
hormones. The action of thyroxin. |
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Parathyroid function. |
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Testicular steroid production and
its control. |
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Hepatic and alimentary tract hormones. |
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A knowledge of the gross anatomy
of the foetus with particular reference to the skull
and CVS.
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Foetal growth
and maturation. |
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Oxygen and carbon
dioxide transport in the foetus. |
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Foetal lung
development and factors involved in the initiation of
respiration. |
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Physiological adaptation of the neonate
to extra uterine life during the first few days. |
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The principles of immunology including antigens, antibodies
and their reactions. Blood grouping. Function of the
reticulo endothelial system, lymphocytes, macrophages
and complement. |
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The immune response
in infection, transplantation, immuno suppression and
hypersensitivity. |
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The immunology
of the conceptus as an Allograft. Functions of the trophoblast.
Transplantation allo antigens. The immune status of
the neonate and graft versus host reaction. |
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Immuno diagnosis.
Pregnancy testing, principles of immunoassay and tests
of immuno competence. |
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The immunological basis of foeto maternal
iso-immunization. |
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Auto immune disease. Placental transmission
of Immunoglobulins. |
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Immunology of
tumours. Onco foetal antigens (tumour markers) |
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The principles of microbiology
including broad outlines of bacteriology and virology.
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A knowledge
of the behaviour and characteristics of bacteria, viruses,
fungi, protozoa and parasites causing disease of the
female reproductive tract and foetus. |
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Principles of
control of infection. Antisepsis, asepsis, sterilization,
isolation and epidemic control. |
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The principles
underlying the use of antibiotics and allied chemotherapeutic
agents. |
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Anesthetics, analgesics, sedatives
and Hypotensive agents.
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Chemotherapeutic
agents and antibiotics. |
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Cytotoxic drugs. |
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Drugs acting
upon the sympathetic and parasympathetic nervous systems. |
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The teratogenic dangers of drugs and
other drug hazards to the foetus. |
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The pharmacology
of drugs acting upon the female reproductive system
including oxytoxic and tocolytic drugs and sex hormones. |
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Reproduction. Much of this is covered
under other headings within this syllabus. A detailed
knowledge of all aspects of male and female reproductive
physiology including coitus.
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Electrolyte
and water metabolism. |
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Acid base balance |
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Normal renal
function and micturation. |
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The CVS including a knowledge of the
control of blood pressure, heart rate and regional blood
flow. |
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Respiration,
oxygen and carbon dioxide transport mechanisms. |
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The working and
arrangement of somatic and autonomic nervous systems
including the chemical transmission of nerve impulses. |
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Uterus and tubes. Myometrial and tubal
function. |
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Alimentary tract, including absorption
of food substances and defecation. Functions of the liver. |
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Nutrition. The
general principles of dietetics. The constitution of
a normal diet and the particular requirements of pregnancy. |
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Coagulation and haemostasis. Fibrinolysis,
haemolysis. |
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Breast development and lactation. |
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The physiology
of pregnancy. Special emphasis should be placed on the
physiological changes of normal pregnancy, weight gain,
duration of pregnancy, renal CVS, respiratory, alimentary
and haemopoietic changes, parturition and the Puerperium. |
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PREPARATION FOR THE PART II MRCOG: |
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The MRCOG Part II examination
is attempted by medical graduates in the UK at the end of
four years of training in Obstetrics and Gynecology. The knowledge
level expected is that of a Registrar with two years experience
in OBSTETRICS & GYNECOLOGY. In depth knowledge of common
problems is expected. Complex problems, techniques and newer
technologies are dealt with at the level of a Specialist Registrar
and Consultant and hence only knowledge of these subjects
without any details is required. Preparation time
for the examination should be six months to one year,
depending on the work schedule and time available for preparation.
The examination consists of two parts.
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This can be attempted
in many countries around the world including India.
It consists of four papers of two hours each attempted
one after the other with gaps in between, in a single
sitting. The EMQ is for 45 minutes. |
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| Paper I– Short Answer Questions in Obstetrics |
| Paper II -
Multiple choice questions in OBSTETRICS & GYNECOLOGY |
| Paper III
- Short Answer Questions in Gynecology |
| Paper IV
- Extended matching questions |
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The oral examination
will consist of a three-hour oral assessment. Candidates
are examined in a sequence of twelve 14-minute stations.
Two of these stations will be rest or preparatory stations
where pieces of work will be provided for discussion
at the next active station. At all stations,
apart from the rest stations, a single examiner will
be present. At some stations a role player may also
be present. |
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Candidates will
be assessed on their ability to obtain obstetric and
gynaecological histories, to counsel patients and to
demonstrate clinical skills. At other stations candidates
will be expected to critically appraise pieces of written
work in discussion with examiners and to discuss aspects
of obstetrics, gynaecology and allied subjects in structured
oral examinations. The examination will test
not only factual knowledge and understanding, but also
problem solving skills, diagnosis, investigation, treatment,
clinical skills and communication skills. |
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It is important
to note that the candidates accent or his ethnic background
is of no consequence while being assessed for the oral
examination. Candidates are expected to be formally
dressed. However, there is no fixed dress code. |
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While preparing
for the exam, it is very important to practice one SAQ
paper daily for four weeks before the exams. MCQs and
EMQs are also important, but carry less weightage and
should be practiced whenever time permits. There is
a common pool of questions and same/similar MCQs are
repeated. |
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Books of MCQs and SAQs including
past papers are published by the RCOG bookshop and
are useful while preparing for the examination. It
is important to read books by British authors only,
as this is an examination which tests the practice
in the UK.
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It is important that candidates
have realistic expectations so as to put in reasonable
effort but without getting very frustrated on facing
difficulties. Friends from the same country or region
especially those who have cleared the examination
may help in explaining new situations and provide
an idea about the examination and how to prepare for
it.
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The Membership
examination test the ability to construct answers from
multiple sources and candidates have to learn how to
integrate new knowledge of practice in the UK with their
existing knowledge and experience gained in their home
countries. They must not discard their existing knowledge
and start from a scratch as this can lead to retardation
rather than progress. |
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Problem
areas encountered are communication skills such as those
involved in counseling and using information leaflets
which are quite important for patient care in the UK,
areas like management, audit, litigation and research
are not as prevalent in non industrialized countries
and are totally new to overseas doctors. Failure
in the examination should not be regarded as failure
in life and career and in fact the ability to take failure
and to know how to deal with it is an important feature
of the matured doctor who is able to deal with life’s
ups and downs smoothly.
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| The availability of past questions
and answers on the college website is very valuable in
guiding training as to the level and scope of answers
expected in the examinations. |
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