Advice on how to prepare for "overseas" candidates from Asma Naqi

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MRCOG

MRCOG: how to pass first time

 

Asma passed the MCOG Part II in November 2010.

She has not worked in the UK and felt that it be helpful to give a view on preparing for the "overseas" candidate.

If there is any additional advice you would like from Asma, let me know and I'll pass it on.

List of contents

  1. abbreviations

  2. introduction

  3. our problems

  4. key questions

  5. planning your studies

  6. starting your studies

  7. where to study from

  8. how to study

  9. revision

  10. the new format of the exam

  11. how I studied

  12. the OSCE exam

  13. final thoughts

 

 

Abbreviations.

CEMACE:      Center for Maternal and Child Enquiries

CNST:            Clinical Negligence Scheme for Trusts

GTG:               Green-top guidelines from the RCOG

MCQ:              multiple-choice question

NICE:             National Institute for health and Clinical Excellence

OGRM:           Obstetrics, Gynaecology and Reproductive Medicine

OHSS:            ovarian hyperstimulation syndrome

SIGN:             Scottish Intercollegiate Guidelines Network

STD:               sexually-transmitted infection

TOG:               The Obstetrician and Gynaecologist

RCOG:           Royal College of Obstetricians and Gynaecologists

 

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Introduction.

After passing the MRCOG Part 2 exam in November 2010, I received a number of calls and e-mails from candidates preparing for the upcoming exam asking for advice.

Itís not easy to describe how to get through this tough exam.

But Iíll try to share with you what I think has made a difference for me.

I hope this will help you too, with some modifications according to your individual needs.

To become a member of RCOG is indeed a tough task.

And more so for the candidates who have never worked in UK.

I know many candidates who have been trying to get through this exam for several years.

Our main problem is that we are not familiar with the systems in the UK.

Also, we are often already carrying a lot of other responsibilities like challenging jobs, family, children and adding to it is the study.

The MRCOG is a clinical exam, but, regardless of your clinical experience it needs a number of specific techniques to prepare and get through it.

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Our Problems:

The most common problems we all face are:

The syllabus is so extensive that preparation and revision seem to be almost impossible.

With good organisation, you will be able not only to cover all of it, but to revise it too.

I was able to revise the entire syllabus twice.

 

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Key questions:

The key questions are:

 

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Planning your studies:

There is a popular saying, Ďwell begun is half doneí.

And I totally agree with it, especially when you plan the study.

You should have a good three to six months period in hand for a thorough preparation, depending whether it is your first attempt or a re-sit.

For the first time, 6 months is appropriate.

For the further attempts, 3-4 months should be OK.

But with a proper plan and after a critical assessment of what was lacking last time.

I would recommend you to spend a couple of days devising a plan before proceeding to the actual preparation.

I found this very useful.

Divide the plan into sections e.g.:

Obstetrics                                                                     

Medical disorders                            

  1. chronic disorders
  2. emergencies
  3. endocrinology                                             

Genetic disorders

Infections                                                     

  1. sexually transmitted                                   
  2. in pregnancy

 

Fetal medicine                                                         

Antepartum events

Labour and delivery

Postpartum events

 

Gynaecology:

oncology

paediatric and adolescent gynaecology

menopause

urogynaecology

This list is not complete.

You need to make a full list of all the major groups covered in O&G and related fields such as genetics, paediatrics and STDs.

Make your own list so that the groupings make sense to you.

 

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Starting your studies:

After making out the plan of things to cover, you are ready to start.

Select one topic.

Try to alternate obstetrics with gynaecology to avoid monotony.

Make a list of ALL the disorders that could be covered in that section.

E.g. if you decide to start with medical disorders, it would include:

hypertension,

diabetes,

anaemia,

hemoglobinopathies,

endocrinology etc.

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Where to study from:

For detailed advice please see Dr Tom's and Elaine Church's pages on preparation

I have found that it is enough if you study:

You need to look up some topics which are not available on these elsewhere like in a text book, CEMACE and the web.

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How to study:

a) I would suggest that before you start reading a particular topic, write down all that you already know about it on a scrap paper.

Try to follow a set pattern of covering every topic, e.g. definition, prevalence, aetiology, pre-pregnancy, antenatal, labour, postpartum.

You will be glad to find that you already know a lot about each topic.

But the importance of this is much more than that.

Now start reading from whatever available material you have in hand.

If you have a GTG, still you need to revise some basic stuff about each topic from either a text book or an article from TOG or OGRM.

I personally didnít find a need to go through the text books if there was an article available in either of these journals.

 

b) Now when you read that topic, concentrate on what you have missed.

After reading it all from the available stuff, note down the points missed in the pre reading notes.

Basically all you would need now is to focus on the points you had missed as you already know the rest.

Why do I recommend this way?

It saves a lot of time, energy and makes your life much easier.

When we start reading any article we still tend to repeatedly focus on what we already know.

And by the time the points not yet registered well in our memories arrive, we are already exhausted.

But if you extract the points you already know, now you just need to focus on what is new for you.

  

Buzz words: (most important for the non-UK candidates)

I used to make my notes after these two steps.

Donít write down the whole subject.

I covered every topic only in bullet points, but under the specific pattern of headings as mentioned above.

And using not more than two sides of A4 paper.

Dr Tom suggests a card system and Elaine Church describes using a large book, with one page per topic.

The important thing is to decide on the system that suits you and use it from the start.

After completing the topic, I go back to it with a new view.

And this time concentrate on what are the buzz words and managerial issues in that topic.

And make a prominent note of these at the end of each topic.

e.g. in OHSS, buzz words are

I think this part is the most important one for non UK candidates as this is what we do not do in practice.

This is where it makes a difference between a pass and fail.

And when you do it like this with each topic, by the end you are not left with any confusion what is needful and where.

This covers the most important CNST and audit issues too. 

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Revision:

When you make your notes highlight the points which you missed initially so when you revise, your focus is on what you tend to miss.

Trust  me, you will be able to revise at least twice in the last two weeks if you follow this.

I did so successfully.

 

When you revise for the first time, follow the same steps a and b.

I.e. quickly put up somewhere that you already and this time it would be certainly more than the initial one.

And there would be even less points to re mark and to focus further.

 

I have found that studying in compartments is beneficial because all you need to do is to follow the entire group under a basic format.

By doing so, when you have done all the disorders, youíd be able to clearly spot the differences in the history, examination, investigation and management among them.

This  basic format would help you to answer even the most unknown question.

And never forget the buzz words and managerial issues in each and every topic that you do. 

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New examination format:

EMQs become the main bulk of examination from March 2011.

It will be very helpful to follow the above mentioned plan of study because answering EMQs needs a very clear concept of the things and an in-depth knowledge.

EMQs need practice.

There are lots of books published by college which can help in time management and practice.

Most of the NICE guidelines are covered in the EMQs.

So while reading the NICE guidelines, do concentrate on different scenarios and how they should be managed according to the guidelines. 

Overseas candidates need to concentrate on the antenatal, intrapartum and post partum NICE guidelines.

The clinical practice in these areas varies a lot from country to country.

To stay on track with the British system, memorize these by heart.

For MCQs read past paper book of mcqs published by college and all the mcqs from TOG and OGRM.

In my opinion it would be perfectly fine if you don't not waste money, time and energy on any more mcq books as most of them are oudated.

Also, I have never seen or heard of anything coming in the exam from these books.

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How I studied:

 I started by going through all the MCQs on the website.

And I strongly recommend you to do this because it gives an insight to the overseas candidates how the British think.

I am sure while composing all this Dr McFarlane was not aware of this and he didnít plan it.

But at least I found my way of thinking changed grossly after reading the answers of those MCQs.

It helps you to enjoy what you read and to think a bit more rationally on a topic than just trying to memorize what is written.

Additional to this, thereís nothing more valuable than Dr Tomís tutorials.

Because no matter how many courses you attend, no one gives you a continuing teaching and so much focused.

My pattern of study and approach towards this exam was entirely changed after listening to Dr McFarlane.

This is much more important for the non-UK candidates because it really gives you an insight to the UK system.

I cannot emphasize it more.

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The OSCE exam.

The OSCE is totally different to the written but you need a thorough knowledge and good techniques.

Dr Tom and Elaine Church have provided detailed advice and I don't think I could add more to that, except a few thoughts of mine.

The format is well explained by Dr Tom in his advice.

Without basic facts you cannot proceed on any station, but you donít need more than basic facts for it.

Communication skills are most important part.

The trick I followed was to let the role player lead me through the marking scheme.

On viva stations, if you have done your theory in a systematic way, then you would automatically proceed smoothly. Thatís why I said in the beginning that well begun is half done.

The main issue of bother for non UK candidates is the risk management stuff.

The articles in OGRM and the MCQs on website are of great help. The best way for learning the communication skills and the risk management is to attend regularly the tutorials.

Practice is all that you need and again Dr McFarlane is the best guide for communication skills and clinical risk management.

The college has now provided a new centre in AbuDhabi which is an excellent opportunity for the candidates in middle east and far east.

There is a false concept that any centre other than London has a poor pass rate.

This is true in the sense that there are no UK candidates there, so automatically the pass rate is less.

But the standard of the exam is exactly the same.

The examiners and role players are just the same.

Even the examination hall is prepared in the same way with screens in a big hall like the college.

I passed from AbuDhabi

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Final thoughts.
This is a nerve-tearing exam.

A lot of us have upsets while going through this:

        time pressure due to family commitments,

        financial issues with repeated attempts
 
        or psychological setback and feelings of being incapable of getting through it.
Passing this exam is no joke, it could never be passed just by luck or by chance.

It really needs sheer hard work.

So please, please, before embarking on this difficult journey, understand the the exam fully.

Understand what should be the aim of your study.

Understand that the college does not want 'your' clinical practice, it is the practice in UK that is important.

So you should be thinking that way all through your study.

You certainly have to make a lot of sacrifices in terms of family life, financial and even departing from your family for some period of time.

It is very painful if after all of this one cannot get through.

So, do it once and do it for all.

Quantity is of study is not important, its the quality that maters.

This is why I emphasise proper planning for your studies.

I wish you all best of luck.

If there's anything else which is not clear, please do not hesitate to write to Dr Tom about it and I would try to include that in this article.

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