How to pass the MRCOG first time!

Home Page MRCOG page Search the site for a word or phrase.

This section is being updated.

There is a Word document that is up-to-date with the relevant advice.

Email if you would like a copy.

My email is on the Contact page.


Most of the advice in this section is from Tom McFarlane.

But the best  is from Elaine, who won the Gold Medal in 2010, Lucy, who won it in 2011 and Gemma, who won it in 2013.

Also the experience of Asma, who has not worked in the UK and passed in 2010, giving the perspective of the "overseas" candidate.

And Anupama. winner of the Vijaya Patil award 2013.

This is gold-dust.

In fact, it is better you would be really stupid not to go through it in detail.


The exam is computer-based.

Check the RCOG website for details.

Get organised well in advance to avoid unnecessary stress.

what you need to bring with you need to bring with you on the day,

security checks etc.

Pay attention to the instructions on the day:

     how to correct an error?

    how to move back?        

The College main Part 3 page infomation is here.

It is not well organised and some stuff is hard to find; e.g the calendar is hidden in the 'book an exam' section, when it shold be on the main page.

I have written to them and had a helpful reply - I await improvements


List of contents.

  1.     you must be eligible to sit the exam

  2.     apply to the College in good time and check they got your application

  3.     allocate adequate time for preparation

  4.     prepare thoroughly & find a "study buddy"

  5.     teaching as learning

  6.     know the format and syllabus 

  7.     what to read

  8.     develop techniques to enable you to read constructively

  9.     learn and practise techniques appropriate to each type of question

  10.     practise EMQs and SBAs

  11.     try to spot 'hot' topics

  12.      master CTG interpretation

  13.      build a last-minute revision list of difficult-to-remember topics

  14.     book study leave for the week before the written exam 

  15.     Part 3 skills:

  16.            hone your communication skills

  17.             make sure you have the necessary practical knowledge 

  18.             prepare all the known types of station

  19.            go on an OSCE course 

  20.     Go on a course for the written exam

  21.     consider your special requirements if you haven't worked in the UK

  22.     other sources of information


      Return to the top of the page.

      Return to "Suggested Reading".

      Go to the bottom of the page & other links.


1.    Apply to the College in good time & check they got your application.

The College publishes calendars for the part 2 and part 3 exams.

These give:

     the dates of forthcoming exams and where you can sit them.

     the closing dates for getting your training and certificates approved.

       the closing dates for applying to sit the exams.

The College rejects all late applications and won't listen to any excuses.

But it has an unreliable system for booking people in.

In a recent round of exams I had one DRCOG trainee and one MRCOG trainee who were refused permission to sit the exam.

This was on the basis that they had applied late.

Yet both had applied in good time.

One had even had her cheque cashed by the College!

My advice is to check a week or so after you submit your application that you are definitely on the list.

I have enquired of the College about this problem and am told that an improved system will be introduced shortly.

You would have thought that the simple answer would be to send confirmation of receipt to every applicant!

What's so difficult about that?


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       


2.    Allocate adequate time for preparation.  

Six months is an appropriate time for most people.

But be prepared to allocate most of your spare time to the task.

If you can make it twelve months, so much the better.

If you can not prepare thoroughly, do not apply for the exam.

It is very depressing to fail and it takes time to pick yourself up and get re-motivated.

More importantly, you don't want to sacrifice more than one six-month slab of your life to the exam.

The written exam is the hardest part with a much lower pass rate than the clinical.

So concentrate on the written exam; you will have enough time to prepare for the OSCE once you have passed.

I have started to put some OSCE stuff on the website.

And there are plenty of books and courses giving practice with the different types of OSCE station.

One thing you can think about and refine in the interim is your communication with patients, of which more below.

It is also worthwhile thinking about having a model for taking an obstetric or gynaecological history.

Practising the model will help you learn it and reduce the chance of you missing something important in a roleplay.

I have put a model for an obstetric history on the web page.

I will do the same for taking a gynaecology history in the near future.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       


3.    Prepare thoroughly.

If you do not know enough, you fail!

Obvious and basic.

If you can find someone preparing to sit the exam at the same time as you, that can be very helpful.

You can prepare stuff to share and motivate each other.

If you arrange to meet a couple of times a week, it will make you work even if tired or fed-up.


You need to know the exam regulations:

      part 2 regulations,

     part 3 regulations.

You need to know about the new extended matching questions.

The College has examples on its web site.

We will practise EMQs in the tutorials.

Likewise the SBAs, examples of which are on the College website.


 You need to know the examination syllabus.


Make sure you have enough knowledge.

Make sure you have read appropriately.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.





Take every opportunity to teach, medical students, junior colleagues, nurses, midwives etc.

You have to prepare and it will help you know and remember stuff.

Learn humility and practise honesty.

No one knows everything.

I almost never have a MRCOG tutorial session in which I do not find something about which I am ignorant or unsure.

It is good to admit that you don't know - but always make sure that you find out afterwards.

Your audience will appreciate your honesty and humanity.

No one likes liars or people pretending to be God-like.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.


Know the format and syllabus.

This is so obvious I am almost embarrassed to mention it.

You need to know about the introduction of part 3 of the exam in 2016.

The written exam consists of EMQs (Extended Matching Questions) and SBAs (Single Best Answers).


You need to know the format and syllabus.

The format is here.

The syllabus is here.


MCQ paper 1 and EMQ paper 1 relate to modules 5, 6, 7, 13, 14, 15, 16, 17 & 18

MCQ paper 2 and EMQ paper 2 relate to modules 2, 3, 8, 9, 10, 11 & 12



Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page &


4.    Suggested Reading.

Click here for a list of suitable reading materials.

The most important things to read are the RCOG  and NICE guidelines plus all the TOG articles for at least 3 years.

Note the box in the RCOG advice with links to more than Green-top guidelines: consent advice, SIPs etc.

There is advice on:

   clinical governance,


   joint guidelines, etc. 

Read the clinical guidance from the Faculty of Sexual and Reproductive Healthcare.

Most successful candidates will tell you that the bulk of the exam is covered by these sources.

So, it essential that you know them thoroughly.

It is very interesting as it shows how textbooks have become of secondary importance.


I advise my trainees to do the following:

  1. Get through all of my MCQs. The first is on this web page - it's a good way to get you started although the exam no longer has MCQs. All the papers and answers are on Dropbox. If you want access, send me an e-mail.

  2. Learn -don't just read - everything published by the College and NICE.

  3.     make out a card or cards for every RCOG Green-top guideline and NICE equivalent (or get them into whatever revision system you are using).

  4.     don't forget the RCOG stuff like  clinical governance, consent etc.

  5. Read all the "TOG" articles for the past three years.

  6. Read all the Obstetrics Gynaecology & Reproductive Medicine articles for the past three years if you have time but they are much less important than TOG.

  7. Make sure you do all the EMQs and MCQs in TOG & OGRM: even better make out cards - identical questions have featured in the exam.

  8. Keep an eye on the RCOG website: in the March 2010 exam teenage pregnancy and swine flu were on the website and featured in the essays.

  9. The above is the essential core of your preparation. What follows is helpful, but if you have not done the above, you are likely to fail and some successful candidates will tell you that the above is all that they did.   

  10. Read topics not covered elsewhere in a MRCOG textbook .

  11. Read topics in obstetric medicine not covered elsewhere in "Nelson-Piercy".

  12. Read the papers I have written on stuff that is not well-covered in the textbooks.

  13. Know the Maternal Mortality Report, MBRRACE  - we will cover this in the tutorials.

  14. Know the recent facts on Perinatal Mortality.

  15. Read a bit about statistics, etc. E.g.  "how to read a paper" by Trisha Greenhalgh. It is based on BMJ articles and you can find most of it on the

    BMJ website. There is also a copy of the 2nd. edition on-line which would be OK for your purposes and is cheaper than the latest version. There is another good book: "The Doctor's Guide to Critical Appraisal" by Gosall & Gosall.

    We will have tutorial from Julie Morris on statistics and how to criticise a paper.

  16.  Cancer Research UK has the latest statistics on cancer incidence & mortality and staging, e.g.  cervical cancer.

  17. Patient UK has useful, up-to-date brief articles on selected topics. Have a look at PPROM which gives most of what you need.

  18. Most importantly, read in an analytical and constructive way.

  19. Learn and practise techniques appropriate to the type of question.

  20. Read parallel subjects: genetics, neonatology, family planning etc.

  21. Most of the genetics you need is covered in the MCQs and the questions I will give in the tutorials.


I would guess that you have now done about 95% of the necessary preparation.

And easily know enough to pass.

But do the following to get up to 100%.


  1. Consider subscribing to "StratOG". There have recently been questions from it in the exam.

  2. Use subsidiary sources of advice.

  3. Read as many of the small MRCOG texts on EMQs & SBAs as possible.

  4. "High Risk Pregnancy" is a mini-encyclopaedia: read selectively from it for things not covered elsewhere.

  5. You need to know the management of the common emergencies.

  6. The "Oxford handbook of O&G" is portable and a basic summary.

  7. Know the key joint RCOG publications,

  8. Think of important subjects that are not routine in UK practice.

  9. HIV will always rear its ugly head.

  10. Use the RCOG series "Subject X for the MRCOG and Beyond" to fill in gaps, though some are now a bit dated..

  11. Keep up to date with HRT and other fast-changing subjects.

  12. Talk to colleagues who have recently passed the exam about how they prepared..

Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading"

Return to "Reading constructively".

Go to the bottom of the page & other links.       


a. It is crucial that you know everything the RCOG has produced: “Green-Top” guidelines etc.

You can access all of this in the section "Guidelines" on the RCOG website .

The RCOG website gives useful links to other sources of guidelines.

Similarly, NICE produces guidelines that you need to know.

There are loads of other guidelines.

Patient UK has links to loads of guidelines from the UK and elsewhere. 

It also has very useful summaries of conditions. Have a look at its version of PPROM.

My experience is that its materials are kept up-to-date.

Cancer UK has the latest statistics and useful summaries.

E.g. the staging of cervical cancer.

Don't waste time on esoteric material.

The RCOG and NICE advice is the stuff you need to know.

Keep an eye out for guidelines that are in the pipeline.

The draft guideline is usually put out for comment months before the final version is published.

The exam committee sets the exam questions six months in advance.

It will be aware of guidelines that will be published in the months before the exam.

These will be very tempting as sources of questions.

Details will be published on the RCOG website.

Return to "Suggested Reading".


Talk to colleagues who have recently passed the exam.

What did they read?

What courses did they attend and how useful were they?

Make use of all learning opportunities within your department and further afield.

Return to "Suggested Reading".


b.  The next vital reading is:

        The Obstetrician & Gynaecologist, usually known as "TOG"

       Many of the questions in any examination have been covered in recent issues of these journals.

Ideally, read all of the articles for the past three years.

TOG is a RCOG journal and standard reading for ages.

Members, Fellows and trainees get it sent them, so you have no excuse for not reading it!

It covers topical stuff is a nice, concise way, that is ideal for MRCOG preparation.

Similarly, Obstetrics, Gynaecology & Reproductive Medicine is helpful, but not so important - OK if you have the time and money.

It aims to cover all key topics in a 3 year cycle, so try to read all the issues for the past 3 years.

Return to "Suggested Reading".


The College also publishes StratOG.

I think it is quite expensive and don't use it much, but I am told that recent exams had identical question.

It is advertised as comprehensive and using all the latest web tricks and educational aids.

I had a look at a few sections e.g. the genetics section.

It contained the necessary information.

There were a few links to external sites and explanatory papers.

I think is meets the needs of the MRCOG candidate.

You'll need to make up your own mind about its value-for-money.

Return to "Suggested Reading".    


c.  There are subsidiary sources of advice.

Khaldoun Sharif has a blog that keeps up-to-date with stuff of interest.

It's an obvious plug for his MRCOG course as it is to be found on the web page for his courses. 

However, this does not diminish its value.

He obviously puts in a lot of effort to keep it abreast of topics of current interest.

Some of these are likely to appear as questions in the written or OSCE stations.

The Cochrane Collaboration gives access to their excellent reviews.

SIGN has published a couple of relevant guidelines.

The Department of Health,, and related agencies issue advice and information on current topics, such as:

     HPV immunisation,

     the national chlamydia screening programme: and chlamydia generally.

     fortification of flour with folic acid, 

     screening of neonates for cystic fibrosis, 

     screening of neonates for Medium Chain Acyl CoA Dehydrogenase Deficiency (MCADD),  

     varicella in pregnancy and varicella vaccine. 

The British Medical Association produces some data of relevance to the exam. 

E.g. its excellent document of June 2007 on alcohol and pregnancy. 

And its "Consent Toolkit".

Professional associations of other countries produce advice e.g. 

    the American College,

    the Canadian Society of O&G  where you can access guidelines like the one on soft markers,

     the Royal Australian and New Zealand College of O&G where you can access guidelines like the one on prenatal screening. 

The Centers for Disease Control and Prevention has numerous documents on its web site: e.g. on immunisation in pregnancy.

CMACE publishes data on maternal and neonatal mortality and morbidity. 

OMIM is invaluable for looking up genetic conditions, 

Use these sources for data you can’t find elsewhere, but don’t get sidetracked into wasting time on obscure stuff.

Return to "Suggested Reading".     


d.  MBRRACE took over the production of maternal and perinatal mortality reports.

It produced its first Report in 2014.

This will generate a lot of EMQs and SBAs.

Return to "Suggested Reading".


e. Use a textbook to fill in gaps

"Obstetrics & Gynaecology An Evidence-based Text for MRCOG" was published in its 3rd. edition in 2016.

The editors were Luesley & Baker, but are now Luesley & Kilby.

It is not perfect, but covers most topics.

It has a companion book of questions to check your retention of key facts: "MCQs and Short Answer Questions for MRCOG".

I don't know when that will come out in a new edition.

The standard textbook used to be "Dewhurst".

A new edition  was published in 2007 edited by Edmonds and published by Blackwell. 

It is now a bit out-of-date, though I am sure that a new edition will come soon.

There are other standard textbooks; it is a matter of individual preference.

Return to "Suggested Reading".


f. I like my trainees to go through all 13 of the MCQ papers I use for my DRCOG candidates.

The first paper is on this web site.

I like them to get through them in the early weeks of their preparation.

Their virtue is that they span most of the spectrum of MRCOG topics including some that are not well-covered in the textbooks.

For example, paper 2, question 40 gives you all you need to know about Fragile X syndrome and FXTAS. 

Some of the answers are MRCOG level, like the one on Fragile X and paper 1, question 1, which deals fairly exhaustively with MSAFP.

Others are obviously more DRCOG standard.

Click here for the list of topics covered by the MCQs.

The papers and answers are on Dropbox - send me an e-mail if you are interested and I'll link  you to them.

Return to "Suggested Reading".     


g. You need to read related subjects: genetics, family planning, neonatology, sexually-transmitted disease etc.

Many of these are dealt with in the College series "Subject X for the MRCOG and beyond".



This is best learned on a training course for the DFFP (now the DFSRH).

These courses are reportedly excellent and provide all you need to know for the MRCOG.

The Faculty of Faculty of Family Planning puts loads of good information and protocols on its web page.

It has lots of excellent guidance, for example:

   oral contraception use and cancer risk, 

    on first prescribing oral contraception,

    on emergency contraception,

    on missed pills,

    all of which topics are ideal for written or OSCE questions,

   and topics that are not directly about contraception - like vaginal discharge. 

This is a superb resource and you should make use of it. 

Other suitable texts (watch the date of publication) include:

Handbook of Family Planning and Reproductive Caree-5th-edition

Glasier & Gebbie


Contraception Today



Handbook of Contraception and Reproductive Sexual Health


Baillière Tindall

Contraception Your Questions Answered



Return to "Suggested Reading".


The menopause & HRT are fast-changing and you need to be sure that you are up-to-date with the latest advice.

You can get this from the UK and American menopause societies, and

E.g. The British Menopause Society & Women's Health Concern recommendations on HRT from 2013.


    hormone replacement therapy

    alternative and complementary remedies 

    local oestrogen for atrophy of the vaginal skin.

The government issues advice via MRHA, "The Medicines and Healthcare Products Regulatory Agency".

The Chief Medical Officer also pronounces on the subject when something alters.  

You need to keep abreast of the latest advice from studies such as WHI,

Alternatives to oestrogen are going to appear in the exam.

Suitable reading includes:

Menopause - What you need to know  Rees, Purdie & Hope RSM

Management of the Menopause - The Handbook

Rees & Purdie


Managing the Menopause without Oestrogen  Rees M. & Mander T. RSM

Return to "Suggested Reading".



You need to know resuscitation of the newborn and its latest protocol.

The best source of information is a paediatric registrar or consultant neonatologist.

It is well covered in Luesley & Baker and in the "Illustrated Textbook of Paediatrics" mentioned below.

Neonatal jaundice is a common topic.

See MCQ paper 7, question 12.

You could be asked about:

    examination of the newborn,

    management of congenital abnormality, from CDH through to ambiguous genitalia or diaphragmatic hernia

    and neonatal infection.

Suitable texts are:

Illustrated Textbook of Paediatrics

Lissauer T & Clayden G

Mosby Elsevier

Essentials of Neonatal Medicine

Levene et al.


Resuscitation of babies at birth Royal Colleges of Paediatrics and O&G BMJ Publishing Group

 There used to be "Neonatology for the MRCOG and beyond".

The RCOG bookshop says that a new version is awaited, but no date has been given. (October 2007)

It was worth buying before so I'm sure the new version will be too.

In the meantime I'd use whichever undergraduate textbook is in your library.

Or splash out and get the Illustrated Textbook of Paediatrics.

It has good sections on all the basics like:

    ambiguous genitalia,

    examination of the newborn,

    neonatal jaundice,

    neonatal resuscitation,

    problems of the IUGR baby etc.

Return to "Suggested Reading".


Sexually transmitted diseases will certainly feature.

The "ABC" book is adequate.

ABC of Sexually Transmitted Infections


BMJ Books

It would also be worth paying a visit to your local clinic to see what their procedures are.

Return to "Suggested Reading".


Genetics crops up all over the place.

Most of it is covered in the MCQs.

The text below amplifies the MCQs.

Medical Genetics for the MRCOG and beyond


RCOG Press


Return to "Suggested Reading".    


The RCOG stopped publishing in 2013 and most of its books are now produced by Cambridge University Press.

The RCOG published a series of small books entitled “*** for the MRCOG and beyond”.

Subjects included:

    antenatal disorders,

    gynaecological oncology,

    gynaecological urology,

    haemorrhage and thrombosis,


    intrapartum care,

    medical genetics,

    psychological disorders,

    reproductive endocrinology.

They are invaluable for filling gaps but watch out for the date of publication: some will soon be pensionable.

Return to "Suggested Reading".


h. There are masses of books written specifically for the MRCOG.

Some try to cover all the components of the exam.

Some deal with only one part, e.g. the written or the OSCE.

Some are now very old and of limited value.

I would give them a miss.

Have a browse before you buy and use your critical faculties.

The more you practise the better.

Remember to practise time-keeping too.

Return to "Suggested Reading".


i.   There are review books:

         the best known being "Progress in O&G" edited by Studd and published by Elsevier

       and "Recent Advances", edited by Bonnar and Dunlop and published by RSM Press.

Less well known is:  "Vignettes for the MRCOG" by Farquarson and published by Quay.

Their role has largely been superseded by “TOG” and I doubt that modern trainees use them..

Return to "Suggested Reading".      

"Handbook of Obstetric Medicine"  by Catherine Nelson-Piercy is valuable for filling in gaps.  

At the back of the book is a very useful section with a table of common symptoms such as breathlessness, palpitations and abnormal findings like proteinuria and abnormal LFTs.

Differential diagnoses are given and appropriate investigations.

It is an invaluable section that is overlooked.

Go though it, make notes and add it to your last-minute-revision list.

Return to "Suggested Reading".      




















k.  High Risk Pregnancy"  by James et al and published by Saunders is superb but huge.

It should be consulted on an ad hoc basis.

Return to "Suggested Reading".      


























The  MOET handbook  is worth reading for the management of emergencies.

These are also dealt with in Emergencies in O&G" by Arulkumaran and published by OU Press.

Return to "Suggested Reading".      





























The "Oxford Handbook of O&G" by Arulkumaran and published by OU Press is popular.

It fits in a pocket, so can be carried at work for consultation and exam preparation when you have a spare moment.

Return to "Suggested Reading".      






















































l. I have produced some papers on topics not well-covered in the textbooks.

You need to be au fait with Clinical Governance,  CNST, Risk Management,  Protocols, Audit, etc. as practised in the UK.

This is particularly important if you have not worked in the UK, as the systems under which you have trained may be significantly different.

Similarly, you need to know about Consent and Complaint procedures.

The College has produced advice on Consent, accessible via its web page.

The GMC has done the same, but its advice is rather large.

You can find the College and GMC advice in the Consent section.

I couldn’t find a single comprehensive source for reading about Complaint Procedures, so wrote one.

A recent OSCE examination included a viva on electrodiathermy.

This was a killer and could feature in an essay or MCQ.

See the document on this web page for further information.

Return to "Suggested Reading".


























You should know the basics of joint publications by the RCOG, RCM and DOH such as    "Safer Childbirth" and “Changing Childbirth”. 


Return to "Suggested Reading".      
























You need to think of subjects that could crop up that are not met in routine practice, e.g. malaria or tuberculosis in pregnancy.

Return to "Suggested Reading".      






























You need to be well versed in HIV and pregnancy.

This web page has a summary sheet.

There are a number of web sites to keep you up to date:

    the British HIV Association,

    and The Health Protection Agency,

There is an intercollegiate report, “Reducing Mother to Child Transmission of HIV Infection in the United Kingdom”, July 2006.

It can be accessed via the HPA web page.

There are a number of topics that are not easy to get full information on from the textbooks.

I have produced a number of papers on them - click here.

Make sure you read them all.

Return to "Suggested Reading".





















5.    Read constructively.

The immediate conclusion from the suggested reading section might be that the task is impossible!

It is daunting, but not impossible.

It means that your reading has to be disciplined and efficient.

The volume of necessary reading makes it evident that you cannot read anything more than once.

Hence, you need a technique that allows you to capture all of the important information at the first sitting.

Ideally this should be in a format that facilitates revision.

You need all of the information securely stashed in your head and available for the exam.

You cannot just read and hope that everything relevant will stick.

There is advice from Elaine and Lucy.

I used cards. Postcard-size or slightly smaller.

Big enough to contain the information you want, but small enough to carry in a pocket.

You go through them whenever you have a spare moment at work.

For example, you might make out a card on postmenopausal bleeding and the risk factors to elicit in the history.

On the front of the card you would write the title, Postmenopausal bleeding with a sub-text, isk factors to elicit from the history.

There is a good summary on the SIGN page. 

You would then make out a list of all the things you feel should be included.

There would be obvious things such as:

    her age and the interval since the menopause - the older she is and the further from the menopause, the bigger the risk of cancer,

    the frequency and duration of the bleeding (the SIGN page says the pattern of bleeding doesn't help),

    associated symptoms like discharge or pelvic pain,

    a history of treatment for gynaecological malignancy or premalignancy etc.

You would include the increased risk with unopposed oestrogen and the reduced risk with continuous, combined HRT.

You would mention tamoxifen, which, used for > 5 years, increases the risk at least fourfold. (See SIGN page.)

Family history would include the possibility of the woman being from a HNPCC family (MCQ paper 1, question 13) etc.

Make sure you go to MCQ paper 1, question 13, it contains links to trials being run for HNPCC women in relation to endometrial cancer risk.

Once you had compiled your list on the back, you would count the items and put the number on the front.

When you use the card for revision, you read the front and have to try to recall all of the headings on the back.

There are several values to this system.

You have to read analytically to ensure that you have captured all of the important points in whatever you are reading.

Often when we are reading we are only half-concentrating.

You cannot do this if you have to make out cards.

You have to pay attention and decide what information you need to capture.

This helps you to remember it.

Then putting it down on paper helps to cement it into your head.

You also need to deal with stuff you do not fully understand.

You cannot just put it off to another day.

Once you have made out your cards, you do not need to read the source again.

You should then revise the cards time and again until they are memorised and their contents are easily recalled.

If you come across some additional information, you amend the card.

You may well prefer to move from the dark ages and uses an electronic storage device.

So long as it is portable and you have regular backup in case it is stolen or crashes.

And the information must be stored and then presented to you in a way that tests your knowledge.

Do  not fall into the trap of just copying large chunks of stuff from your computer into the organiser.

An important part of the process is that you write the stuff that you store.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       































6.    Learn and practise appropriate techniques.

Whatever you are practising, essays, EMQs etc. learn to keep track of the time.

MCQs and EMQs are best practised using the books mentioned above.

Practise writing at speed for an hour or two.

Give yourself three or four essays and write them in one session.

You'll find that the muscles in your hand and forearm tire.

So they need to be exercised to get them fit for action in the exam.


MCQ techniques.

EMQ techniques.

Short essay techniques.

Return to "List of contents".  


































With all the reading you do, make out MCQ cards.

Put the likely questions on the front.

And the answers on the back.

The technique for the MCQ paper is to go through the questions answering all those you are confident you know.

Then go back through, answering those you need to think about.

Finally, guess the ones about which you have no clue.

There is no negative marking.

So, by the Law of Averages, you should get half of them right.

Keep an eye on the time to ensure that you answer every question.

Return to "Learn and practise appropriate techniques".






































With EMQs, read what the question is about and then the scenario.

You should then have a pretty good idea of what the answer is.

You can then read the list of options.

Don't read the list of options first.

You will waste time trying to remember points about things you half-remember.

E.g. Noonan's syndrome might be on the list.

And you will waste valuable time trying to recall its key features.

Yet it might not be the answer to any of the scenarios.


If the answer you thought correct is on the list, go for it.

Don't waste time going through the list to check that there is not a better answer.


If you are not sure about the answer, you need to decide which might be correct answers.

There will probably be one or two answers close to what you thought the answer should be.

The hard bit is deciding which is the best.

You might have to do a bit of lateral thinking.

A recent question was along the lines of a woman admitted at 28 weeks with significant hypertension and features of PET.

A question was whether she should first have a hypotensive drug or magnesium sulphate.

For most people it was a daft question as you would administer both.

However, it you think it through, the biggest risk to her health is intracranial haemorrhage from bleeding due to hypertension.


The most important thing is to do as many examples as you can find.

Get at least one book of EMQs.

I'd start with EMQs for the MRCOG part 2 by Duthie and Hodges.

Return to "Learn and practise appropriate techniques"





































EMQs and SBAs.


Return to "Learn and practise appropriate techniques"

Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       




































7.    Spotting Essay Topics.

See also "possible essay topics".

This is a useful game.

Think of the poor exam committee. 

They have to dream up the questions.

Some topics are important and recur:

    management of cancer,

    terminal care,

    diabetes and pregnancy,

    management of obstetric emergencies and so on.

These will be dragged out of the database from time to time.

They will also try to include stuff that is new or topical.

They may have read about this in TOG or an editorial - see below.

So it is really important to have read TOG and the editorials in the leading journals for at least the past couple of years.

Khaldoun Sharif tries to keep up-to-date stuff on his blog.

Some of these topics are bound to find their way into the exam.

Nowadays the essays tend to be straight-forward clinical problems.

So, you are not likely to have an essay on pre-pregnancy counselling for Fragile X and FXTAS.

But you could in relation to cystic fibrosis.

Fragile X and FXTAS would be more likely to be in the MCQs or EMQs, being more esoteric.

And you could be asked difficult stuff, like the range of triplet repeats for normal, carrier and affected statuses. 

A topic that appeared in the last exam is not likely to reappear for a few years.

Most people will be aware of recent questions and have thought about how they would have answered.

So, it is useful to know the questions that occurred in the papers over the past couple of years.

The exam has to test you on all the basics and anticipates an awareness of things of topical interest.

TOG and the review books try to keep all the important and topical issues up-to-date.

So it should be no surprise that as many as half of any batch of essay questions will have featured in recent TOG articles.

Make sure that you have read the back issues from the previous two or three years.

Current topics appear as editorials and leading articles in journals such as the BMJ, Lancet, British Journal of O&G, etc.

It is worth spending an afternoon once a month in the library going through them for the past couple of years.

Make out cards on each topic.

The articles will generally give comprehensive answers that would make perfect model essays.

Now go to: "possible essay topics".


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       


8.    Practise CTG interpretation.

You need to be good at CTG interpretation.

Mainly to keep your patients and their babies out of harm and to reduce interventions.

But also to pass this exam.

There is advice from NICE.

And there are lots of books.

The Perinatal Institute has produced a free trainer and would advise you to use it unless you have an equivalent.

As this is such an important skill and one that is in daily use, I think it is great that the trainer is freely available.

         The RCOG with other bodies has produced eFM, "electronic fetal heart rate monitoring.

           NHS staff can use it free of charge.

           Others have to pay £100 per annum.

            This is a lot for one course, but it is a core skill and features regularly in the exam.

            It has sample sessions that you should have a look at to see if you feel it is worth the money.

Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       
















Difficult-to-remember topics.

Some stuff just does not stay long in your head.

Mostly things that you do not deal with every day.

Make out cards well in advance or load them into whatever alternative revision system you are using..

Rehearse them like all your other cards.

But mark them in some way or keep them separately so that you can get all of them out in the days before the exam.

For example, use cards of a different colour or put a coloured sticker on these cards.

The important thing is to be organised.



1ry amenorrhoea. (MCQ4, question 6)

Ambiguous genitalia at birth. (MCQ9, question 5)

Precocious puberty. (MCQ6, question 22)

Vaginal discharge in a child. (MCQ1, question 23)

Adreno-genital syndrome. (MCQ6, question 23)

Staging of gynaecological cancer.

Treatment of gynaecological cancer.

Palliative care.

FIGO table of prognostic features in trophoblastic disease. (MCQ6, question 19):

    this may seem super-specialist,

    but there has been an essay on the subject

    and it is in the MCQ database

Maternal mortality: (MCQ5, question 18; MCQ9 question 1):

            main causes, direct and indirect,

                list them on your cards in order and with numbers, as some of these will stick,

            main causes internationally,

            ten top recommendations:

                these would make a perfect essay,

  the "Back to Basics" chapter, which would also make a perfect essay, 

            early warning systems.

RCOG: maternity dashboard. See RCOG website.

Complaint procedures. See document on the website.

Consent for specific procedures: RCOG website.

Malaria & pregnancy. (MCQ12, question 25), TOG: 2005; 7:1:5-11 and Malaria Site.

Tuberculosis & pregnancy. (MCQ12, question 21) and CDC fact sheet.

Infection in pregnancy: see TOG: 2009; 11:2:108-116 for a very good summary - exactly what you need!

WHI figures & HRT. (MCQ7, answer 17)

NICE & UK's National Screening Committee and screening for T21. (MCQ4, question 26; MCQ11, question 10):


    not just the recommendation re combined first trimester screening,


        you need figures about sensitivity, screen +ve rates etc.


Fragile X syndrome. (MCQ2, question 40)


    This has not yet appeared as an essay.


    But it will one day and cause havoc.


Drugs for PID.


Heart disease & pregnancy.

Inheritance of congenital heart disease.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Return to "Hot Topics".  

Go to the bottom of the page & other links.       



Book study leave.

Your last-minute-revision list will grow quite large.

Much of the detail will only stay in your short-term memory.

You need adequate time in the days before the written to go over it.

Make sure you have all the topics in note form - this time should be for revision, not new learning

Book your leave early so that you don't have problems in the run-up to the exam fighting for authorisation.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Return to "Hot Topics".  

Go to the bottom of the page & other links.       



OSCE skills.

Once you have passed the written exam, you know that you have the necessary knowledge.

The OSCE tests this knowledge again, mainly seeing how you would apply it in a clinical setting.

And how you communicate with patients.

As you have the knowledge, it is mostly about technique.

Use these links:

     hone your communication skills

     make sure you have the necessary practical knowledge

     prepare all known types of station

    go on an OSCE course


Return to NW OSCE course.

Return to "Should I go on an OSCE course?"

Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       
































8.       Hone your communication skills.

You should think about improving your communication skills in anticipation of the role-play stations.

And, more importantly, to make you a better doctor.

I like my trainees to use a set form of words when:

    introducing themselves to patients,

    encouraging patients to ask questions,

    explaining difficult concepts like recessive inheritance etc.

Start with the forms of words I have suggested.

They work for the exam.

Once you start using them with patients, you will modify them and end up with forms that suit you and reflect your style.

That's fine, so long as you are sure that they are an improvement on my suggestions.

You can find details on this web page.

Many hospitals have training in general communication skills and in dealing with specific problems like breaking bad news.

Get on these courses and start honing your skills.

Most importantly, practise the following:

speaking slowly: one of the most common problems is speaking too quickly,

introducing yourself to the patient,

avoiding big words and medical jargon,

explaining terms like recessive inheritance,

listening to the patient and picking up clues, both verbal an non-verbal,

good techniques for getting her to ask questions.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       




Make sure that you have the necessary practical knowledge.

You don't want to be caught out by lack of practical knowledge.

Could you talk throught the steps taken in hysterectomy or vaginal hysterectomy?

Make sure you have assisted with enough cases to be able to discuss such topics in a viva.

Even better, do a few cases yourself.

Have you seen colposcopy, loop excision, hysteroscopy?

Can you demonstrate the use of Kiellands forceps?

Can you distinguish between a cystoscope and a hysteroscope?

Ask the gynae theatre sister to talk you through all the common surgical instruments, their names and what they are used for.

Can you tie proper knots and explain to a trainee how to do it?

Familiarise yourself with urodynamics.

And not just from the books.

Attend a clinic to see what is done.

Then attend a session with a uro-gynaecologist or urologist to learn how to interpret printouts.

The OSCE bank has a station in which you are taken through taking a history of a patient with urological problems.

You are then asked for the appropriate investigations.

When you say "urodynamics" you are given the printout and asked to come up with the diagnosis.

Get it prepared!


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       


































9.       Going on a course.

Most people attend at least one course.

There is a huge array of courses.

If you live in the Manchester area, you are welcome to attend my weekly tutorials.

Even if you are only in the area on a short term visit, we will be pleased to see you.

There is no charge for the teaching.


If you live in the NW, it would also make sense to attend the North West MRCOG Course.

This is a five-day course with masses of exam practice.

Have a look at the programme.

Varsha Mulik, who runs it, puts in a prodigious amount of effort and it shows.

I help with the course, so must declare an interest.

If you come to this course, you are also welcome to attend my tutorials.


You can find other courses via Google on the Internet.

They are also listed on the College web page: MRCOG Revision Courses .

A listing on the College web page is not a College seal of approval.

The College just lists any course of which it is informed.

So, if you are disappointed by the course you attend, don't blame the College!

I can't vouch for their quality apart from the ones run by the College itself - they are the only ones I have taught on.

The feedback I get about the others is that they range from OK to excellent.

I haven't heard of any really bad ones.

Some, such as Whipps Cross have excellent reputations stretching back for ages.

The RCOG's own courses are very popular.

I used to teach on these and they were well organised and "fit for purpose", as the jargon has it.

At the British Congress in 2007 I heard that their recent pass rates had been ~ 60%.

This is equivalent to the overall pass rate for UK graduates.

These are excellent results, as most of those attending have not worked in the UK.

The popularity of the College courses is reflected in the fact that they are fully-booked months in advance.

If you want to attend, book early.

Note that there are separate RCOG courses for the written and the clinical examinations.


The College now takes its courses to other countries.

You may find one that is a lot easier for you than coming to the College itself.

You will be able to find details, as they emerge, on the MRCOG Revision Courses web page.

The College recently announced the Enhanced Revision Programme in Pakistan.

This looks very interesting and I'll be very interested to have feedback from anyone going on it.


There are other overseas courses already established.

Some are on the MRCOG Revision Courses section of the RCOG website.

You should be able to find others by "Googling" "MRCOG course + the country you want".

They ought to be of a similar standard to the UK courses.

Most, if not all, have UK Members and Fellows on their faculties.

This should help ensure that they keep abreast of changes in the UK.

However, with the abundance of talent available locally in most countries, they should eventually be self-reliant.

They will have two main advantages:

    the cost of attending them will be a fraction of the costs of coming to a UK course,

    the organisers will have particular knowledge of the differences between practice in the region and the UK.

Most courses in the UK don't focus on the needs of the doctor who has not worked in the UK.

Overseas courses will be able to do so with special insight.

Like all courses, the best thing will be to find someone who has attended and get their opinion.


There are on-line courses.

Evelyn, one of my trainees, used one of these, "RCOG Courses"  and passed the written exam.

She felt that she had gained a lot from it, especially in improving her essay-writing.

I don't have any information about any of the others.


Most of the UK courses are very expensive.

Despite this, they are not sufficient to get you through the exam on their own.

You need to do a load of other preparation.

If you are not prepared to do this, don't waste your money on a course!


If you go on a course, let me know what you thought of it so I can advise others.


If you have not worked in the UK, read the section on "special requirements" before booking a course.


Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       


































10.       Consider your special requirements if you haven't worked in the UK.

There may be differences in clinical practice between the UK and the hospitals in which you have trained.

However, most of these should be obvious from reading:

    RCOG and NICE guidelines,

    textbooks by UK authors,

    the papers I have written on topics that are not always well-covered in the textbooks.


Despite being on a tiny island, the RCOG refers to all non-UK doctors as "overseas".

England (forget other parts of the UK such as Scotland) remains the centre of the universe!

I look forward to the arrival of little green men from billions of light-years away who say they are doctors.

They will be able to apply for membership of the RCOG as "overseas" doctors.


The bigger differences are likely to be the patients and management practices.

Part 2 books written by non-UK authors are beginning to appear.


E.g. "MRCOG. A structured approach".

This is by Drs. Reddy & Ram and published by Orient Longman.

It is an excellent guide to the exam.

It has the particular virtue that the authors work in Chennai & Hyderabad in India, but know the UK system well.


In some countries patients expect the doctor to have a single diagnosis and treatment.

If a doctor gave them four treatment options, they might think the doctor did not know what they were about.

In the UK, many patients behave like this too.

But others will want to know the possible diagnoses.

Most will want to know the range of treatment options.

Some may have read up on the subject on the Internet or in the library.

This could make them genuinely expert on a subject, but could equally give them a load of daft ideas.

Most patients will expect to have a conversation with the doctor and be given a reasonable amount of information.

Doctors need to supplement oral information with the printed variety.

There are plenty of doctors to pick from, so patients can afford to be "choosey".

This makes communication skills and "bedside manner" particularly important.


You need to understand about consent, which could be an OSCE roleplay.

You also need some basic understanding of the structure of the NHS and how it links with other bodies:

    what is the role of the Department of Health? 

    what is the role of the General Medical Council? 

    what is NICE?  

    what is the Healthcare Commission? 

    note that the Healthcare Commission has a role in hospital complaint procedures.

    what are Trusts and what do they do?

    what services are provided by community services?

    what do social services do?

    how do hospitals, General Practitioners and social services interact?

It is important to have a grasp of Clinical Governance, Audit, Risk Management, Protocols etc.


If you go on a course, look carefully at the programme.

Make sure that there is adequate time allocated to these topics.

It is likely that "overseas" courses will deal with these areas more than those in the UK.

Time spent on these issues will be far more useful than, for example, sitting for hours doing MCQ papers that you could do at home!

I am sorry to say that many courses still waste valuable time on MCQs which means not doing stuff of vastly greater importance.

I don't allocate any time to MCQs in my MRCOG classes.

There are masses of books of MCQs in addition to the ones linked to this site.

Spending time on the technique for EMQs would be reasonable.

An ideal course would include time spent on:

    updating key clinical topics, particularly in sub-specialties e.g. chemotherapy & ovarian cancer or thrombophilia & pregnancy,

    (you don't want to waste time on standard topics like diabetes - cover these from the books,)

    updating clinical governance, audit, risk management, complaint procedures etc. using:

        didactic teaching,

        small group sessions writing essay plans or practising vivas for these topics,        

    practising communication skills in small groups using roleplays:

        doing OSCE circuits is great, but small group sessions are invaluable.

        in my training sessions we could easily spend an hour dealing with one roleplay,

        what are the key things to discuss?

        how would you explain Down syndrome?

        what is the best way of explaining the concept of screening?

        The aim of small group roleplay practice is to develop techniques so as to improve your performance.

        It also highlights areas that you need to improve - a tendency to use medical jargon or to speak too quickly.

        You don't need to go on a course to do this.

        You can do it with a colleague, relative or friend. 

        You be the candidate, they the role-player.

        Ideally have someone who is also sitting the exam to be there to comment.

    practising how to survive talking for 15 minutes in a viva,

    how to write short essays:

        exactly what is the essay about?

        what are the key points likely to be awarded a mark?

        how can you summarise these key points so they all get covered?

        will there be marks for mentioning protocols, risk management, multi-disciplinary working etc?

    technique for EMQs and MCQs.

Return to the top of the page.

Return to "List of contents".  

Return to "Suggested Reading".  

Go to the bottom of the page & other links.       



Return to Top of the Page
Return to "possible essay topics"
Return to "list of suitable texts"
Return to "Complaint Procedures"
Return to MRCOG page
Return to Home Page