Format of the examination.



DRCOG Page The Stockport DRCOG Package Sample MCQs



The examination has consisted of of two written papers, each lasting 1˝ hours, since October 2007

The OSCE examination has been jettisoned.


The  syllabus changed to narrow "the domains of knowledge required to those areas of Women's Health appropriate to a UK-based GP".

In my ignorance I thought this was already what the exam was about!

The good thing is that you won't be asked about safe techniques for inserting a laparoscope or how to interpret a CTG.

For the RCOG page about the format, click here.


The exam is marked by computer.

This means that you don't write anything.

You just select the appropriate answer(s) and "black out" the associated box(es) using a pencil.

See the examples below.


Despite the changes, I think getting the DRCOG remains worthwhile:

    you'll have a much better theoretical knowledge of the subject,

    preparing for the exam will make you likely to get greater benefit from your O&G post (if you do one),

    better knowledge will make you a better and more confident GP,

    having the DRCOG could give you a competitive edge in a job application / selection process.

It has become quite fashionable to say that it is a useless qualification.

I think you will find that those who say so have not done the exam.

Or took it in the old days, before MCQs, when you needed to know a lot less and the exam was easy.

MCQs mean that you are tested on a wide range of topics, making the exam more thorough but distinctly harder.


The exam is made up of two papers, each lasting 1˝ hours.

There will be a fifteen minute break between the papers.

I presume that you will stay in the examination hall during the break.

Fifteen minutes hardly seems time for hundreds of people to dash to the loo and back.

If your bladder won't last 3 hours, you had better check out arrangements with the College.

I wrote to the College on this subject.

The reply I received made me suspect that they had not foreseen this as a potential problem.

In essence, the answer was that the senior invigilators would made sure all was well on the day!


Paper 1: time 1˝ hours.

This will include the “EMQs” (Extended matching questions) and “BOFqs” (Best of five questions). 

These are explained below.


 Type of question

Number of questions

Mark per question

Total available marks

% of total exam marks



10 topics e.g.  1ry amenorrhoea

each topic having 3 questions








The College recommends that you spend 60 minutes on the EMQs and 30 minutes on the BOFs.

But the timing will ultimately be up to you.

I expect that the EMQs will be harder than the BOFs and there are more of them, so they will take more time.

My inclination would be to start with the BOFs.

With any luck you will finish them in under the suggested 30 minutes, giving a bit more time for the EMQs.

Whatever you do, you’ll need to keep an eye on the clock.


Paper 2: time 1˝hours.

Type of question

Number of questions

Mark per question

Total available marks

% of total exam marks



40 questions  with 5 parts each






In the standard type of MCQ you will select "true" or "false" to all of five statements.

A question might be:

A patient presents to the A&E department at 36 weeks with 250 ml. of painless vaginal bleeding and a transverse lie. 

Probable diagnoses are:

a. bicornuate uterus True   False  
b. acute red degeneration in a fibroid True   False  
c. placental abruption True   False  
d. placenta previa True   False  
e premature labour True   False  


In this type of question you have to decide if each of "a" to "e" is true or false.

Then you have to "shade in" the box alongside "True" or "False" using a pencil.

In the exam there will be forty questions.

Each will have five parts, so, in effect, you will be answering two hundred questions.


Click here for the answer


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In a "best of five" question you will choose the best of five possible answers:

A patient presents to the A&E department at 36 weeks with 250 ml. of painless vaginal bleeding and a transverse lie.

Select the most likely diagnosis from the following list.

a. bicornuate uterus  
b. acute red degeneration in a fibroid  
c. placental abruption  
d. placenta previa  
e premature labour  


In this type of question you will select only one answer and "shade in" the box alongside it using a pencil. 

All five answers could be "possibles". 

You have to pick the one you think fits best.

In the exam there will be eighteen questions like this one.


Click here for the answer


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In an extended matching question you will be presented with:

    the topic, e.g. "This question is about antepartum haemorrhage",    

    your instructions, "e.g. choose the best management" or "pick the most appropriate investigation".

    three separate clinical scenarios,

    a list of options from which to pick the answers.

The three clinical scenarios all relate to the same topic.

They all use the same list of options.


Run through the following example and it might be a bit clearer.


The topic is antepartum haemorrhage.


Your instructions:

The clinical scenarios below relate to a woman at 36 weeks gestation.

Read each scenario carefully.

Which one of the following potential problems should be given top priority?


Clinical scenario:

She presents to the A&E department with 250 ml. of painless vaginal bleeding and a transverse lie.


Option list.



prolapsed cord



ruptured uterus from obstructed labour



Rhesus sensitisation from feto-maternal transfusion



bleeding from placental abruption



bleeding from placenta previa






cervical polyp



vaginal laceration






Von Willebrand’s disease



In this case, the answer would be "e"; bleeding from placenta previa.


In the exam you have three questions for each topic, but only one list of options.

There could be ten or more options in the list. Obviously, some cannot be used.

So you get a standard piece of advice: each of the options can be used once, more than once or not at all.

To be naughty, the examiners could make one answer apply to all of the questions.


In the exam there will be ten topics, sets of instructions and option lists like the one above.

Each topic will have three questions linked to it.

Hence, there will be thirty questions in total.


The College has put two sample EMQs on its web page.

Make sure you can answer them - they are likely to be used in the exam!

The samples given when EMQs were introduced in the MRCOG were used in the exam proper.


Click here to go to the relevant College webpage.

Return to MCQ2, answer 1, "Cystic Fibrosis".


There are further sample EMQs in the answer to the question on cystic fibrosis.


There aren't yet a load of books with EMQ examples.

One that I think gives a good idea of the genre is "EMQs in Obstetrics and Gynaecology".

The authors are: Andrea Akkad, Marwan Habiba and Justin Konje.

You can get details from the RCOG Bookshop. 

The problem is that such books are guessing what the RCOG questions might be like.

And we won't know that in details until we have feedback from a few exams.



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The rationale of the answers is that placenta previa is classically associated with painless bleeding and a high head or abnormal lie.

A bicornuate uterus could cause a transverse lie, but not painful bleeding.

Acute red degeneration in a fibroid causes pain, but not bleeding.

A fibroid would not cause an abnormal lie unless it was very low in the uterus or cervix and blocking the pelvis.

See MCQ5, question 2.

Placental abruption almost always causes painful bleeding and does not cause an abnormal lie.

See MCQ9, question 31.

See MCQ3 and MCQ paper 5, question 24.

Premature labour could be associated with painless "tightenings" and bleeding, but 250ml. is more than is likely.

And there would need to be a second problem to explain the transverse lie.

So it is "possible" but improbable.

In the EMQ, the biggest risk of heavy bleeding is from placenta previa.

Vaginal examination (including speculum examination) is not going to provide useful information.

(Except in rare situations like the bleeding being due to cervical cancer).

It runs the risk of triggering further bleeding from placenta previa, so should not be done.

Informing the Consultant is part of the protocol for significant APH (and other major problems).

"Call for help" is often the first thing you are expected to do.

But it would make it an automatic answer for the first thing to do in any emergency situation, so not much use as an exam question.

The answer will depend on how the question is worded.

If it said "get someone to call for help", that would be the first thing to do.

But you should get the immediate "first aid" administered to the patient before making the call if you are going to do it yourself.

With significant bleeding, you would site the IV line and take the bloods for haematology as a priority.

You would delegate someone to inform the Consultant.

Rhesus sensitisation needs to be considered and anti-D administered if needed, but this is not a priority.

Cord prolapse can't occur without rupture of the membranes.

The patient should not be transferred to the maternity department until you have secured her immediate well-being.

You should also check the notes to see if the 20 week scan had suggested that the placenta was low.

But you ought to have done it when taking the history - the patient would have been told and warned about the risk of bleeding.

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Return to MCQ example.

Return to BOF example.

Return to EMQ example.


The most important part of your preparation will be getting enough reading done so that your knowledge base is good.

Do as many sample MCQs and EMQs as possible.

If you haven't done an O&G job, it would be worth attending a few clinics to see how things are done.

For fuller advice see "Preparation".

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Tom McFarlane.


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