How to prepare for the MRCOG part 2 examination. Elaine Church.

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Background.

Elaine Church won the gold medal in the May 2010 part 2 examination.

A fantastic achievement to come first when about 1,000 of your peers take the the exam at the same time.

Elaine has been kind enough to make notes about how she prepared for the exam.

And has included everything she can think of to help other applicants.

You can scroll down to read the document from start to finish.

Or use the links in the "list of contents" to be selective.

Tom McFarlane.

 

List of contents.

  1. introduction

  2. suggested reading list

  3.         guidelines, reports etc.

  4.             TOG

  5.             RCOG's Green-top guidelines

  6.             other RCOG publications

  7.             NICE guidelines

  8.             CMACE publications

  9.         books

  10.         watch the RCOG homepage

  11. how to get started

  12.         getting going

  13.         Tom McFarlane's website

  14.         NW revision course

  15.         notes and revision

  16. study leave

  17. useful advice

  18.         essays

  19.         EMQs

  20.         MCQs

  21.         changes to the exam

  22.         my tips

  23.         basics

  24.         buzz words

  25.         OSCE

  26.             basics

  27.             NW OSCE course

  28.             RCOG OSCE course

  29.             other NW resources

  30.             practise with a friend

  31.             tips for the Big Day itself

  32.                 basic facts               

  33.                 stay overnight in London

  34.                 read the questions carefully and make a plan

  35.                 time management

  36.                 communication skills

  37.                 the examiners

  38.                 what about the station that goes badly?

  39.             getting the results

  40. postscript               

       

 

 

 

Introduction.

Dr McFarlane asked me to write how I achieved the MROCG Part 2 Prize Medal in May 2010.

I am still not sure I can explain how.

But I can explain what I did to prepare for the exam and share some useful tips given to me by others.

Although at first appearing to be an impossible task, once I started to study, Part 2 slowly began to seem more achievable.

I spent a long time wondering where on earth to start.

In the end I made a list (I am a big fan of lists) of things to cover.

And then estimated how long I would need to cover it all.

I started studying in August for the March exam.

Working in a small quiet unit (Barrow in Furness) meant I had lots of revision time!

I would say that you need at least 6 months.

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My list was as follows:

 

Guidelines, Reports etc.

TOG articles for the last 3-4 years (in March 2010 there were MCQs from a 2006 issue)

RCOG Green-top guidelines

Questions are often based on Green Top Guidelines.

In March 2010 we had:

        management of breech presentation in labour,
        HRT,
        and pelvic inflammatory disease.

Make sure you know these inside-out.

Other RCOG publications:

        RCOG Scientific Advisory Committee Papers,

        Joint Guidelines,

        Working Party Reports,

        Consent Series,

        Patient Information Leaflets

Make sure you have read these. 

NICE guidelines relating to O&G

These cover numerous aspects, especially obstetric issues.

 

CMACE publications.

Saving Mothers' Lives Report (new report due in late 2010)

Perinatal Mortality Report

You must know the basic data from these reports.

My Book List:

 Handbook Of Obstetric Medicine – Catherine Nelson-Piercy

(fantastic for maternal medical disorders, new edition currently awaited)

 Obstetrics and Gynaecology. An evidence-based textbook for the MRCOG. – Phil Baker, D Luesley

(good for some subjects but not enough detail on others)     

Dewhurst's Textbook of Obstetrics and Gynaecology – Keith Edmonds

MCQ and EMQ books – there are many

Whilst textbooks such as Dewhurst are comprehensive, they are difficult to read and soon become outdated.

I found Dewhurst good for subjects not well covered in Luesley and Baker but I would not recommend reading cover to cover.

The TOG articles are much easier to read, more up to date and are good for MCQ practice.
RCOG website.

Keep an eye on the RCOG website homepage.

Documents about topical issues are posted here and these make good SAQs.

We were the lucky ones who were asked the dreaded swine flu question, but also teenage pregnancy.

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How to start.

I began with the areas which I did not know well.

For me these were oncology, infertility and paediatric/adolescent problems/ genital tract anomalies.

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Tom McFarlane's webpage.

I also started using Dr McFarlane’s website early: www.drcog-mrcog.info.

This contains a wealth of information including reading lists, useful tips, interesting anecdotes and 13 MCQ papers with very well written answers and explanations.

Note from TMcF: the MCQ papers & answers are on Dropbox - send me an e-mail if you want to access them.

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NW written course.

I attended the North West revision course organised by Dr Varsha Mulik at Tameside Hospital in January 2010.

This 6 day course was excellent.

We wrote 12 practice essays and completed practice MCQ and EMQ papers during the week.

As there were only 7 candidates we received individual and group feedback which was really useful.

We also had lectures on topics not well covered in the textbooks such as oncology, paediatric gynaecology and contraception, which were great.

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Notes and revision.

Whilst I was revising I had an A5 notebook in which I wrote useful facts and figures and important information, one topic to a page.

Other people used revision cards.

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Study leave.

I booked study leave for the week prior to the exam, essential for last minute revision.

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Useful advice:

 

Essays / SAQs:

Read the question very carefully.

Write legibly and only in the space provided.

Look at the marking scheme to see how much information is needed in each section.

Spend a few minutes after reading the question writing an essay plan.

I suppose I can now admit that my plans were always in my head and never written down!

Remember to include the buzz words (see below).

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EMQs:

These test your applied knowledge / management.

Imagine that patient is sitting in front of you, what would you do in practice?

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MCQs:

These test your knowledge.

Practise the ones in TOG and on the website then read Dr McFarlane’s wonderfully comprehensive answers.

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Changes to the exam.

NB. The exam is changing.

From March 2011 there will fewer SAQs but more EMQs and MCQs.

The SAQs (4) will be worth 30%.

The MCQs (240) will be worth 30%.

The EMQs (90) will carry 40% of the total marks.

 See the RCOG's advice.

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My tips:

 

Basics.

Remember it is a CLINICAL exam.

It tests application of knowledge / management.

You need to show that you are a SAFE registrar.

There are more and more aspects of management creeping into the exam.

Attend Labour Ward Forum / case reviews / risk management meetings.

Write / update guidelines.

Get involved in CNST in your trust.

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Buzz words:

Include as many as are appropriate in your essays.

    staffing: training, competency, skills/drills

    documentation

    CNST

    protocols/guidelines 

    inform consultant

    incident forms  

    MDT

    clinical governance

    audit                                                                       

    HELP

    ABC

    explain to patient

    support/counselling

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OSCE:

Basics.

When I found out that I had passed the written exam I was obviously pleased but also very scared about the prospect of having to do the OSCE.

The most important things for the OSCE are:

    communication,

    the use of non-medical language in role play stations,

    and being able to show empathy and respond to the patients’ concerns.

There are many books with practice OSCE stations but many are outdated.

Continue to attend Dr McFarlane’s sessions for the best OSCE advice and practice.

I also had to revise some of my factual knowledge again as it was surprising how much I forgot in the 9 weeks between the written exam and the OSCE.

Do not be complacent.

The pass rate for the written exam is only about 19% and for the OSCE it is 75%.

But some of the stations are complicated though manageable if you are well-practised and have good technique.

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NW OSCE course.

Nearer to the time of the OSCE I attended the course at Royal Bolton Hospital.

This one day course (on a Saturday) provides 2 complete OSCE circuits with personal feedback.

This course is usually 3-4 weeks before the OSCE so gives enough time for more practice and to improve upon identified weak areas.

 Details of the next course will be available here as soon as the date has been arranged.

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RCOG OSCE course.

I also attended the RCOG OSCE course.

This is also a one day course which was well worthwhile.

Even if just to find your way to the College and know how the place will look on the actual day.

It is a long day as there are three complete circuits.

Each person completes a whole circuit as the candidate.

Then another as an observer.

Then the third circuit is completed and the stations discussed as a group.

There will be a course in Kuwait on the 24th. October 2010.

And daily courses at the RCOG from Monday 1st. to Friday 5th. November 2010.

These courses usually overbook: register your interest now if you want to attend.

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Other NW resources.

There are also extra sessions such as a mock exam circuit set up by Aziz Ibrahim and colleagues at Stepping Hill Hospital the week before the exam.

Dr Ahmed Yassin does a very useful session on urogynae and urodynamics which you should attend.

Details of these can be obtained from Tom McFarlane: http://www.drcog-mrcog.info./contact.htm.

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Other practice.

In addition I spent 2 or 3 evenings the week before the OSCE practicing stations with a very good and patient colleague and friend (Dr NK).

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Tips for the the Big Day.

Basics.

The OSCE is run as 3 or 4 sessions over 2 days, depending on the number of candidates.

The morning candidates are kept away from the afternoon candidates (who are literally locked in a room until the morning candidates leave the building).

This is to ensure that no information about the stations can be exchanged.

The stations on day one are slightly different from those on day 2 and the pass mark is also different.

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Stay overnight in London.

Go to London the day before to avoid having to rush in the morning.

If you have not been to the College before, have a trial run.

This will familiarise you with the means of getting there and indicate how long it will take.

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Read the questions carefully and make a plan.

Like the SAQs, these are often in 3 or 4 parts.

So you must ensure you have enough time to cover all the parts to gain the marks.

Use the notepad provided to make a plan or write down important things which you do not want to forget.

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Time management.

There are 14 minutes per station.

This goes very quickly in the real exam.

Make sure that you manage the time well at each station.

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Communication skills.

Speak slowly and clearly.

Maintain eye contact with the patient in a role play station (ignoring the examiner), or with the examiner in a viva station.

Use a standard format for introducing yourself and starting the station.

Have a structure to your history taking.

Remember to ask the patient if they have any questions.

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The examiners.

Do not be put off by the examiners!

They are instructed not to react to you.

They will either not look at you and concentrate on their marking scheme......

or they may just watch and listen, then mark you at the end of the station.

With the exception of the viva stations, where the examiners give you information and ask specific questions.

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What if a station goes badly?

You will be nervous.

I cannot remember ever having been as nervous as I was before the OSCE.

But once the circuit started I felt much better and got on with it.

If you have a ‘bad’ station, forget about it once the buzzer sounds and move on to the next.

It only accounts for 10% of the total mark and you will have got some marks.

A 'bad' station does not mean failure.

Look forwards to the end – you will feel a huge sense of relief!!!

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The results.

You only have to wait 3 or 4 days for the results of the OSCE which are posted on the RCOG website at around 1pm on the Friday following the exam.

Unlike the 4 week wait for the results of the written exam.

During which you should book some leave to do something nice – I went skiing for a week.

It is a very stressful and emotional time.

I have to admit that I cried for at least half an hour when I got my results.

I called my family and friends and of course Dr McFarlane (who was out, so Valerie was first to hear!).

Then I went home to open the champagne!

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Postscript.

Looking back it was hard work as it is not an easy exam.

But it is manageable and we are lucky in Manchester to have so many people who are willing to help us through it.

Many thanks to Dr Tom McFarlane (and of course Valerie and Kathleen), Dr Varsha Mulik, Dr Narmada Katakam and Mr Phil Chia for all their help, advice and support.

 

Elaine Church

MRCOG May 2010.

 

 

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