My Guide on MRCOG exam (all three parts)

 MRCOG-1

 

I appeared in MRCOG-1 in July 2018.

I prepared for about four to five months beginning from January 2018 to July 2018. I used the following resources

1-    Passmrcog online question bank and books

2-    Oxford book (link is below)

https://www.amazon.co.uk/Revision-Notes-Oxford-Specialty-Training/dp/0199592330

3-    Past questions

 

In my opinion, you need three to four months of dedicated preparation for this exam. However, time duration can vary depending on your prior knowledge.

 

MRCOG-2

 

I appeared in MRCOG-2 in July 2021 in my ST3 year.

I started preparation in November 2019. However, I didn't start properly until beginning of March 2021. I used to study 3-4 hours per day but it varied according to my shifts. The days where I was not able to study, I did practice questions only. I also did practice questions at the hospital and used to discuss them with my seniors and consultants. 

 

In November & December 2020, I made a start with going through STRAT OG online modules uncompleted about 70% of them by the end of December 2020. they were not as useful as I hoped as most as some of the material was outdated.

 

In February 2021 I gathered the information and assemble the curriculum and the resources into a drop box and then begin studying seriously from March 2021. 

I made a start with going through RCOG green top guidelines, making concise summary notes as I went through each guideline. Similarly, I went through NICE, FSRH, BASH, colposcopy, oncology guidelines and TOG articles and made concise notes for them. This helped me not to go through the whole guideline when I was doing my second and third revision. By end of April 2021 I was able to finish my first revision. I also tried to do J. Konje practice book and Mr Sizer’s SBAs book alongside my first revision. I must say J.Konje book was very hard and I didn’t get many questions right in my first go but it gave me an idea of how deep I should study.

 

In May 2021, I started doing my second revision alongside swallowing practise books (I've mentioned the practise books I have been through and how many times). In June 2021 I was only focusing on the practise questions and use to just open the guidelines if I were in doubt. I need a 7-8 pages summary of the important percentages and other useful but volatile information needed for exam and used to revise it daily.

 

I would like to mention here that I was doing full time job doing this preparation. I also joined a course by Dr Sidra Ali that began in Jan 2021 but I joined in March 2021. The most helpful thing in the course was the recorded voice summaries of all the guidelines (NICE, green top and TOG articles) that made my revision quicker and focused. Also, the weekly live lectures by her were immensely useful as it provided a summary and understanding of the guidelines and cleared concepts. However, I understand this is not everybody's cup of tea as the course was expensive and not everyone is comfortable with long recordings etc. I also attended Mr Sizers course which was an excellent summary of overall curriculum. mainly focused on the recent TOG articles so they were well prepared after the course.

There were few other useful things that helped me in my preparation. There is one telegram group and few Facebook groups which were free to access. They help when you want to confirm your answers from practice books/resources. I would strongly encourage you to join these really early on and just scroll through the questions when you ae at work or free or watching TV etc.

 

MRCOG-2 curriculum overview:

Gynaecology

 

Benign Gynaecology:

HMB (NICE 88)

Surgical mx of HMB (TOG 2017)

Menopause (NICE 21)

Chronic pelvic pain (GTG 4)

Unscheduled bleeding with HRT (TOG 2019)

HRT following treatment of gynae cancers (TOG 2019)

Primary and secondary amenorrhea (Strat OG tables)

PCOS – Long term consequences (GTG 33, 2017)

ESHRE endometriosis (algorithm only) & Endometriosis (NICE)

Dysmenorrhea (TOG 2010)

PMS (GTG 48)

Outflow tract disorders of female genital tract (TOG 2017)

Differences in sexual development (TOG 2020)

Endometrial polyps (TOG 2012)

 

Early Pregnancy:

Recurrent miscarriage (GTG 17, 2017)

Diagnosis and mx of ectopic (GTG 21, 2016)

Ectopic pregnancy and miscarriage (NICE 126, 2019)

Gestational trophoblastic disease (GTG 38, 2020)

The mx of NVP (GTG 60, 2016)

Amniocentesis and CVS (GTG 8, 2017)

Down syndrome screening

Abortion care (NICE 140)

Abortion act 1967 (Clauses of abortion)

 

Sexual health:

FSRH guidelines (recommendations, flow charts and tables only)

Vaginal infections (BASHH + start OG)

PID (BASHH)

 

Fertility:

Fertility problems (NICE 156).

Unexplained infertility (TOG 2016)

FET (TOG 2020)

Overview of ART (TOG 2018)

Fertility preservation (TOG 2015)

Assessment of infertile male (TOG 2013) and male fertility update (TOG 2020)

Long term mx of WHO type 1 anovulation (TOG 2020)

Early ovarian aging (TOG 2019)

Role of surgery in improving ART (TOG 2013) Table only

OHSS (GTG 5)

 

Oncology:

NHS Cx screening programme 2020 (flow charts only)

Vulval skin conditions (BASHH)

Ca cervix, endometrium, ovary and vulva- diagnosis, staging, treatment according to stage, one-year and five-year survival rates (BGCS and cancer research UK)

Tumor markers and chemotherapy side effects (Strat OG)

Risk reducing surgeries for women at high risk of epithelial ovarian cancers (TOG 2014)

Endometrial hyperplasia (GTG 67)

Mx of suspected ovarian masses in premenopausal women (GTG 62)

Ovarian cysts in postmenopausal women (GTG 34)

Mx of ovarian cysts in children and adolescents (TOG 2020)

Mx of borderline ovarian tumors (TOG 2012)

Gynae malignant melanoma (TOG 2020)

PMB (TOG 2012) flow chart only

 

Urogynaecology:

Urinary incontinence and pelvic organ prolapse (NICE 123)

Post-hysterectomy vaginal vault prolapse (GTG 46)

Mx of BPS (GTG 70)

A guide to indications, components, and interpretation of urodynamic investigations (TOG 2019) Tables only

 

Surgical module:

Surgical site infections (NICE 74)

The perforated uterus (TOG 2017)

Catheter use in gynae practice (TOG 2014) flow chart only

Laparoscopic injuries (GTG 49)

Recurrent UTIs (TOG 2020)

Caesarean niche (TOG 2020)

Vascular injuries at laparoscopy (TOG 2020) and common vessels injured

Urinary tract injuries in laparoscopic gynae surgery (TOG 2014)

Safe use of electrocautery (TOG 2019)

Best practice in OP hysteroscopy (GTG 59 + TOG 2016)

Abdominal incision and sutures (TOG Sutures and needles)

C-section (NICE 132)

Nerve injuries associated with gynae surgery (TOG 2014 and 2020) Tables only

The role of transabdominal cerclage in maternity care (TOG 2016)

Enhanced recovery (TOG)

Ogilvie post C-section (TOG 2019)

Gynae surgery in women on anticoagulants and antiplatelets (TOG 2020)

Surgical smoke (TOG 2019)

Placental histology TOG (table only)

Lynch syndrome (TOG 2021)

Raised Ca-125 (TOG 2021)

 

Obstetrics

 

Mx of labour:

Mx of breech presentation (GTG 20A&B)

Shoulder dystocia (GTG 42)

OVD (GTG 26)

3^rd/4^th degree tears (GTG 26)

Umbilical cord prolapse (GTG 50)

VBAC (GTG 45) 

Preterm labour and birth (NICE 25)

IOL (NICE 70)

Intrapartum care + CTG interpretation (NICE 190) 

Intrapartum care for women with existing medical disorders (NICE 121)

 

Fetal medicine:

Evaluation in screening for Down’s syndrome (TOG 2019)

British Committee for Standards in Haematology (BCSH) guidelines on Anti-D

Red cell antibodies in pregnancy (GTG 65)

SGA (GTG 31)

RFM (GTG 57)

IUD and stillbirth (GTG 55)

 

Antepartum + postpartum Care and Emergencies:

Blood transfusion in obstetrics (GTG 47)

APH (GTG 63)

PPH (GTG 52)

Placenta previa, accreta and vasa praevia (GTG 27 A&B)

Maternal collapse (GTG 56)

Obesity in pregnancy (GTG 72)

ANC for uncomplicated pregnancies (NICE 62)

Monochorionic twin pregnancy (GTG 51)

Twin and triplet pregnancies (NICE 137)

Selective termination of multifetal pregnancies (TOG 2020)- Tables only

Vaccination in pregnancy (TOG 2015)- Table only

FGM (GTG 53)

Antenatal and postnatal mental health (NICE 192)

Antenatal and postnatal analgesia (SIP 59)

Breastfeeding and drugs (TOG 2021)

Advanced maternal age (TOG 2021)

 

Maternal medicine:

1)    Infections in Pregnancy

GBS (GTG 36)

Chicken pox in pregnancy (GTG 13)

Malaria in pregnancy (GTG 54 A &B)

Sepsis in Pregnancy (GTG 64 A&B)

Genital herpes in pregnancy (BASHH 2014)

HIV (British HIV association guidelines for the management of HIV in pregnancy)

CMV, toxoplasmosis, parvovirus, listeria (/TORCH)– Strat OG

Syphilis (BASHH + TOG 2020)

Zika

 

2)    Medical disorders:

HTN in pregnancy (NICE 25)

Diabetes in pregnancy (NICE 3)

Epilepsy in pregnancy (GTG 68)

Sickle cell disease (GTG 61)

VTE in pregnancy (GTG 37 A&B)

Thalassemia in pregnancy (GTG 66)

Mx of inherited bleeding disorders (GTG 71)

Breast cancer and pregnancy (GTG 12)

OC (GTG 43)

MI and pregnancy (TOG 2013)

PKU in pregnancy (TOG 2018)

Mx of DKA in pregnancy (TOG 2017)

Mx of diabetes insipidus in pregnancy (TOG 2018)

Headaches in pregnancy (TOG 2014)

Multiple sclerosis in pregnancy (TOG 2019)

SLE in pregnancy (TOG 2012)

Pregnancy and spinal cord injury (TOG 2014)

Iron deficiency anaemia (TOG 2017)

Surgical causes of acute abdominal pain in pregnancy (TOG 2019)

Skin eruptions in pregnancy (TOG 2013)

Thyroid dysfunction and reproductive health (TOG 2015)

Asthma in pregnancy (TOG 2013)

Appendicitis in pregnancy (TOG 2015)

IBD in pregnancy (TOG 2016)

Stroke in Pregnancy (TOG 2020)

Palpitations and arrhythmias in pregnancy (TOG 2019)

Postural tachycardia syndrome (TOG 2018)

Spinal cord injury (TOG 2014)

Use of aspirin and calcium in pregnancy (TOG 2014) Table only

Thrombocytopenia in pregnancy (TOG 2011)

Diagnosis and mx of liver masses in pregnancy (TOG 2016)

Biologics in pregnancy (TOG 2016)

Acute pancreatitis (TOG 2021)

 

Teaching/Research/Misc:

Teaching methods and models

Clinical governance

Ethics

ARCP outcomes

Research methods

Statistics

Genetics (AR, AD etc – modes of inheritance) 

Common USS findings for congenital syndromes

MBRACE 2019 and 2020 (charts, tables, definitions)

Mental capacity and legal consent

Neonatal extracranial injuries

Phases of clinical trails

Types of pelvis

Diameters of fetal skull

Physiological changes in pregnancy

RCOG consent advice percentages (I made a summary chart on just 1 paper)

 

 

MRCOG-2 practice question books:

1-    J. Konje (I went through it thrice)

2-    Amanda Jones (went through it twice)

3-    Mr Andrew Sizer’s both books (went through them thrice)

4-    Seema Sharma (twice)

5-    Mr A. Sizer online Q bank (useful for percentages)

6-    Start OG questions (modules + TOGs) (twice)

7-    Kalavani (once only)

8-    P Sinha (Obs and Gynae- twice)

9-    Brain Magowen (once only)

10- J. Gupta (started but did 2-3 modules only once, did not finish). 

11- Mastering (started and did 1-2 modules, did not complete the rest)

12- Rekha 500 questions (twice)

The actual exam:

I found the exam quite hard and did several mistakes. Yes, I did discuss questions after the exam as I can't help it ;) but overall I felt I could not have prepped any better. 

It was an exhausting exam and I felt really tired after that.

However, I passed with respectable percentage :)

Leaves:

I used quite a lot of my annual leave chunk and 1 week of study leave. I made quite a lot of swaps that I had to pay back.

Using annual leave was handy in Covid times as I could not travel to Pakistan where I usually spend my annual leave.

 

Summary and take-home message:

 

I think the key thing is that once you are going through your first revision you should make concise summary notes for you to revise in your second or third division closer to your exam. Do as many practice questions as you can 

MRCOG-3 

 

I appeared in MRCOG-3 in November 2021. this was just three months after the results were announced for Part 2. I had quite a lot of free time and leave before the exam hence I was able to focus and give more time for the preparation. I used a fair share of my annual leave for exam.

 

Again, I joined Dr Sidra Ali’s course mainly because of the time constraints.

 

There are 14 modules for this exam (curriculum shared below). There are broadly 2 types of stations

1-     Structured discussion where an examiner asks you questions on a certain topic (in involves checking your clinical knowledge only). This makes up 4-5 stations out of 14.

2-    Simulated patient tasks where you interact with patient or a colleague. An examiner is there to mark you.

So, I began studying module wise, roughly 1 module per week along with regular virtual practice session with study partner and finish the 14 modules by mid-October. Afterwards I was practising the modules as well as the other important stations from the question books on almost daily basis up until the exam date which was on 8^th Nov 21.

 

There are some important topics which tend to get asked in the exam more frequently than others, so I focused mainly on those. 

 

As I recently sat in Part 2, so I didn't have to revise the guidelines all over again. I mainly focused on my communication skills and how to approach the individual scenario.

 

I think the most important thing for this exam is to find a study partner who is dedicated, available and flexible. I was lucky to have one study partner with whom I studied on regular basis and few other study partners with whom I used to practice every now and then.

 

The practice books I used were

1-    J Konje (It has 5 circuits each comprising 14 stations, very useful to practice)

2-    Oxford (just few stations)

3-    Lisa Joel videos

4-    Get through (just few stations)

MRCOG-3 modules 

 14 Modules

1	Teaching
2	Core surgical skills
3	Post-operative care
4	Antenatal care
5	Maternal medicine
6	Management of labour
7	Management of delivery
8	Puerperium
9	Gynaecological problems
10	Urogynaecology
11	Subfertility
12	Sexual health and reproduction
13	Early pregnancy care
14	Oncology

 

Summary and take-home message:

 

·      To do it soon after your part 2 so that you don’t have to spend time revising your clinical knowledge

·      Find a dedicated study partner and practice, practice, and practice!!!!!!!!!!