MRCOG Part 2—550 MCQs, EMQs and SAQs Rekha Wuntakal, Tony Hollingworth, David Redford
INDEX
×
Chapter Notes

Save Clear


1MRCOG Part 2: 550 MCQs, EMQs and SAQs
23MRCOG Part 2: 550 MCQs, EMQs and SAQs
Rekha WuntakalMBBS MD(O&G) DNB DFFP MRCOG Specialist Registrar in Obstetrics and Gynaecology, Barking, Havering and Redbridge University Hospital NHS Trust; Honorary Research Fellow, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK Tony HollingworthMBChB PhD MBA FRCS(Ed) FRCOG Consultant in Obstetrics and Gynaecology, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK David RedfordMB FRCS FRCOG Consultant in Obstetrics and Gynaecology, Royal Shrewsbury Hospital, Shrewsbury, UK
4© 2013 JP Medical Ltd.
Published by JP Medical Ltd
83 Victoria Street, London, SW1H 0HW, UK
Tel: +44 (0)20 3170 8910
Fax: +44 (0)20 3008 6180
The rights of Rekha Wuntakal, Tony Hollingworth and David Redford to be identified as authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission in writing of the publishers. Permissions may be sought directly from JP Medical Ltd at the address printed above.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included or from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from or related to use the material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
9781907816505
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
JP Medical Ltd is a subsidiary of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India
Publisher:
Richard Furn
Commissioning Editor:
Hannah Applin
Senior Editorial Assistant:
Katrina Rimmer
Design:
Designers Collective Ltd
Typeset, printed and bound in India.
5Preface
The MRCOG examination is made up of two parts. This book provides a revision aid for the exam. It presents 250 MCQs, 250 EMQs and 50 SAQs, all mapped to the syllabus topics. The EMQ and SAQ answers are supplemented with explanatory notes and further reading. The SAQs are in the current style used in the MRCOG examination, with fully worked answers that are accompanied by the marking scheme, to give trainees a thorough understanding of how the SAQs are marked in the real exam.
The aims of the book are to help trainees to work through a wealth of questions, understand the exam format and focus on topics of weakness. Any exam can seem daunting in the lead up to it. It is important to read widely and cover all aspects of the specialty. Answering practice questions is a vital part of the revision process.
We hope that this book will prove useful in your preparations for the MRCOG exam.
Rekha Wuntakal
Tony Hollingworth
David Redford
October 2012
6Dedication
Dedicated to my mother, Akkamma, my brothers Sateesh and Manjunath, my sister Neelu and all my teachers in the UK
Rekha Wuntakal
9Revision advice  
 
Introduction and syllabus
The aim of the MRCOG exam is to set a standard for the competent and safe practice of Obstetrics and Gynaecology. The exam is made up of two parts, MRCOG and MRCOG . The MRCOG deals with the basic sciences relevant to the specialty, which must be passed before taking the MRCOG .
The MRCOG is divided into two parts, namely the written, which aims to test knowledge, and the Objective Structured Clinical Examination (OSCE), which tests the application of knowledge. The written exam is composed of three types of questions: short answer questions (SAQs), extended matching questions (EMQs) and multiple choice questions (MCQs). The exam is aimed at the level of an ST5 trainee in Obstetrics and Gynaecology, and ‘blue printed’ to ensure the whole of the syllabus is covered by the written and OSCE components.
The MRCOG exam is a test of knowledge in Obstetrics and Gynaecology. The modules in the syllabus include teaching and appraisal, information and technology, clinical governance and research, core surgical skills, postoperative care, surgical procedures, antenatal care, maternal medicine, fetal medicine, puerperium, management of labour and delivery, gynaecological problems, subfertility, early pregnancy care, women's sexual and reproductive health, gynaecology oncology and urogynaecology. A thorough description of the topics covered in each of these modules is available on the Royal College of Obstetricians and Gynaecologists’ (RCOG) website (http://www.rcog.org.uk).
 
Format of the paper
The MRCOG written exam is held twice a year, in March and September. It comprises SAQs, EMQs and MCQs. Only candidates who pass the written exam can proceed to the OSCE exam.
The entire written paper is 375 minutes in duration. The timetable starts with the SAQ Paper, comprising four questions to be answered within 105 minutes. This is followed by a short break of 30 minutes. The next section is EMQ and MCQ Paper 1, which comprises 45 EMQs and 120 MCQs to be answered within 135 minutes. This is followed by a 45-minute lunch break. After lunch, EMQ and MCQ Paper 2 begins, which comprises 45 EMQs and 120 MCQs to be answered within 135 minutes.
The time is evenly divided between the EMQ and MCQ Papers 1 and 2. However, for each Paper, the RCOG suggest that candidates spend 85 minutes answering the EMQs and 50 minutes answering the MCQs. The marks are divided as follows: SAQs – 30%, EMQs – 40%, MCQs −30%.
The RCOG website provides details about the written exam format, with set examples of SAQs, EMQs and MCQs. We have matched the RCOG format in this book.
 
How to prepare for the exam
The best time to sit the MRCOG is while working at the level of an ST4 or ST5 trainee in Obstetrics and Gynaecology. Without realising it, the necessary knowledge will be gathered relating to the syllabus topics by discussing cases with senior colleagues (senior registrars and consultants), attending consultant ward rounds, obstetrics and gynaecology outpatients, and 10attending organised departmental and regional teaching sessions. However, a theoretical base is important to ensure that trainees understand why they are doing what they are doing when undertaking a particular task. The role of textbooks is essential to acquire this knowledge and to succeed in the exam.
Start planning for the exam at least 12 months before the exam date, especially if your clinical experience (post-registration training) has to be assessed for approval to sit for the exam (the application for assessment of training for entry to the MRCOG exam is available via RCOG website). Applications must reach the RCOG examination department by the preceding 1 October for the March exam or the preceding 1 April for the September exam. Doctors in training posts can sit the MRCOG two years after passing the MRCOG , while doctors in Trust posts (clinical fellows) can sit the exam following four years of experience in obstetrics and gynaecology (MRCOG regulations are also available on the RCOG website).
Start preparing and reading for the exam at least six months before the exam date and use the initial month or two to gain momentum to study faster. By this stage, you should have gathered all the necessary revision aids, including relevant textbooks, guidelines (RCOG, NICE, family planning) and exam revision books. Sign up to recommended exam revision websites and work through as many questions as many times as possible, in order to learn and memorise the topics. When doing this, you will be surprised at the amount of information you process and take in.
An effective method for exam study is to ensure that information is quickly and readily accessible. Organise yourself and take the time to learn about the exam: what it is like, the type of questions likely to be encountered and the exam format. Make a list of common topics and repeated themes from the syllabus and past papers. Then three months before the exam, attend an MRCOG theory course to speed up revision and develop knowledge further. Write down the important topic-based points in a small notebook or make revision cards. These can be used to revise topics in a short period of time several times over when the exam is approaching.
Plan ahead, make notes and revise common topics and themes, reading EMQs, MCQs, SAQs and past papers. Practice answering a wealth of questions before the exam to acquire the necessary knowledge and identify any gaps in learning. The main emphasis is on reading the question and answering each one carefully. A week of study leave before the exam is ideal for revision purposes and make sure you are not on call the day before the exam. Take note of the time and place of your exam, and arrive on time to avoid the added pressure of running late (remember you will not be allowed to sit for the exam if you arrive late).
To ensure success in the exam, it is important to develop and expand knowledge beyond the basics of the syllabus. A brief list of RCOG recommended textbooks and guidelines is given below:
  • RCOG Green-top Guidelines (all): http://www.rcog.org.uk/guidelines
  • Non-RCOG guidelines, e.g. The Faculty of Sexual & Reproductive Healthcare: www.fsrh.ord
  • NICE guidelines in obstetrics and gynaecology (all): http://www.nice.org.uk
  • The Obstetrician & Gynaecologist, published four times a year. The MRCOG SAQs are set six months prior to the set date for the exam. Therefore, read the issues covering at least three years prior to this period.
    11
  • Luesley DM and Baker PN. Obstetrics and gynaecology: an evidence-based text for MRCOG (2nd edn). London: Hodder Arnold, 2010.
To help save time when preparing for the MRCOG exam and to encourage trainees to broaden knowledge on each topic, we have provided further reading (current key textbooks and journal articles) after every answer or groups of answers.
 
SAQs, EMQs and MCQs
 
Short answer questions (SAQs)
The exam comprises four SAQs and you will get approximately 26 minutes to answer each one. Each SAQ is divided into three- or four-part questions and marks are divided according to complexity. It is important to note that the writing space for each answer is limited (two sides of A4-size paper) and paper is not replaced in the event of mistakes. Therefore, spend the first two to four minutes planning the answer by logical thinking rather than impulsive writing. Write down the key words from the question and plan each component of the essay answer in order of priority so that you do not miss any important marks when writing the final answer onto the main sheet (do not just write everything you know, be specific to the question that is asked). You can write the plan on the coloured paper provided in the exam. Then start writing the actual answer, which should be written on the basis of the essay plan. The systematic approach described in this book will help to ensure that important facts and vital information, which need to be reproduced in the exam, are not forgotten. This method is recommended when practising SAQs prior to the exam and during the actual exam, to help score the maximum marks. The RCOG recommends that the answers should be written in the given space for each subdivision of the question. If you write anything outside this given space, you will be wasting time and will not gain any marks. The examiner will ignore written text in the non-designated areas.
The exam is a test of knowledge and clinical experience in Obstetrics and Gynaecology at ST5 level or Year 3 specialist registrars (the best care to patients with the best available evidence after considering the resources and setting). If you are not certain about an answer, consider a patient you have discussed with a senior colleague or have managed in the past, in order to answer the question.
Marks are awarded for legible writing, concise answers and good coherent English. Read and understand the question before proceeding to plan the answer. Familiarise yourself with the different terminologies used to frame the questions. These include the words ‘discuss’ (write in detail), ‘debate’ (list pros and cons), ‘evaluate’ (put a value on something), ‘justify’ (proving something to be reasonable or right for that particular scenario or patient), ‘critically appraise the treatment’ (treat as well as appraise the treatment) and ‘appraise’ (to assess the value of something).
Answer all the questions. You are likely to fail the exam if you fail to answer one of the SAQs or if you answer a SAQ incorrectly. Spend an equal amount of time answering each question and try not to leave difficult questions to the end, when you will not have time to think intelligently and quickly. Most examiners suggest answering the questions in numerical order. Do not spend a disproportionate amount of time on one question.
Examiners discuss the answers with other examiners before they start marking papers. Marks can be deducted for unsafe or dangerous statements regarding patient care or management. So be careful, do not write something of which you are not really sure.12
 
Extended matching questions (EMQs)
Papers 1 and 2 consist of 90 EMQs. Each EMQ presents up to five stems with 10–14 options. To answer the EMQ, match the stem (typically a statement or clinical scenario) with one of the 10–14 options available. The options are presented in alphabetical order and not all the options may be used. However, a single option may be used more than once. The questions are of a more practical nature than scientific, and the main focus is on the MRCOG syllabus. Therefore you are likely to fail if you do not have the necessary knowledge or clinical experience before sitting the exam.
When answering EMQs, formulate an answer in your head before going through the 10–14 options and then look for the right answer. This will save time and avoid confusion. Sometimes you may not be sure between two similar options. In this case, choose the most likely option. If you do not know the answer, start eliminating the options one by one until you get a suitable option which seems like a close fit. Occasionally, you may not have any clue about the answer or lack appropriate knowledge about the topic. If this is the case, relax and take a logical approach to make an educated guess. There is no negative marking for EMQs.
Finally, remember to read each question carefully. The question may seem familiar but it may not be exactly the question you read before, for instance the framing of the question may be different.
 
Multiple choice questions (MCQS)
Papers 1 and 2 consist of 240 MCQs. To answer MCQs, a good theoretical knowledge of obstetrics and gynaecology is required. Each MCQ is made up of five stems (statements), which must each be answered true or false. Marks are given for answering stems correctly. However, there is no negative marking or penalty if any option is answered incorrectly. Remember to answer all the questions.
Make sure you do not leave any questions unanswered as it is difficult to come back later owing to time constraints. If you have time at the end, it is worth going back and reading through the difficult questions to check they are answered correctly. It is important not to get any answers out of sync.
 
Taking the exam
Finally, remember this is your exam. Take a calm and collected approach, and be positive.
Ability is what you're capable of doing. Motivation determines what you do. Attitude determines how well you do it.
Lou Holtz
Good luck for the exam!
Rekha Wuntakal