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Part 1 MRCOG syllabus summary

The Part 1 MRCOG examination covers the basic and applied sciences relevant to the clinical

practice of obstetrics and gynaecology. These are summarised here under the modules of the

curriculum, which is available in full here. There is inevitably overlap between modules, whilst at

the same time not all subjects and domains are relevant to a particular module. This can be seen

in extended form in the accompanying syllabus matrix.

Module 1 Clinical skills

You should be able to define patterns of symptoms and understand the importance of risk factors.

You should know about the pathophysiological basis for physical signs and clinical investigation.

You will be expected to interpret results of clinical investigations.

Modules 2, 4 & 19 are not examined by the Part 1 MRCOG

Module 3 Information Technology, Clinical Governance and Research

You should understand the principles of screening, clinical trial design - multicentre, RCT, etc. ,

and the statistical methods used in clinical research. You should know about levels of evidence,

quantification of risk, power of study, level of significance, informed consent, and ethical and

regulatory approvals in research.

You should demonstrate an understanding of the principles of safe prescribing, quality control in

medicine and the accuracy of tests.

Module 5 Core Surgical Skills

You will be expected to demonstrate an understanding of the underlying physiology, pathology and

biophysics of basic surgical skills. You should understand the methods of measuring clinically

important physiological variables, including the range of imaging techniques. You will be expected

to demonstrate knowledge of the basic clinical skills in core surgical practice.

You will be expected to demonstrate knowledge of the pathophysiology underpinning fluid and

electrolyte balance, coagulation, control of blood flow, wound healing, inflammation and immune

response, including tissue grafting. You should be able to show understanding of the pathology,

management and epidemiology surrounding surgical complications, infection, infection control, and

trauma.

Module 6 Postoperative Care

You will be expected to demonstrate knowledge of applied clinical science related to the

postoperative period. This will include physiological and biochemical aspects of fluid balance, the

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Module 9 Maternal Medicine

You should have an understanding of the epidemiology and pathological processes that underlie

common maternal diseases that occur in pregnancy, including. diabetes, endocrine, respiratory,

cardiac and haematological disease. In addition you should know the pathophysiology and

presentation of all common infections that affect pregnant women and the treatments and

interventions that are used for these infections.

You should know the drugs that are used to treat maternal disease, and the potential maternal and

fetal complications associated with their use. You should have an understanding of, and an ability

to interpret results of, the imaging methods used to screen for maternal and fetal complications of

maternal disease, e.g. ultrasound, X-ray and magnetic resonance imaging.

Module 10 Management of Labour

You should understand the physiology, biochemistry and endocrinology of parturition. This will

include the maturation of the fetal endocrine system, the influence of hormones on signalling

pathways in the myometrium, and the biochemistry of myometrial contractility. You should also

understand the principles of tocolysis and stimulation of uterine contraction.

You should be able to describe fetal physiology in late pregnancy. You should be able to

demonstrate knowledge of, and ability to interpret results of, fetal assessment in late pregnancy

and labour.. You should also know about placentation and understand the implications of infection

on labour and know the optimal therapeutic options.

Module 11 Management of Delivery

You need a knowledge of the anatomical adaptations of the pelvis and abdomen in late pregnancy

and labour and the mechanism and physiology of childbirth and the third stage of labour. You need

a knowledge of the aetiology and pathology of congenital and bone malformations of the genital

tract.

You need to understand the mode of action of drugs used in labour, at delivery and the third stage

of labour. You should be able to demonstrate an understanding of the indications and risks of

operative delivery.

You need to understand the biochemical basis of acid-base balance, the normal fetal physiological

changes in labour and demonstrate an ability to interpret fetal and cord blood gas analysis.

You will be expected to have a detailed knowledge of the female perineum and the principles

underlying the management of perineal repair.

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Module 12 Postpartum Problems

You should be able to demonstrate an understanding of the physiology and structural changes in

the neonate. In the mother, you should understand the physiology of lactation, uterine involution,

and the pathology and management of puerperal sepsis and infection. You should be able to

demonstrate knowledge of common puerperal complications, including mental health issues.

You should be able to demonstrate an understanding of postpartum contraception and other drugs

used postpartum and during lactation.

Module 13 Gynaecological Problems

You will need to know the anatomy, physiology and histopathology of the pituitary gland and

female reproductive tract. This will include an understanding of changes at puberty, the

menopause and during the menstrual cycle including ovulation. You will need to know the

epidemiology, microbiology and therapeutics of benign gynaecological conditions including

infection. You will be expected to interpret results of commonly performed investigations for

benign gynaecological conditions. The principles of medical and surgical management of

gynaecological problems should be understood.

Module 14 Subfertility

You will be expected to know about the epidemiology of subfetility and treatment.You will be

expected to understand the anatomy, development, function and cell biology of the organs of the

male and female reproductive tract in context to their relevance to fertility and its disorders.

You will be expected to interpret results of investigations commonly performed as part of the

investigation of subfertility.

Module 15 Sexual and Reproductive Health

You will be expected to know about the physiology, endocrinology, epidemiology and

pharmacology of contraception. You should demonstrate an understanding of the epidemiology

and serology of sexually transmitted infections (STIs), the micro-organisms involved, the drugs

used their treatment and the pathological features of sexually transmitted disease.

You should know about termination of pregnancy, including, assessment, Fraser competency,

surgical management and the drugs used in the medical termination of pregnancy.

Module 16 Early Pregnancy Care

You will be expected to demonstrate knowledge of the basic sciences pertaining to early

pregnancy and its loss. This will include the endocrine aspects of the maternal recognition of

pregnancy, the luteal maintenance of early pregnancy and the physiology of feto-maternal

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communication. You should have detailed knowledge of the aetiology and histopathology of

miscarriage, ectopic pregnancy, and trophoblastic disease. You should be familiar with the

diagnostic features of ultrasound used in early pregnancy, the epidemiology of pregnancy loss and

the medical agents used to manage early pregnancy loss miscarriage, ectopic pregnancy and

trophoblastic disease. You should be able to interpret the results of investigations used in early

pregnancy problems.

Module 17 Gynaecological Oncology

You will need to know the surgical anatomy of the abdomen and pelvis. You should understand

cellular biology of cancer, the genetic origins of cancer and the principles of diagnosis and

screening for gynaecological cancer. You should be aware of pain pathways, transmission of pain

centrally and the pathology of pain in gynaecological malignancy.

You should know the epidemiology and aetiology of cancers effecting women. You also need to

know the pathology and classification systems of gynaecological cancer and pre-malignant

gynaecological conditions..

You should be aware of the principles of radiotherapy and chemotherapy in the management of

gynaecological cancer and their effects on gonadal function.

Module 18 Urogynaecology and Pelvic Floor Problems

You should know the structure of the bladder and pelvic floor and their innervation. You shouldunderstand the mechanisms of continence and micturition and the principles of pelvic floor

support. You should understand how congenital anomalies, pregnancy and childbirth, disease,

infection and oestrogen deficiency affect these mechanisms. A knowledge of principles underlying

the treatment of bladder and pelvic floor problems and the impact of other drugs on bladder

function will be expected.