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Important Notes from themedideas.com
This is an article for the Part 2 MRCOG Examination published by themedideas.com to help
the candidates improve their understanding of the Part 2 MRCOG Examination. It is not
guaranteed that the candidates would pass the Part 2 MRCOG Examination by reading this
article only. The discussions are not exhaustive on the topics covered. These aim to highlight
the important relevant aspects of the topics rather than every minute detail, which is outside the
scope of this article.
While every effort has been made to provide updated information, as format and style of the
Part 2 MRCOG Examination change, the candidates are advised to consult recent information
from the RCOG as well.
While every effort has been made to ensure the accuracy of the information, no responsibility
for loss or injury whatsoever occasioned to any person acting or refraining from action as a
result of information contained herein (questions and answers) can be accepted by the
themedideas.com.
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How to pass the Part 2 MRCOG Examination - Volume 3
Your preparation for the Part 2 MRCOG Examination
Level 3 analysis: How do you do well in the Test?
This article is the Volume 3 (the last volume) of "How to pass the Part 2 MRCOG Examination"
series that consists of three volumes. It discusses comprehensively the “Level 3 analysis: How
do you Plan, Prepare & Perform well in the examination?”
This volume provides a comprehensive coverage of the preparation, answering techniques and
tips for different formats e.g. EMQs, MCQs, SAQs and OSCEs to improve the candidates’
performance in the examination. The candidates must understand these thoroughly to learn the
rule of the game. In fact it is more important than just reading as you would benefit greatly from
these information and tips. It also includes in depth analysis of the answering techniques for
different components of the examination e.g. EMQs, MCQs, SAQs and OSCEs, and strategies
to maximise the marks obtained in the examination. These techniques have been used
successfully over the years to increase the efficiency of the preparation for the examination and
achieve higher marks. The candidates would definitely improve their performance in the
examination if they could implement these techniques appropriately. By following these
techniques they would have an edge over the other candidates taking the examination.
The format of the Part 2 MRCOG examination has changed significantly since March 2011.
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Since then the emphasis has shifted substantially from the SAQs to the EMQs primarily and
the MCQs to a lesser extent. This means that the candidates need to modify their approach
towards the examination. Several candidates, especially who have appeared in the
examination before, but have been unsuccessful, are frightened and confused about how to
prepare efficiently given the enormity of changes in the format.
This effort is meant to guide and help the prospective candidates prepare well so that they
would be in a better shape when they appear in the examination. Over the years, hundreds of
candidates have benefited by following these methods.
The candidates would also find it helpful to use the examination and trainee materials provided
in the MCQs, EMQs, SAQs, OSCEs, Examination, Career, Trainee and Health sections of
themedideas.com in the form of Banks, Tests, Articles etc.
Dr Sudipta Paul
MD, FRCOG, DFFP, CCST
Consultant Obstetrician & Gynaecologist
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How to pass the Part 2 MRCOG Examination - Volume 3
Your preparation for the Part 2 MRCOG Examination
Level 3 analysis: How do you do well in the Test?
A. The written Examination
I. The MCQ papers
(i) The facts
(ii) The preparation
(iii) The technique
II. The EMQ papers
(i) The facts
(ii) The preparation
(iii) The technique
III. The SAQs paper
(i) The facts
(ii) The preparation
(iii) The technique
B. The OSCE
(i) The facts
(ii) The preparation
(iii) The technique
Ten Commandments for the Part 2 MRCOG Examination
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How to pass the Part 2 MRCOG Examination - Volume 3
Your preparation for the Part 2 MRCOG Examination
Level 3 analysis: How do you do well in the Test?
A. The written Examination
Introduction
* This is the first and a difficult hurdle to cross.
* The pass mark to qualify for the OSCE is variable.
* The pass rate is usually lower than that in the OSCE.
* The SAQs paper account for 90 marks. There are standard model answers for the SAQs and
the marks awarded depend on the number of correct points mentioned matching the model
answer. As it is not possible for the examinee to know the points in the model answer, it might
be difficult to obtain higher marks in the SAQs paper.
* The EMQs and MCQs papers account for 210 (120 + 90) marks. As these are objective,
higher marks could be obtained with proper preparation. It might compensate for lower marks
in the SAQs paper. Therefore, the aim should be to obtain as high marks as possible in the
EMQs and MCQs papers.
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I. The MCQ papers
(i) The facts
* The two papers contain 240 MCQs (120 in each paper with 45 EMQs).
* There is variable number of stems (topics) with variable number of responses to each stem
(usually 1- 5). The total number of responses is 240 (120 in each paper), each carrying equal
mark.
* The MCQ Bank is being updated continuously replacing outdated and controversial questions
by new standard questions (neither too easy nor too tough).
* There is no negative marking.
(ii) The preparation
* There are few MCQ books on the market, but only a handful of them are useful. There are
MCQs available on the internet as well. You should search for them and read the ones that you
find useful.
* Remember common facts and figures, causes, clinical features, investigations, complications
and management of all important topics.
* Practise answering MCQs under an examination setting.
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(iii) The technique
* It might be better to answer the MCQs first before proceeding to the EMQs in the
papers as it is relatively easier to obtain marks in the MCQs if you knew the answer.
* Read the question carefully and answer it at its face value, do not try to find any hidden
meaning.
* Answering 120 responses on different topics in approximately 50 minutes (leaving 85 minutes
for 45 EMQs in the paper) is a brainstorming exercise that often leads to technical errors in
answering as you get only 25 seconds to answer each MCQ.
* In this circumstance, it might be worthwhile to answer the familiar MCQs first without wasting
time to think about the answers of the unfamiliar MCQs, then proceeding to the unfamiliar
MCQs later.
* It might be better to answer the sure shot MCQs in the first round, the familiar but less
certain MCQs in the second round and the rest in the third/ fourth round. It has got three
advantages –
Firstly, after the first round the standard of the MCQ paper would be obvious.
Secondly, it might reduce the number of technical errors in answering sure shot MCQs.
Thirdly, if the number of the MCQs in each round is noted it would give some idea about
your performance. It would be useful for future MCQ examinations.
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* It might be time-saving to mark the true(T) / false(F) answers on the question paper and
transfer them to the answer sheet later as then you do not have to switch between the
question paper and answer sheet for each MCQ. It distracts attention as well that might
lead to unnecessary mistakes. Be careful to keep at least 12 minutes (6 seconds per
MCQ) to do that or do it after each round, which is a safer alternative. Alternatively,
lightly block in your answers on the answer sheet as you go along, and then boldly mark
over them at the end.
* As there is no negative marking all the MCQs should be answered, as you have
nothing to lose.
* When guessing, always follow your first impression as it is more likely to be correct.
II. The EMQ papers
(i) The facts
* The two papers contain 90 Extended Matching Questions (EMQs) (45 in each paper
with 120 MCQs).
* It tests more complex understanding than the MCQs.
* It covers a wide range of topics than the short essays.
* There is no negative marking.
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(ii) The preparation
* There are few EMQ books on the market, but only a handful of them are useful. There are
EMQs available on the internet as well. You should search for them and read the ones that you
find useful.
* Remember common facts and figures, causes, clinical features, investigations,
complications and management of all important topics.
* Write down the important aspects and the management of all common problems and
uncommon but important situations encountered at work. Try to implement it into your practice,
which would make it easier to remember and reproduce in the examination. The need for
adequate involvement in day-to-day patient management cannot be overemphasised as
the EMQs are usually clinical problem oriented.
* Practise answering EMQs under an examination setting.
(iii) The technique
* The most important aspect is to select the single answer that best fits. Apparently,
there might be several answers that are related to the question, and are not wrong, but
you must select only the most likely one (for that question) from the option list. The
answer would also depend on the other questions in that EMQs set. Therefore check
which of the related options fits best with which question.
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* It might be useful to select the possible answers first, and then try to exclude them.
The answer that cannot be excluded by any logic at all would be the most likely one.
* It might be worthwhile to answer the familiar EMQs first without wasting time to think about
the answers of the unfamiliar EMQs, then proceeding to the unfamiliar EMQs later.
* Read the question carefully and answer it at its face value, do not try to find any hidden
meaning.
* Answering 45 responses on different topics in approximately 85 minutes (leaving 50
minutes for 120 MCQs in the paper) is a brainstorming exercise that often leads to
technical errors in answering as you get only 1.89 minutes to answer each EMQ.
* It might be better to answer the sure shot EMQs in the first round, the familiar but less
certain EMQs in the second round and the rest in the third/ fourth round. It has got three
advantages –
Firstly, after the first round the standard of the EMQ paper would be obvious.
Secondly, it might reduce the number of technical errors in answering sure shot EMQs.
Thirdly, if the number of the EMQs in each round is noted it would give some idea about
your performance. It would be useful for future EMQ examinations.
* It might be time-saving to mark the answers on the question paper and transfer them
to the answer sheet later as then you do not have to switch between the question paper
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and answer sheet for each EMQ. It distracts attention as well that might lead to
unnecessary mistakes. Be careful to keep at least 10 minutes (13.33 seconds per EMQ)
to do that or do it after each round, which is a safer alternative. Alternatively, lightly
block in your answers on the answer sheet as you go along, and then boldly mark over
them at the end.
* As there is no negative marking all the EMQs should be answered, as you have
nothing to lose.
* When guessing, always follow your first impression as it is more likely to be correct.
III. The SAQs paper
(i) The facts
* The paper contains four SAQs (two Obstetrics and two Gynaecology) each carrying
equal marks.
* Most of them would be on practical problems faced in the clinics, wards, labour ward
and theatres.
* Each SAQ is usually broken down into two to four parts with individual marks.
* The parts of each question are printed on different areas of an A4 size page with
specified spaces to write, and the answers must be completed within those specified
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spaces provided on two sides of that page.
* Formal introduction and conclusion are not essential requirements.
* The answer would generally cover three broad areas that are checked (1) concept on the
topic (background to and context of the topic), (2) clinical acumen and (3) justification for the
proposed management.
* Marks would be awarded only for points included in the model answers.
* The total time for the paper is 105 minutes allowing 26.25 minutes per essay.
(ii) The preparation
* There are few SAQ books on the market and you could get information on the SAQs from the
internet. Search for them and use what you find helpful.
* You cannot do the preparation by sitting in the library.
* First, make a list of all common problems and uncommon but important situations
encountered at work. Then go through the literature and discuss with a colleague who is
academically up to date. Also check the TOG (RCOG), the Royal College guidelines and other
recommendations (e.g. NICE). Write down the important aspects and the management of the
topics on your list. Try to implement it into your practice, which would make it easier to
remember and reproduce in the examination. The need for adequate involvement in day-to-
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day patient management cannot be overemphasised as the majority of the SAQs would
be based on clinical problems.
* Making a list has several advantages –
1. The actual workload would be known. It would be easier to make an efficient plan
regarding how to deal with the workload. It would also reduce the fear of the unknown that
would have appeared otherwise when the actual workload is unknown.
2. The most important topics would be evident. Therefore, the energy could be directed
towards the most productive areas that would increase efficiency (marks obtained per
unit / hour of reading or preparation). This is one of the important benefits of making a
list of topics according to the ranking of their importance in relevance to the
examination.
To learn in detail how to prepare a list of important topics for examination see
http://themedideas.com/career/examination/the-secrets-of-preparing-suggestions-for-any-examination/
3. As you go through the list you could assess your progress and modify your plan
accordingly, depending on your progress so far. With your progress recorded on the list it
is very easy to modify the plan in relation to the workload and time as you could assess how
long you have been spending to prepare each chapter or topic.
4. Once you have completed your preparation on all the topics on the list you
would feel confident that you have not missed any relevant topics in the syllabus. A
confident candidate usually performs better in an examination compared with an inconfident or
anxious candidate. The self-confidence would definitely boost your performance in the
examination.
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5. You could add the number of topics that have been completed and find out what
percentages of the total topics you have covered. You could vary this according to your
individual requirements and target marks you would like to achieve in the examination.
6. It is easier to recall information that is fed in a systematic order to the brain. This is a
very important issue. If you read the same number of topics over a period of same
duration, it would be easier for you to recall facts from your memory if you have read
the topics in a systematic manner (or in an order) compared with reading them without
any sort of order (haphazardly).
* Practise writing short essays in an examination setting within two sides of a page (A4
size) in 22 minutes leaving 4.25 minutes for revision. It is the best way to improve the
SAQ writing skills and performance in the examination.
* The majority of the candidates who fail, lack the skills of writing short essays in an
examination setting leading to poor performance in the examination.
(iii) The technique
* The most important factor is to consider all the SAQs with equal importance and
answer them properly. It would be almost impossible to compensate for two SAQs being
answered badly. The minimum optimum target should be to answer at least two SAQs
very well and one SAQ average to good that might compensate for a bad to average
answer for the fourth SAQ. If all the four SAQs could be answered well that would be the
best anyway.
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* First check the questions in the SAQ paper carefully and mark 1, 2, 3, 4 against the
questions as per the order you would answer them. This would reduce any possibility of
confusion later.
* It might be better to start with the SAQs you are familiar with the answer and answer
uncommon essays subsequently. If you started writing an uncommon SAQ first and had
taken relatively long time, it might create a lot of anxiety while writing, affecting the standard of
the answers of the common SAQs as well, along with shortage of time, later. On the other
hand, if you completed answering the common SAQs within a reasonable time, you would have
adequate time to think about the answers of the uncommon SAQs in a relatively free mind.
* It would be prudent to complete each SAQ in 22 minutes (total time = 88 minutes)
keeping 17 minutes (4.25 minutes per SAQ) for revision.
* Do not waste too much time for one SAQ because of the fact that you know a lot about
it as you cannot get more than 22.5 marks in one SAQ, but might lose a lot of marks in
other SAQs due to lack of time. In fact, it is unlikely that anybody would get 90% or
above marks in one SAQ, even if it is answered very well. By trying to do that several
marks might be lost in other SAQs if those are answered badly.
* It might be useful to give more time for the uncommon SAQs, as you have to think about the
answer. You should use your judgment regarding how much time you provide to each
individual SAQ.
* Read the questions carefully and identify the key points that you have to cover in your
answer. Beware of the fact that the questions might not always have a direct relation to
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the statement or topic mentioned. Consider each question under the statement or topic
mentioned separately as individual question and answer only what is being asked in
that part.
* Once you have understood what it is asking about, plan the answer and write it down.
Do not write “what you know” about the topic, answer the part of the question
specifically and write what it is asking for. How much you write would be guided by the
marks allotted against each question. A rough guide would be approximately 2 lines per
marks. First think about the points and style of the answer before you write anything.
The space is specified and limited. Therefore, there is not much scope of major
corrections. To be safe, you could write down the outline of your answer on a rough
paper first before you start writing the actual answer. This would improve the quality of
the answer and reduce the necessity of corrections to minimum (that would reduce time
wasted).
* Always, always, always answer the question. Probably the most common reason for a
poor mark is not answering the question, and writing whatever you know about the
topic.
* Always use common sense and think how you would manage the problem in your
practice. Even if you get an uncommon question that, at first thought, appears that you
do not know anything about at all, do not panic. Answer the questions you know first
then try to think about the uncommon question using your common sense, you would
be able to write something at least. Follow the basic principles of symptoms, signs,
investigations, diagnosis, treatment etc when you try to find answers for uncommon
topic.
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* Do not hesitate to mention that you (as a Registrar/Specialist Trainee) would involve senior
persons if you think it is appropriate. Do not ever forget to inform the Consultant if you are
dealing with a case of major obstetric haemorrhage!
* Do not start and finish abruptly.
* It would be wise to mention as many relevant points as possible because the points in
the model answers would be unknown. Scoring points may be missed if the relevant points
are not mentioned, but there is no negative marking for mentioning extra points. Be cautious
not to mention something irrelevant, not evidence based and unsafe. There should be a
balance between how much you write and the time it takes (there is page restriction as well).
This balance is also an important factor that is checked in the examination, as it is
relevant in clinical practice.
* Write a short essay, not several lines of relevant facts. Your message should be clear
to the examiner.
* Try to discuss critically using only evidence based facts as it is expected from a
candidate taking Part 2 MRCOG examination. If you have not worked in the NHS system
(UK) you should be extra careful not to write something that you usually do in your
practice but is not evidence based.
* Always revise what you have written before you leave. This is very important. When
you revise, not surprisingly, you would notice something you would like to modify. It
would be better to do that during the examination rather than repenting later.
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B. The OSCE
(i) The facts
* It consists of twelve 15-minute stations, making a three-hour oral examination in total
* There are two preparatory stations where the candidates are given some information (a short
paper, letter from the GP, case or investigation report, patient information leaflet, complaint
letter, research or audit report etc.), which would be used for critical appraisal at the following
station.
What is tested:
* Factual knowledge Clinical, audit, research, statistics, clinical governance
* Dealing with the patient Show respect as an individual, introduce yourself,
address formally, reassure, relieve anxiety, be honest,
be polite
* Attitude towards the patient Non-judgmental, non-patronising, empathetic
* Communication skills With the patient and/or relatives & with the examiner; be
simple, make direct eye contact, positive body language
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* Listening skills Be patient, be careful
* Analytical skills Clinical, audit, research, patient information leaflet
* Decision making skills Clinical
* Counselling skills Discuss pros & cons, be honest
(ii) The preparation
* There are few OSCE books on the market and you could get information on the OSCE from
the internet. Search for them and use what you find helpful.
* There is no alternative to practical experience of managing patients.
* Be familiar with the investigation reports and their interpretations (such as ultrasound scan,
HSG, X-ray, urodynamics, CTG, fetal blood sampling, blood reports, laparoscopic and
hysteroscopic pictures etc.).
* Be prepared to answer about common instruments and operative procedures (such as
ventouse, forceps, caesarean section, fetal blood sampling, hysterectomy, pelvic floor repair,
laparoscopy, tension-free vaginal tape / transobturator tape procedure etc.).
* Make firm logical view about management of common problems, especially
emergencies (such as antepartum and postpartum haemorrhages, shoulder dystocia, cord
prolapse, severe pre-eclampsia and eclampsia, breech presentation in labour, delivery of
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the second twin, prelabour rupture of the membranes, preterm labour, ectopic pregnancy etc.).
* Thoroughly prepare all the counselling you might have to provide in day-to-day
practice (such as preconceptional, missed miscarriage, recurrent miscarriage, antenatal
screening for Down’s syndrome, fetal anomaly, perinatal death, sterilisation, hysterectomy,
laparoscopy, hysteroscopy, abnormal cervical smear, diagnosis of cancer, infertility etc.).
* Prepare how to prioritise different patients on the labour ward. This is quite difficult
even for the candidates working in the UK. During preparation, you need to make a list
with different types of patients, seen on the labour ward, arranged in chronological
order according to the urgency or seriousness of their conditions.
* Be prepared to express your views on topical controversial issues.
* Be clear about the basic principles of audit and research. Be familiar with the Cochrane
database and the way the statistics are presented there. You might be asked to plan an audit
protocol or critically appraise a paper.
* Candidates not working in the UK should collect information about the UK practice.
* Practise answering in OSCE setting with another candidate or a senior colleague.
(iii) The technique
* The OSCE is quite demanding, so sleep well the night before.
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* Dress well (and appropriately)
Male – Black, dark grey or dark blue suit; preferably white shirt and a matching tie.
Polished shoes (and clean socks!)
Clean shaved unless you keep moustache or beard
Neatly cut and combed hair
Neatly cut fingernails
Clean glass (if wearing any)
Suitable perfume (not too much)
Should not smell of cigarettes – Avoid smoking at least for an hour before
going to the OSCE and /or use mouth spray
Female – Suit, skirt or any traditional formal dress (any colour, but not too flashy)
Polished shoes and (clean socks!)
Neatly cut and combed hair
Neatly cut fingernails
Clean glass (if wearing any)
Suitable perfume (not too much)
Should not smell of cigarettes – Avoid smoking at least for an hour before
going to the OSCE and /or use mouth spray
* Reach in time.
* Take it as it comes.
* Look confident.
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* Always, always, always introduce yourself to the patient (actress) and the examiner.
* Always check patient’s identity unless specifically mentioned by the examiner.
* Always explain to the patient (actress) what you are doing or intend to do.
* Always be polite and listen to the patient (actress) and examiner carefully.
* Always avoid using medical terms as far as possible when talking to the patient
(actress).
* Always say sorry and apologise if the patient (actress) becomes upset.
* Always thank the patient (actress) once you have finished talking to her.
* Imagine the Examiner as your supervising Consultant, as if you were discussing
problems at work.
* Outline how you would manage the problem usually, and be ready to justify it.
* Use common sense.
* Be practical in your answer.
* Mention common things first.
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* Do not keep quiet and waste time as you would not score any marks by doing so. If
you do not know something say so and move to the next question.
* Do not say something completely irrelevant, not evidence based or unsafe (as per the
UK NHS practice). Whatever you say be prepared to justify it with evidence. Usually if
you say the right thing (evidence based and safe) it is very unlikely that the patient
(actress) or examiner would contradict you or interfare with your talking. Try to find cue
from what the patient (actress) or examiner says or from their body language. Although
they are not supposed to give you any lead they are human beings and their body
language would reflect their feelings if you take a wrong track. The other interesting
thing is that sometimes subsequent questions / discussions in the OSCE could not be
asked / introduced if the initial one leads to a totally different track. Therefore, there is a
possibility that they might try to bring you back to the right track.
* Do not be frightened if the Examiner disagrees with your views, as he/she might be
testing your confidence. Try to avoid argument, but do not change your answer
illogically just because the Examiner is not agreeing with you.
* Always remember that you have to show a standard of Year 4/5 Specialist Trainee
(Year 2/3 Specialist Registrar in the past) in the UK and tailor your answers to that. You
would sail through!
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Ten CommandmentsTen CommandmentsTen CommandmentsTen Commandments
fffforororor the the the the Part 2 MRCOG ExaminationPart 2 MRCOG ExaminationPart 2 MRCOG ExaminationPart 2 MRCOG Examination
1. Achieve the standard of ST 4/5 in your knowledge regarding the UK NHS practice
before taking Part 2 MRCOG.
2. Practical experience in patient care is more important than theoretical knowledge.
3. Keep up to date and implement your knowledge in clinical practice.
4. SAQs and OSCE questions are usually on problem based practical topics.
5. Practise answering SAQs, MCQs and EMQs papers and practise OSCE in an
examination setting.
6. It is relatively easy to obtain higher marks in the MCQs and EMQs papers than the
SAQs paper. Aim to obtain high marks in the MCQs and EMQs papers.
7. Sleep well the night before the examination (both written and OSCE).
8. Read the question before you write and revise before you leave.
9. Be democratic, give equal importance to all questions and use your common sense.
10. In the OSCE, respond to the examiner as you would to your supervising Consultant,
appear confident and make direct eye contact.
Paul S, 2013
themedideas.com
© Dr Sudipta Paul, themedideas.com, 2012 25
How to pass the Part 2 MRCOG Examination - Volume 3
Dr Sudipta Paul
References
1. Paul S. The changing patterns of the Part 2 MRCOG Examination. Hosp Med 1999;
60:592-595.
2. Paul S. The job and the exam. BMJ Classified Career Focus 1999; 318:2-3.
3. www.rcog.org.uk
N.B. An extra mark scored by any other candidate taking the examination means you need to
get an extra mark to keep the difference in your performance with him or her the same. The
better the other candidates do the more your performance would be devalued. Therefore, your
aim should be to improve your performance, not others’, as then you lose the advantage you
get by planning efficiently.
Thank you for readingThank you for readingThank you for readingThank you for reading &&&&
Best of LuckBest of LuckBest of LuckBest of Luck for the exam for the exam for the exam for the exam
Plan & Prepare efficientlyPlan & Prepare efficientlyPlan & Prepare efficientlyPlan & Prepare efficiently
&&&&
You would surely getYou would surely getYou would surely getYou would surely get
The MRCOG CertificateThe MRCOG CertificateThe MRCOG CertificateThe MRCOG Certificate