In the recent MRCOG part 2 results, we saw a huge geographical variation with a striking observation of some areas having a 0% pass rate. Such a situation definitely causes waves of apprehension among the prospective exam candidates. It raises suspicions in the minds of those who sat for the exam regarding their capability of ever being able to get through. While those who haven’t yet written the exam but are planning in near future, also get shaky. This is a serious and distressing situation that needs some critical review.
The most commonly heard phrase ‘the result is very bad’ is a wrong statement. Result is just the same as it was meant to be. If many of those whom you know haven’t passed it simply means they haven’t prepared well for the exam. But please don’t misunderstand me here. I am not doubting anyone’s capability.
By stating this, I simply mean that they didn’t prepare well enough to meet the RCOG criteria. This brings us back to square one. What are RCOG standards? How to prepare for this exam? What to do to pass this exam? Wish the answer was so simple that I could have explained to you in a few words. A lot of people ask questions about how to prepare for the exam, which books to read and how to organize themselves? The answer is not a list of books or some standard techniques to study and that’s why I feel overwhelmingly distressed when I find such questions in my inbox or someone asks me in person.
What distresses me is to see that most of the candidates really have no idea what to do and quite a good proportion is not even willing subconsciously to understand what to do. I never give anyone a list of books to read, my usual reply to such questions is that the syllabus and the material to read is all on the college website. Because that is the fact. But, then why do people still keep failing if everything that you need to study is on the website? So it’s definitely not about gathering the reading material, printing out piles and piles of papers and doing nothing except struggling through them over and over again.
In this blog I will try to give you a glimpse of the pitfalls in your preparation. One thing you really need to understand and accept is that there has been some flaws in your approach towards the preparation. If you have already completed one post-graduation from another college, then that might be a major reason because your mind still insists on working on the same pattern. If that is the case with you then you need to erase everything about your previous certification and its system from your mind, so that your mind can accept the new information regarding the system of MRCOG. The rule of thumb is that before doing anything else, you must put a huge amount of effort in understanding what the exam is all about.
Have you ever seen the syllabus for part 2 that is provided on the college website? Have you read in detail about the curriculum of each module? I can guarantee that 99% candidates have no idea about RCOG curriculum. Let me explain this to you using an example: In MRCOG part 2 syllabus, module 1 is Clinical skills and the description says:
You’ll need to demonstrate your ability to:
• Take an obstetric and gynaecological history
• Communicate effectively
• Take notes concisely and accurately Below this they have given a link to download full curriculum for module 1.
Have you ever looked into this curriculum? This sounds very simple that history taking is required, with effective communication and concise and accurate notes. And at this point most of the people scroll down the page thinking they already know this bit. But if you go into the details of the curriculum, it further guides you about the knowledge criteria, clinical competency and professional skills that are required by the college and should be demonstrated in the exam in order to satisfy the examiners.
So for clinical skills module, the knowledge criteria of the exam is:
“- Define the patterns of symptoms and identify risks factors in women presenting with obstetric and gynaecological problems
– Comprehend the different elements of history taking – Recognise that patients do not present their history in a structured fashion
– Recognise that the woman’s wishes and beliefs and their history should inform examination, investigation and management ”
Now if your answer to a question that asks you about history does not demonstrate your knowledge of the points mentioned above, you will simply never score a pass mark, no matter how well you know the symptoms of a certain disease. How to achieve such level of knowledge is the trick and the skill that you have to acquire while you prepare for the exam.
Next column of curriculum describes the clinical competency that is expected from you in this module of clinical skills. So here is what it says:
“- Take and analyse an obstetric and gynaecological history in a succinct and logical manner
– Comprehend that effective history taking in non-urgent cases may require several discussions with the woman over time
– Supplement history with standardised instruments or questionnaires when relevant
– Manage difficulties of language, physical, educational and mental impairment, with carers and family members as appropriate
– Use interpreters and health advocates appropriately. Maintain focus and recognise that relatives may be affecting decisions made by a woman – Manage alternative and conflicting views from family, carers, friends and members of the multidisciplinary team.
– Assimilate history from the information available from women and other sources including members of the multidisciplinary team – Manages time and draw consultation to a close appropriately”
Well, those who have attended my tutorials, especially for OSCE will be able to see through these statements very clearly. And now if your answer has included all the history points and every other information but you haven’t mentioned a few things according to the question scenario e.g. use of questionnaires to assess effects on quality of life, giving patient ample time, offering a second consultation, considering her language barrier and using an interpreter, involving her family in her care when the situation dictates, recognizing and demonstrating your knowledge on the limitations that the family and care givers have on decision making on behalf of the patient, and how to deal with conflicting views either with the patient or team members etc..
There is a lot more that you need to include in your answer to a question that apparently is asking you something about the history. Then the next column of the curriculum provides you a list of professional skills that are required. So, cutting it short, after reading this small example only on history taking skills, would you still complain that you did your best but didn’t pass? Would you still blame the college that has provided you so clear instructions on what it wants from you? Now look back to the exam you just have failed.
Look at the question of SAQs and think of your answers: did you include the criteria set by the college in your answers?
If you have never looked into the curriculum of the exam you are sitting for, are you still surprised on your results?
I have used these skills throughout my tutorials so it saves a lot of your time and effort by providing all the required skills for each module in every tutorial. But, again this helps only and only if you are ready to acknowledge the importance of reflecting these skills in your answer. Otherwise even my efforts are in vane if someone doesn’t acknowledge these facts.
My sincere advise to all the candidates is:
– Please don’t gather too much information and don’t do the ‘window shopping’ on how to study and what to study. This confuses you and is a waste of time.
– The answers to your questions is right there on your own college’s website, please look into it, get familiarize with the exam you are going to take and benchmark the standards you need to achieve.
– Please put an effort to recognize and spot out your flaws instead of insisting that the exam is very difficult.
Very soon I am introducing a ‘one-to-one skype’ session in which you would be able to talk to me for a specified length of time and get a chance to discuss your personalized troubles and deficiencies related to exam preparation. These sessions are introduced for those who can’t buy the BeMRCOG course for one reason or another. I hope to be able to help you as much as I can but in a manner that can bring a change in your approach towards the exam. Please do drop a line of comment if this blog has served as an ‘eye opener’ for you.