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Requirements for Core Curriculum 2019

Part 1 MRCOG

The Part 1 MRCOG assesses the Scientific Platform for Clinical Practice. It examines the 15 core Knowledge Areas in four domains of understanding. There is inevitably overlap between Knowledge Areas and Requirements and not all domains are relevant to a particular Knowledge Requirement. This is assessed using single best answer (SBA) questions.

i. Understanding Cell Function: This incorporates physiology, endocrinology and biochemistry
ii. Understanding Human Structure: This incorporates anatomy, embryology and genetics
iii. Understanding Measurement and Manipulation: This incorporates biophysics, epidemiology and statistics, data interpretation and pharmacology
iv. Understanding Illness: This incorporates immunology, microbiology, pathology and clinical management

Summary Knowledge Requirements: PART 1 MRCOG

Knowledge Area 1 – Clinical skills

  • Patterns of symptoms and understand the importance of risk factors
  • Pathological basis for physical signs and clinical investigation
  • How to interpret results of clinical investigations

Knowledge Area 2 – Teaching and research

  • Principles of screening, clinical trial design (multicentre, randomised controlled trials, etc.) and the statistical methods used in clinical research
  • Levels of evidence, quantification of risk, power of study, level of significance, informed consent and ethical and regulatory approvals in research
  • Principles of safe prescribing, quality control in medicine and the accuracy of tests

Knowledge Area 3 – Core surgical skills
  • Demonstrate an understanding of the issues surrounding informed consent, including knowledge of complication rates, risks and likely success rates of different gynaecological operations, together with an understanding of diagnostic methods and treatment of complications
  • Demonstrate your familiarity with surgery by discussing the common operations together with common surgical instruments and sutures
  • Demonstrate detailed knowledge of the basic surgical procedures in O&G, including diagnostic laparoscopy, hysteroscopy, gynaecological laparotomy for ovarian cysts, ectopic pregnancy, hysterectomy and vaginal surgery for prolapse, incontinence and vaginal hysterectomy
  • Know the principles and procedures involved in more complex gynaecological surgery for cancer and endometriosis
  • Have good knowledge of the principles of safe surgery, surgical instruments and sutures and the management of common complications of surgery
  • Be aware of the principles of surgical teamworking, risk management and risk reduction

Knowledge Area 4 – Postoperative care
  • Applied clinical science related to the postoperative period, including physiological and biochemical aspects of fluid balance, the metabolism of nutrients after surgery and the biochemistry of enzymes, vitamins and minerals
  • Organisms implicated in postoperative infections and the therapies used to treat them
  • Therapeutic drugs used perioperatively, including analgesics and thromboprophylactic agents
  • Histopathology of the pelvic organs, the breast and the endocrine organs, including the pituitary and the hypothalamus
  • Classification systems of gynaecological and obstetric conditions

Knowledge Area 5 – Antenatal care

  • Maternal anatomical, endocrine and physiological adaptations occurring in pregnancy
  • Pathology of major organ systems, including the common haemoglobinopathies and connective tissue disorders as applied to pregnancy Screening tests commonly performed in pregnancy
  • Fetal anatomy, including abnormalities, embryology, endocrine function and physiology
  • Normal fetal physiology and development, together with the aetiology of fetal malformations and acquired problems, including abnormalities of growth; this will include regulation of amniotic fluid volume and fetal interaction with the amniotic fluid
  • Development and function of the placenta in pregnancy, with specific knowledge of how the placenta handles drugs
  • Principles of inheritance and features and effects of common inherited disorders
  • Basic ultrasound findings in pregnancy
  • How to define and interpret data on maternal, neonatal and perinatal mortality
  • Impact of maternal health and other variables, e.g. social deprivation, on pregnancy outcome

Knowledge Area 6 – Maternal medicine

  • Epidemiology and pathological processes that underlie common maternal diseases in pregnancy, including diabetes and endocrine, respiratory, cardiac and haematological disease
  • Pathophysiology and presentation of common infections that affect pregnant women and the treatments and interventions used for these infections
  • Drugs used to treat maternal disease, and the potential maternal and fetal complications associated with their use
  • Imaging methods used to screen for maternal and fetal complications of maternal disease, e.g. ultrasound, X-ray and magnetic resonance imaging, and how to interpret their results

Knowledge Area 7 – Management of labour
  • Physiology, biochemistry and endocrinology of parturition, including maturation of the fetal endocrine system, the influence of hormones on signalling pathways in the myometrium and the biochemistry of myometrial contractility
  • Principles of tocolysis and stimulation of uterine contraction
  • Fetal physiology in late pregnancy
  • Fetal assessment in late pregnancy and labour, and how to interpret the results
  • Placentation and the implications of infection on labour, and the optical therapeutic options

Knowledge Area 8 – Management of delivery
  • Labour, and the mechanism and physiology of childbirth and the third stage of labour
  • Aetiology and pathology of congenital and bone malformations of the genital tract
  • Mode of action of drugs used in labour, at delivery and in the third stage of labour
  • Indications for and risks of operative delivery
  • Biochemical basis of acid–base balance, normal fetal physiological changes in labour and how to interpret fetal and cord blood analysis
  • Female perineum and principles underlying the management of perineal repair

Knowledge Area 9 – Postpartum problems
  • Physiology and structural changes in the neonate
  • Physiology of lactation, uterine involution and the pathology and management of puerperal sepsis and infection
  • Common puerperal complications, including mental health issues
  • Postpartum contraception and other drugs used postpartum and during lactation

Knowledge Area 10 – Gynaecological problems
  • Anatomy, physiology and histopathology of the pituitary gland and female reproductive tract, including an understanding of changes at puberty, at menopause and during the menstrual cycle, including ovulation
  • Epidemiology, microbiology and therapeutics of benign gynaecological conditions, including infection
  • How to interpret results of commonly performed investigations for benign gynaecological conditions
  • Principles of medical and surgical management of gynaecological problems

Knowledge Area 11 – Subfertility
  • Epidemiology of subfertility and treatment
  • Anatomy, development, function and cell biology of the organs of the male and female reproductive tracts in the context of their relevance to fertility and its disorders
  • How to interpret results of investigations commonly performed as part of the investigation of subfertility

Knowledge Area 12 – Sexual and reproductive health
  • Physiology, endocrinology, epidemiology and pharmacology of contraception
  • Epidemiology and serology of sexually transmitted infections (STIs), the microorganisms involved, the drugs used in their treatment and the pathological features of STIs
  • Termination of pregnancy, including assessment, Fraser competency, surgical management and the drugs used in medical termination of pregnancy

Knowledge Area 13 – Early pregnancy care
  • Basic sciences pertaining to early pregnancy and its loss, including the endocrine aspects of the maternal recognition of pregnancy, the luteal maintenance of early pregnancy and the physiology of fetomaternal communication
  • Aetiology and histopathology of miscarriage, ectopic pregnancy and trophoblastic disease
  • Diagnostic features of ultrasound used in early pregnancy, the epidemiology of pregnancy loss and the medical agents used to manage pregnancy loss (miscarriage, ectopic pregnancy and trophoblastic disease)
  • How to interpret the results of investigations used in early pregnancy problems

Knowledge Area 14 – Gynaecological oncology
  • Surgical anatomy of the abdomen and pelvis
  • Cellular biology of cancer, genetic origins of cancer and principles of diagnosis and screening for gynaecological cancer
  • Pain pathways, transmission of pain centrally and pathology of pain in gynaecological malignancy
  • Epidemiology and aetiology of cancers affecting women
  • Pathology of and classification systems for gynaecological cancer and premalignant gynaecological conditions
  • Principles of radiotherapy and chemotherapy in the management of gynaecological cancer and their effects on gonadal function

Knowledge Area 15 – Urogynaecology and pelvic floor problems
  • Structure of the bladder and pelvic floor and their innervation
  • Mechanisms of continence and micturition and principles of pelvic floor support
  • How congenital anomalies, pregnancy and childbirth, disease, infection and estrogen deficiency affect these mechanisms
  • Principles underlying the treatment of bladder and pelvic floor problems and the impact of other drugs on bladder function

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