MRCOG COMPLETE GUIDE
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MRCOG Part 1 syllabus exam structure 2024 2025 RCOG
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MRCOG Part 1 syllabus exam structure format subjects
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MRCOG Part 1 syllabus subjects weightage anatomy physiology biochemistry pharmacology 2025
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MRCOG Part 1 syllabus domains knowledge areas question distribution 14 areas
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I now have everything needed to produce a thorough MRCOG Part 1 Syllabus & Exam Structure guide. Here it is:
MRCOG Part 1 - Complete Syllabus & Exam Structure Guide
What is MRCOG Part 1?
MRCOG Part 1 tests your knowledge of basic and applied sciences relevant to obstetrics and gynaecology (O&G). It is a prerequisite for Part 2 and acts as the scientific foundation before you progress to clinical assessments. The exam is recognised globally and is run by the Royal College of Obstetricians and Gynaecologists (RCOG).
Exam Format
| Feature | Detail |
|---|---|
| Delivery | Computer-Based Test (CBT) via Pearson VUE |
| Total questions | 200 SBAs (Single Best Answer) |
| Papers | 2 papers, 100 SBAs each |
| Duration per paper | 2.5 hours (150 minutes) |
| Time per question | ~90 seconds |
| Scoring | Both papers weighted equally; combined score determines outcome |
| Pass threshold | Determined by standard setting (no fixed published cut-off) |
| Attempts (UK trainees) | Maximum 6 attempts |
| Fee | £550 (as of 2025) |
Paper 1 is followed by an approximately 1-hour lunch break, then Paper 2 on the same day.
The Four Domains and 14 Knowledge Areas
The MRCOG Part 1 syllabus is structured into 4 domains, covering 14 knowledge areas (as per RCOG Curriculum 2019). All areas appear across both papers.
Domain 1 - Understanding Cell Function
| Knowledge Area | Key Topics |
|---|---|
| Biochemistry & Molecular Biology | Metabolic pathways, cell signalling, enzyme kinetics, DNA replication/repair, protein synthesis, energy metabolism (glycolysis, Krebs cycle, oxidative phosphorylation), nutritional biochemistry |
| Genetics & Genomics | Mendelian inheritance, chromosomal abnormalities (Down syndrome, Turner syndrome, Klinefelter), mitosis/meiosis, prenatal diagnosis, epigenetics, gene therapy basics |
| Immunology | Innate vs adaptive immunity, MHC/HLA system, maternal immune tolerance of the fetus, autoimmunity, transplantation immunology, immunological basis of recurrent miscarriage |
| Microbiology | Bacteria, viruses, fungi, parasites - with emphasis on TORCH infections, STIs, sepsis-causing organisms, antibiotic mechanisms and resistance |
| Pharmacology | Drug mechanisms (agonism/antagonism, pharmacokinetics, pharmacodynamics), drugs used in O&G (oxytocin, prostaglandins, magnesium sulfate, tocolytics, contraceptives, HRT), teratogenicity categories |
Domain 2 - Understanding Human Structure
| Knowledge Area | Key Topics |
|---|---|
| Anatomy | Pelvic anatomy, uterus/ovary/fallopian tube relations, pelvic floor musculature, bladder and ureters, pelvic vasculature and lymphatics, bony pelvis, perineum, breast anatomy, surgical anatomy relevant to O&G operations |
| Embryology | Gametogenesis, fertilisation, implantation, placentation, fetal organogenesis, embryological basis of congenital anomalies, development of the genital tract |
| Histology & Cell Biology | Endometrial cycle histology, cervical epithelium, placental structure, ovarian follicle histology |
Domain 3 - Understanding Measurement & Manipulation
| Knowledge Area | Key Topics |
|---|---|
| Statistics & Epidemiology | Sensitivity/specificity, PPV/NPV, likelihood ratios, RCTs and study design, systematic review/meta-analysis, odds ratio, relative risk, NNT, p-values, confidence intervals, screening principles |
| Biophysics & Imaging | Principles of ultrasound, MRI, CT, X-ray; radiation safety; Doppler principles; CTG interpretation basics |
| Pharmacological Principles | Drug absorption, distribution, metabolism, excretion (ADME); dose-response curves; drug interactions; receptor pharmacology |
Domain 4 - Understanding Illness
| Knowledge Area | Key Topics |
|---|---|
| Pathology | General pathology (inflammation, neoplasia, cell injury/death), gynaecological pathology (endometriosis, fibroids, cervical/uterine/ovarian cancer), obstetric pathology (pre-eclampsia, gestational trophoblastic disease, placental pathology) |
| Physiology | Maternal physiological adaptations in pregnancy (cardiovascular, respiratory, renal, haematological, endocrine), fetal physiology, placental physiology, labour physiology, menstrual cycle hormonal control |
| Endocrinology | Hypothalamic-pituitary-ovarian axis, HPT axis, adrenal cortex, thyroid in pregnancy, steroid biosynthesis, insulin and glucose in pregnancy |
| Clinical Sciences Applied to O&G | Evidence-based medicine, screening (antenatal, cervical), risk assessment |
Subject Weightings (Approximate)
Based on published RCOG guidance and question analysis from multiple sittings:
| Subject | Approximate % of Questions |
|---|---|
| Anatomy | 15-20% |
| Physiology | 15-20% |
| Biochemistry | 10-15% |
| Pharmacology | 8-12% |
| Pathology | 8-12% |
| Genetics | 5-8% |
| Embryology | 5-8% |
| Microbiology | 5-8% |
| Immunology | 4-6% |
| Statistics/Biophysics/Imaging | 8-10% |
Anatomy and Physiology are consistently the highest-yield subjects. Prioritise these, but every subject contributes to the combined score.
What the SBA Format Means
Each SBA question presents:
- A clinical vignette or basic science scenario
- 5 answer options (A-E)
- Only one is the single best answer
Questions are NOT negatively marked. You should always attempt every question.
Approximately 30%+ of questions are adapted from previous sittings, making systematic past-paper practice one of the highest-yield strategies.
High-Yield Topics by Subject
Anatomy
- Pelvic sidewall anatomy: obturator internus, piriformis, ureter relations
- Broad ligament contents and relations
- Pelvic vasculature (internal iliac artery branches)
- Inguinal canal and round ligament
- Bony pelvis: types (gynaecoid, android, anthropoid, platypelloid) and measurements
- Breast lymphatic drainage
- Surgical danger zones (ureter, bladder, bowel)
Physiology
- Cardiovascular changes in pregnancy (CO increases 40%, SVR falls)
- Haematological changes (dilutional anaemia, hypercoagulable state)
- Renal changes (GFR increases 50%, glucosuria is physiological)
- Respiratory changes (progesterone drives hyperventilation, PaCO2 falls)
- Placental gas exchange and Fick's principle
- Fetal circulation (foramen ovale, ductus arteriosus, ductus venosus)
- Oxytocin, prostaglandins, and mechanisms of labour onset
- Menstrual cycle: follicular phase, LH surge, corpus luteum
Biochemistry
- Gluconeogenesis and ketone body production in starvation of pregnancy
- Steroid hormone biosynthesis (cholesterol → pregnenolone → cortisol/oestrogen/testosterone)
- HCG structure and role (alpha/beta subunits)
- Folate and neural tube defects
- Iron metabolism in pregnancy (increased demands, hepcidin suppression)
- Bilirubin metabolism and jaundice types
- Enzyme induction/inhibition (CYP450 system)
Pharmacology
- Oxytocin: mechanism, uses, side effects (hyponatraemia, uterine hyperstimulation)
- Prostaglandins (misoprostol, dinoprostone, carboprost): uses and contraindications
- Magnesium sulfate: eclampsia prophylaxis, mechanism, toxicity signs
- Tocolytics: nifedipine, atosiban, betamimetics
- Metformin and insulin in gestational diabetes
- Teratogenic drugs: warfarin, methotrexate, sodium valproate, thalidomide, ACE inhibitors, tetracyclines
- Contraceptive pharmacology (COC mechanisms, progestogen-only pill, LNG-IUS)
Genetics
- Autosomal dominant conditions: achondroplasia, BRCA mutations, Huntington's, Marfan syndrome
- Autosomal recessive: cystic fibrosis, sickle cell disease, phenylketonuria
- X-linked: Duchenne muscular dystrophy, haemophilia A/B, fragile X
- Chromosomal: trisomy 21 (Down), 18 (Edwards), 13 (Patau), 45X (Turner), 47XXY (Klinefelter)
- Prenatal diagnosis: amniocentesis vs CVS (timing, risk, advantages)
- NIPT and cell-free fetal DNA
Embryology
- Fertilisation to implantation timeline
- Bilaminar → trilaminar disc (gastrulation)
- Somite formation and organogenesis timeline
- Development of Mullerian (paramesonephric) and Wolffian (mesonephric) ducts
- Congenital uterine anomalies (ESHRE classification)
- Embryological basis of undescended testis, hypospadias
- Placentation: cytotrophoblast invasion, spiral artery remodelling
Pathology
- Pre-eclampsia: failed trophoblast invasion, endothelial dysfunction, HELLP syndrome
- Gestational trophoblastic disease: complete vs partial mole, choriocarcinoma, hCG monitoring
- Cervical cancer: CIN grading, HPV 16/18, transformation zone
- Endometrial carcinoma: Type 1 (endometrioid, oestrogen-driven) vs Type 2 (serous, p53 mutations)
- Ovarian tumours: FIGO staging, surface epithelial vs germ cell vs sex cord-stromal
- Fibroids: classification (intramural, submucosal, subserosal), degeneration types
Microbiology
- TORCH infections and their effects on the fetus
- Group B Streptococcus (GBS) and neonatal sepsis prophylaxis
- Chlamydia trachomatis: PID, ectopic pregnancy risk
- Bacterial vaginosis: Gardnerella, Clue cells, Amsel criteria
- Candida vulvovaginitis: diagnosis and treatment
- Listeria monocytogenes in pregnancy
- Hepatitis B serology (HBsAg, anti-HBs, HBeAg)
- HIV in pregnancy: PMTCT protocols, antiretroviral therapy
Immunology
- Maternal tolerance of the fetus: HLA-G expression on trophoblast
- NK cell regulation at the maternal-fetal interface
- Antiphospholipid syndrome: antiphospholipid antibodies, lupus anticoagulant, recurrent miscarriage
- Rh incompatibility and haemolytic disease of the fetus/newborn (Kleihauer test, anti-D prophylaxis)
- Thyroid autoimmunity in pregnancy (Hashimoto, Graves)
Statistics
- Sensitivity = TP/(TP+FN); Specificity = TN/(TN+FP)
- PPV and NPV: prevalence-dependent
- Screening test principles and ROC curves
- P-value and Type I/II errors
- Confidence intervals and their interpretation
- Relative risk vs odds ratio (use in cohort vs case-control)
- NNT = 1/Absolute Risk Reduction
- Forest plots in meta-analysis
- CONSORT: elements of a well-designed RCT
RCOG Curriculum 2019 - Knowledge Requirements Structure
The MRCOG Part 1 syllabus maps to the Capabilities in Practice (CiPs) in the RCOG Curriculum 2019. The key CiP knowledge areas tested at Part 1 include:
- CiP 1: Maintaining patient safety
- CiP 2: Practising holistically, promoting wellbeing
- CiP 6: Managing unscheduled and acutely ill patients (basic science underpinning)
- CiP 7-12: Recognising and managing emergencies and non-emergencies in O&G (physiology/pathology basis)
Recommended Textbooks (Mapped to Library)
Based on the available medical library, these textbooks directly support MRCOG Part 1 preparation:
| Subject | Recommended Book |
|---|---|
| Anatomy | Gray's Anatomy for Students; Netter's Atlas of Human Anatomy |
| Physiology | Guyton and Hall Textbook of Medical Physiology; Ganong's Review of Medical Physiology |
| Biochemistry | Lippincott Illustrated Reviews Biochemistry; Harper's Illustrated Biochemistry |
| Pharmacology | Katzung's Basic and Clinical Pharmacology; Lippincott Illustrated Reviews Pharmacology |
| Pathology | Robbins & Kumar Basic Pathology |
| Embryology | Langman's Medical Embryology; The Developing Human (Clinically Oriented Embryology) |
| Genetics | Thompson & Thompson Genetics and Genomics in Medicine |
| Microbiology | Jawetz, Melnick & Adelberg's Medical Microbiology |
| Immunology | Roitt's Essential Immunology |
| O&G Reference | Creasy & Resnik's Maternal-Fetal Medicine; Berek & Novak's Gynecology |
Practical Preparation Tips
Timeline: 3-6 months of dedicated study. If working full-time clinically, plan for 6 months minimum.
Strategy by phase:
- Months 1-2: Read core textbooks for each domain. Use Lippincott series for biochemistry and pharmacology (concise, illustrated). Use Langman's for embryology (clinically oriented).
- Months 2-4: Topic-by-topic consolidation. Draw diagrams for anatomy (pelvic floor, uterine relations). Create tables for drug side effects and teratogenicity. Use flowcharts for steroid synthesis and fetal circulation.
- Months 4-6: Intensive SBA practice. At least 1,000-2,000 questions from dedicated MRCOG Part 1 question banks. Timed paper practice under exam conditions.
Key tactics:
- Past paper questions: over 30% of questions repeat or adapt from previous sittings
- Focus on clinical application of basic sciences, not pure memorisation
- Physiology and anatomy questions often use clinical vignettes (e.g., "A woman at 28 weeks develops..." - which physiological change is responsible?)
- Statistics questions are highly predictable - master the formulae and study designs
Exam Registration
- Registration opens months before each sitting - check the MRCOG calendar regularly
- The June 2026 sitting registration is currently open for eligible candidates who submitted an expression of interest
- Exams are held at Pearson VUE test centres worldwide
- Fee: £550
Quick Reference Summary
| Item | Detail |
|---|---|
| Total SBAs | 200 (100 per paper) |
| Total exam time | 5 hours (2 x 2.5 hrs) |
| Format | CBT, SBA only |
| Domains | 4 domains, 14 knowledge areas |
| Highest-yield subjects | Anatomy, Physiology, Biochemistry |
| Negative marking | None |
| Maximum attempts (UK) | 6 |
| Fee | £550 |
| Prep time needed | 3-6 months |
Would you like me to go deeper on any specific subject area - for example, a topic summary for Anatomy, a Physiology of Pregnancy deep-dive, or a set of high-yield SBA practice questions?
High yeild guide for mrcog part 1 subjects topics pdf
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