MRCOG Part 2 Course July 2022

RK4 Courses

Enrol Now for MRCOG Part 2 Course July 2022!!

 

Features

• Twice Weekly Interactive Live Sessions 2-3 hours duration conducted using Zoom software
• Session Recordings accessible until the exam day
• Total LIVE Sessions: ~28-30
• Important Exam Topics covered module wise
• All GTGs, NICE, FSRH, BASHH, Important TOGs, Previous Exam Qs will be discussed
• Organised Reading material on fully integrated LMS
• Module-wise SBAs & EMQs for practice
• Duration 4-5 Months
• Session Timings 19:00 to 22:00 PST
• Tips and Tricks to tackle SBAs and EMQs
• Focus on concepts and critical thinking — deal with ANY exam question
• Supervised WhatsApp Study Group to discuss and clarify queries, SBAs, EMQs

 

Course Fee: PKR 74,999 ~ $425

To Register Visit Course Website

https://www.rubabk4courses.com/courses/

 

Payment Options:

• 2 Installments one month apart
• Special Discount on One-Time full payment
• Credit/Debit Card payment available
• Direct Bank Transfer (For Pakistani Candidates)

DIRECT BANK TRANSFER

Account Title: RUBABK4 COURSES (SMC-PVT) LTD

IBAN: PK33 HABB 0015897918851803

Bank: Habib Bank Limited (HBL)

Swift Code: HABBPKKA589

NTN: 826315-7 

Address: Peco Road Centre, Lahore, Pakistan

 

*After the payment, please share the receipt on:

WhatsApp +92 316 4371557

Email: rubabk4courses@gmail.com 

 

LIVE Sessions Outline

 

Module	Topics to Cover
Introduction to Course Early Pregnancy Care	Ectopic Pregnancy —GTG Recurrent Miscarriage —GTG Miscarriage
Early Pregnancy Care II	OHSS —GTG Gestational Trophoblastic Disease— GTG Hyperemesis Gravidarum —GTG
Urogynaecology I	Urinary Incontinence— NICE POP —NICE Urodynamics Studies Cystoscopy Post-hysterectomy Vaginal Vault Prolapse— GTG
Urogynaecology II	Bladder Pain Syndrome— GTG Catheter use in Gynaecology TOG Urethral Diverticulum TOG Postpartum Voiding Dysfunction
Subfertility I	Subfertility — NICE IVF—Facts, Procedures Reproductive aging —SIP
Subfertility II	Male Factor Uterine/Tubal Factors Unexplained Subfertility Endometriosis  Thyroid/Prolactin Surrogacy Legal Issues
Oncology I	General Oncology Staging of ALL Cancers Cervix — NHSCSP  Endometrium GTG + SIP
Oncology II	Ovary GTGs plus NICE Plus SIPs Vulva RCOG + BASHH
Contraception	UKMEC All Contraception Fertility Awareness Methods Barrier Methods Combined Hormonal Contraception Progesterone Only— Implants, Pills, LNG LARC Emergency Contraception Sterilization Postpartum Contraception
Sexually Transmitted Infections	STIs Gonorrhea / Chlymadia/Trichomonass Vaginalis/Bacterial Vaginosis/ Vulvovaginal Candidiasis Syphilis Genital Ulcers
General Gynaecology I	Abnormal Uterine Bleeding HMB— NICE Endometrial Polyp Fibroids UAE Endometrial Ablation
General Gynaecology II	PMS— GTG CPP— GTG Vulvodynia Amenorrhea Premature Ovarian Insufficiency Menopause — NICE Osteoporosis
Core Surgical Skills & Procedures I	General Principles Consent WHO checklist Enhanced Recovery Injuries —Nerve/Arterial Abdominal Incisions & Sutures Perforated Uterus Needle Stick Injury Local Anaesthesia SSI Antibiotics / VTE Prophylaxis
Core Surgical Skills & Procedures II	Laparoscopy —GTG TOG Hysteroscopy— GTG CVS/Amnio —GTG Perineal Tear GTG Assisted Vaginal Birth—GTG CS — NICE TOG VBAC
Antenatal Care I	Antenatal Care NICE Air Travel, Vit D in Pregnancy  Vaccination/Constipation/Smoking in Pregnancy Obesity in Pregnancy—GTG Screening in Pregnancy— NIPT & invasive/ Anomaly
Antenatal Care II	FGM—GTG Domestic Violence Pre-term Labour —GTG Reduced Fetal Movements —GTG Late IUFD & Stillbirth —GTG
Antenatal Care III	Malpresentation — Breech ECV Multiple Pregnancy —NICE Twin —GTG Mx of Red Cell Antibodies  —GTG Blood Transfusion in Obstetrics  —GTG
Antenatal Care IV	Infections in pregnancy Chicken Pox —GTG Rubella, Parvovirus CMV GBS —GTG Malaria —GTG Herpes, HIV  Zika Virus
Labour & Delivery	Intrapartum Care NICE Obstetrical Emergencies APH GTG  Placenta Previa, Accreta, Vasa Previa
Labour & Delivery Postpartum	PPH GTG Shoulder Dystocia GTG Umbilical Cord Collapse GTG Maternal Sepsis Postnatal Care NICE Postpartum Psychosis
Maternal Medicine I	VTE —GTG SGA— GTG Diabetes Mellitus— NICE + TOGs Amniotic Fluid—Poly/Oligo
Maternal Medicine II	Epilepsy in Pregnancy— GTG Breast Cancer in Pregnancy —GTG Hypertension in Pregnancy—NICE Headaches in Pregnancy—TOG ICH Spinal Cord Injury— TOG Appendicitis in Pregnancy—TOG
Maternal Medicine III	Obstetric Cholestasis— GTG Skin Eruptions in Pregnancy— TOG Sickle Cell Disease— GTG Thalassemia — GTG Cardiac Diseases Pregnancy Myocardial Infarction — TOG Asthma in Pregnancy —TOG
Clinical Governance Teaching	Clinical Governance Audit Consent Confidentiality Risk Management Medicolegal issues Teaching Methods
General Discussion + MBBRACE

 

Some Helpful Links

 

Sample Video 

• Peripartum Cardiomyopathy https://youtu.be/7Gqw8opyA7w
• NSHCP
• https://youtu.be/fIkNDPqKQSU
• Epilepsy in Pregnancy 
• https://youtu.be/nFJIvvTbGNc 

Testimonials

• http://www.rubabk4courses.com/testimonials/

 

WHY go 4 MRCOG?

This blog post is intended to help you delve deeper into the first W of the MRCOG exam which was mentioned in my last post.

MRCOG Part Two: 3 Ws & General Advice

The first W was: WHY do you want to take it?

In my last post, I left this question to be answered by readers and just quoted a sentence from the RCOG website “MRCOG: A global exam. The Gold Standard Qualification in O&G”. Today I would like to expand on that to help you find your WHY and to emphasize the impact of having MRCOG degree on your career, especially as a non-UK based obstetrician and gynaecologist.

MRCOG: A Global Exam. Gold Standard Qualification in O&G

Before proceeding further, let's have a look at the dictionary meaning of this word.

gold standard

noun [s]

a thing of superior quality which serves as a point of reference against which other things of its type may be compared.

1.1 The best, most reliable, or most prestigious thing of its type.

As evident from above, MRCOG is a qualification which is used as a benchmark to test your clinical competence in the speciality of Obstetrics & Gynaecology. It is a globally recognized qualification. It is your passport to the very pinnacle of the profession. It can earn you higher credibility even in those countries where they have their own fellowship & membership exams. Most of these countries use RCOG as a point of reference to improve and benchmark their qualifications standards. 

The knowledge part of the speciality is the same worldwide. The only difference in this exam is understanding the RCOG standards and how this knowledge is applied in UK systems. If you are working at a postgraduate level you already have the basic knowledge and clinical skills, which you practise every day as an obstetrician and gynaecologist in your workplace (no matter which part of the world you work). So why not work a bit more harder and go for the gold standard qualification as well? It will help you provide better care to your patients, enhance their trust in you, let you excel in your career and will eventually make you a better person.

Why do we hesitate to go 4 it?

MRCOG is perceived as one of the toughest exams. Yes, I agree that it is tough and difficult, but remember it is not impossible. Let me tell you the reason why most of the non-UK-based doctors find it tough. This exam tests your clinical skills, attitudes and in-depth knowledge of the speciality. For clinical skills, we need practical experience, which almost all of us do have but for in-depth knowledge (as required by RCOG standard) we must study hard. 

There could be many reasons that people hesitate to go 4 it. Just to name a few are:

• Difficult to manage time with busy lives and responsibilities
• Personal reasons
• Non-familiarity with the exam and its format
• Financial constraints
• You may be already working at a very higher post in your country with the highest qualifications that you find unnecessary to do it.

How to overcome this hesitation?

The first step here is to decide that you want to go 4 it. Now, you need to motivate yourself and have strong willpower. You need to change the way you think and you will see change happening in your life.

Imagine this!!! Feel it!! You can be a world-class and gold-standard qualification holder with the same efforts you make every day. Just that you need to have a road map to guide your hard work in the right direction with persistence, perseverance and dedication. 

There are over 16,500 RCOG members and fellows worldwide (as of 26/01/2022). Just remember that they are also humans like any of us. Every one of us is being gifted the same 24 hours every day, it depends on how we utilise that time. It is all about priorities and having a work-life balance.

Since you have decided to pursue your career as an Ob/Gyn you have already shown your commitment in a very sensitive and demanding field. If you want to achieve and demonstrate the highest level of knowledge and skills in this speciality, then MRCOG is the global standard. 

What are the Career Benefits?

Now, I will try to bring to your attention the additional benefits you can have in your career by pursuing this exam. Just to list a few of them:

• It is possible to achieve MRCOG while you work in your respective place and country as it's a global exam and is conducted in many centres worldwide.
• Most of the training done in teaching hospitals for local fellowship or membership exams of Ob/Gyn are accepted and counted towards the assessment of training by RCOG. Even the work experience in Ob/Gyn before sitting for MRCOG part 1 is also acceptable. (Kindly refer to the RCOG website for further details and the latest updates).
• So, you can see you do not need any extra training for this exam. Just keep doing whatever is required for your local postgraduate exams. Keep practising your clinical skills to gain more experience. You can utilise the same training and experience towards attaining MRCOG.
• After having MRCOG you can work at a senior level in most of the countries and can go further in your career progression. It opens many new doors of opportunities for you globally. In many countries of the world, you get smart and good incentives to enjoy a very comfortable living. 
• You can get GMC registration in the UK after doing IELTS only. You can get a job in the UK and can take your career further.
• You will get many opportunities to provide a standard guide to new aspirants aiming to start their career in Ob/Gynae.
• You can implement the evidence-based practice in your workplace which you learn during your journey of MRCOG. It will improve the overall quality of care for women and can be a major contribution towards the development of your country.

This is not an ultimate list. You are welcome to think and add more to these benefits keeping your own situation in mind.

I would like to end my post with a sentence from MRCOG part 3 pass letter which in my opinion is the best summary to all that I have tried to explain till now. RCOG clearly mentions in the final pass letter that:

“This is an exceptional achievement and one of which you should be immensely proud”۔

I hope and wish that all of you who want to start this journey or have already started it... will find your WHY? You will be at your destination one day or another, it is just a matter of being committed, persistent and keep taking small steps towards your goal.

Thanks for your valuable time.

My best wishes to you all as always.

Dr Rubab Khalid

Peripartum Cardiomyopathy

This post is a video summary of TOG article Peripartum Cardiomyopathy published in October 2021. Cardiac disease in pregnancy is one of the hot topic for MRCOG exams as it is the leading cause of over maternal mortality in UK. This article comprehensively covers this topic. It is recommended to read the original article in order to grasp the in-depth concept. 

To download original article: Click Here

To access All TOGs: Click Here  

Our MRCOG Part 2 Revision Courses provide written as well as video summaries of important topics along with LIVE sessions. I hope this will give you an idea how our courses simplify the topics for ease of understanding. 

Please feel free to leave your feedback in the comments below. Thanks

For More Information about our courses

WhatsApp: https://wa.me/923164371557

Website: https://www.rubabk4courses.com/courses/

Epilepsy Video: https://youtu.be/nFJIvvTbGNc

NHSCSP Video: https://youtu.be/fIkNDPqKQSU

GTG 8 Amniocentesis and Chorionic Villous Sampling

This blog post is a Summary of Green Top Guideline 8: Amniocentesis and Chorionic Villous Sampling which was updated in October 2021. As it is a GTG so, it is must to go through the full guideline by yourself in order to have the complete understanding. 

To download the guideline: Click Here

For Infographic: Click Here

For All GTGs: Click Here

RK4 Courses

Background

• Prenatal diagnosis in the form on amniocentesis or CVS is offered due to various reasons such as higher risk for aneuploidy screening, suspected structural anomaly or in cases of known risk of inherited genetic disease
• The only definitive diagnostic tests → both CVS & amniocentesis
• CVS done between 11+0 - 13+6 wks Can also be done 14+0 - 14+6 wks 
• Amniocentesis offered from 15+0 wks 
• Individualised counselling
• Informed written consent Form 3
• Must provide information for aftercare

Organising amniocentesis & CVS

• Women are usually anxious so should support them ± partners
• Follow Fetal Anomaly Screening Program guidance
• Appropriate environment, skilled staff, access to allied specialities and appropriate support for continuation or termination of pregnancy
• Sensitive & unbiased approach
• Discuss religious aspects
• Give time to discuss the decision with partners & friends

Additional Risks with Invasive Testing

Risk of Miscarriage

• Additional risk of pregnancy loss after CVS or Amniocentesis is performed by an appropriately trained operator is < 0.5%

Different studies have been quoted

• Earlier studies showed increased pregnancy loss after CVS, but later studies show that there is no significant increase in pregnancy loss above the background risk with both procedures
• Lower pregnancy loss likely due to improvements in technology, techniques & experience

Systemic Review 2000-2014

• Procedure-related risk of pregnancy loss Amniocentesis 0.11% CVS 0.22% Both 0.35%

Cochrane Review comparing route for CVS (Transabdominal or Transcervical)

• Pregnancy loss below background rate regardless of route
• Procedure-related pregnancy loss Transcervical 1.4% Transabdominal 1%

Other risks

• CVS results may be affected by placental mosaicism in 1-2% 
• Structural anomaly present → Discuss ongoing care (continuation or termination of pregnancy)
• Structural anomaly absent & QFPCR after CVS suggest chromosomal anomaly → full karyotype awaited before any decision 
• Severe maternal sepsis → very rare

Perinatal Mental Health -- Random Facts

This blogpost is a compilation of random facts about peripartum mental health which is one of an important aspect of women care. As a health care provider it is pertinent to provide optimum care for the mental health of the woman. Mental health disorders are prevalent and a woman is vulnerable during pregnancy and in the post part period. According to MBRRACE Suicide is now considered a direct cause of maternal death. 

This post should be used as an adjunct to your study material for this topic as only random facts are given here.

I hope this is helpful for you all.

Thanks 

Psychiatric Disorders

• Common up to 20%
• 3-5% severely affected
• 2015 MBRRACE almost quarter of deaths due to this in 6wks - 1year postpartum
• Psychotic disorders more common than another time in a woman’s life
• Peak onset <7days
• Highest rate of adverse consequences of antenatal exposure  Sodium Valproate
• Postpartum psychosis most commonly associated with bipolar affective disorder
• Approximate risk of developing postnatal depression with h/o depression + 1st degree family member with h/o postnatal depression 40%

The most common mental problems during pregnancy 

• Depression 12% Anxiety 13% 
• Both also affect 15-20% woman in the first year after birth

Psychiatric Assessment vital screening tool

Risks short term or long term

Red Flags Symptoms

• Rapid alteration in mental status
• New symptoms Psychotic symptoms
• Thoughts of violent self harm New ideas
• Guilt Hopelessness
• Acts of violent self harm
• Not eating well Insomnia
• Psychomotor retardation

Suicide risk found → trigger urgent assessment

• Local safe-guarding + infant protection issues

Screening Tools

• Wholly questions
• Edinburgh depression scale most frequently used
• Sensitivity 34-100% Specificity 44-100% PPV 57% NPV 99%
• PHQ-9 Patient Health Questionnaire 0-3
• GAD-2 & 7 Anxiety Screening tools
• Cut off scores — Mild 5 Moderate 10 Severe 15 
• GAD -7 Sensitivity 89% Specificity 82%
• Moderately effective for panic disorders, social anxiety disorders, post traumatic stress disorders

Indications for Referral

• Current illness with symptoms of psychosis, severe anxiety, severe depression, sociality, self-neglect, harm to others or significant interference with daily functioning
• H/o bipolar disorder / Schizophrenia
• Hi/o serious postpartum mental illness like puerperal psychosis

Referral considered

• Illness of moderate severity