Monday, June 10, 2019

MRCOG Part 3: Tips & General Advice

Dr Rubab Khalid Preparation Advice MRCOG Part 3


I am Dr Rubab Khalid from Pakistan. I passed my MRCOG Part 3 exam in September 2018 and have been guiding MRCOG Aspirants since then. I would like to share some tips and general advice for the part 3 exam, which I think could be helpful before embarking upon the last part of the MRCOG exam.

Understand the exam:

The starting point for exam preparation is to understand what is expected from you in this exam and that is “competent ST5 level according to RCOG curriculum”. How to know about this? The answer is very simple. Just visit the MRCOG part 3 section on the RCOG website & go through all the details given in 14 Modules. Explore and understand all five domains. It is very clearly mentioned what is required in each domain in each module. All domains are essential, but patient safety comes at the top as this domain is checked in all 14 stations. You need to show that you are an honest, trustworthy & safe doctor.
This exam tests your knowledge, skills & attitude. Remember it's a UK-based exam & you need to prepare yourself according to those standards, no matter which level you are working in your practical life. Understanding UK systems is essential.
The mindset for this exam is very different from Part 2. If you passed Part 2, you have already proved that you have the required theoretical knowledge. All you now need is to demonstrate & show how you apply this knowledge and communicate in your clinical practice.

Planning the exam:

Once you pass Part 2, plan well ahead with good preparation, keeping in mind your own personal & professional circumstances. Do not attempt the exam just for the sake of experience. This part is a bit different as it has some additional requirements like choosing an exam centre, visa hassles, travel, accommodation, financial constraints, work leave-related issues & leaving your family for some time. But the fact is that almost all of us have to face this and just take it as a part of the exam preparation. The reward is definitely worth the effort.

Preparing for the exam: 
  • Decide how are you going to approach the preparation. Are you a techno person who prefers the latest gadgets or paper-based material? In this world of the internet, it is a must that we all be familiar with basic/advanced technical stuff to keep ourselves updated. Especially in this part of exam, you can use the technology in a very positive way (practising with your study buddy online or in case you don't have a study buddy you can record your own performance in the voice clip & listen to it later which will help you pick up missed points to improve)
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Monday, May 20, 2019

Down Syndrome Screening Evolution


DS screening in pregnancy uk MRCOG tog 2019

TOG Article: Evolution in screening for Down syndrome
Volume 21, Issue 1 January 2019

This article discusses different methods evolved over time for screening of Down Syndrome with some details for latest cell-free DNA testing.


To download original article (free access): Evolution DS Screening

Introduction 
  • The most common reason for invasive testing is to diagnose chromosomal aneuploidies
  • Only done for high risk pregnancies as there is associated risk of miscarriage
  • Down’s syndrome (DS) is the result of an extra chromosome 21
  • Critical factors in screening test are detection rate and false positive rates (FPR)
    • Detection rate: ability of a test to give a positive result for those who have the disease
    • Screen-positive rate: proportion of affected and unaffected persons having a positive result
    • FPR: unaffected proportion yielding a positive result
Screening by maternal age
  • Screening for DS introduced in 1970s.
  • Women aged 40 years or more considered high risk, but it was not possible to offer diagnostic tests to entire population
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Saturday, March 16, 2019

MRCOG Part One: Preparation Advice

MRCOG Exam Preparation

This post is about the very first step towards the MRCOG journey i.e. Part ONE exam.
I have tried to give a piece of general advice, an essential reading materials list and an outline for the preparation of MRCOG part one. 
Before going for this exam, you need to understand what is this exam all about and then plan accordingly.

Understand the exam
All the essential information about the exam is available on RCOG website. Just to summarise important points:
  • MRCOG comprises three parts. Parts 1 & 2 are written exams and part 3 is a clinical skills assessment exam. 
  • Part 1 MRCOG assesses the basic sciences’ knowledge relevant to the clinical practice of Obstetrics & Gynaecology at the level of a UK ST3 Trainee.
  • You can take part 1 after completing your house job / internship.
  • It would be beneficial if you have some working experience in Ob/Gyn as about 25% of questions are based on your clinical knowledge.
  • This exam can be taken while you prepare for the first part of your local postgraduate exams in Ob/Gyn (as usually, all these exams assess knowledge of basic sciences)

How to book the Part 1 MRCOG exam
  • Applying for the Part 1 exam is a two-stage process: eligibility and booking.
  • You must first have your eligibility application processed and approved before you can make a booking application online.
  • Please follow this link for updated information from the website: Booking Part 1

Exam Calendar
Part 1 MRCOG is conducted two times per year in the months of January & July at various locations across the globe

Exam Format
Written exam
Two papers each consisting of 100 Single Best Answer (SBA) questions
Paper 1 —50% of marks
Paper 2 —50% of marks
No minimum score is required for each paper. The outcome is determined by the candidate’s overall marks.

Timetable
SBA Paper 1 
Duration 2.5 hours (150 min)
100 SBAs
Paper 1: Anatomy, Biochemistry, Embryology, Endocrinology, Epidemiology/Statistics, Genetics, Physiology
Lunch break (approx. 60 min)
SBA Paper 2
Duration 2.5 hours (150 min)
100 SBAs
Paper 2: Biophysics, Clinical Management, Data Interpretation, Immunology, Microbiology, Pathology, Pharmacology
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Thursday, February 14, 2019

A Courier : MRCOG


A life changing courier taking to MRCOG

Could a courier change your life and put you on the track of MRCOG? The answer is BIG YES. 

This blogpost is not exactly about the exam, but a real life experience. Some of you might find it interesting and hopefully could learn something as well.

Before I jump on to the courier part, I think some background would be appropriate to make sense of all what I am trying to convey.

Background
To begin with let me tell you the kind-of person I have been all through my life. I was (still am) a very carefree and easy going person. For me life has always been about enjoyment, fun and exploring new things. Studies was just a part of life besides my intense interest in other things like gadgets, music, sports to name a few. 
When I got admission into medical college, I found it very tough in the beginning as I was not really interested in this field. I wanted to escape. I was studying just for the sake of being able to write Dr. in-front of my name without having any long term goals. By the third year, I gave up on my plans to escape as I had realised it was too late to change my career (btw I never had any alternatives in my mind either :) By then, I had developed some interest in this profession. So, I finished my basic medical degree smoothly.

Deciding the speciality
After graduation, I had to make an important decision to choose the speciality. I postponed this decision till I finished my internships and to see which one I would like to pursue. At that time, I didn't like Ob/Gyn, well I didn't like anything else either :-) 
I had no future plans in my mind. I did my house jobs in 3 different specialities, 6 months each (Medicine, Obs/Gyn & Anaesthesia). After that, I realised that Obs/Gyn is a versatile field as it is simultaneously challenging, demanding and rewarding. The feeling of being part of a woman’s one of the most difficult times and then holding a new born, was the most gratifying part of this. Finally, I had found a goal in my life.

Local PG
I decided to do my post-grad fellowship in Obs/Gyn. But unfortunately (or fortunately) I was unable to clear the part1 in-spite of trying twice. As I was firm in my decision to continue as Ob/Gyn and wanted to be highly skillful so I decided to go for membership and joined my postgraduate training. I was lucky to get a very good and supportive department which helped me learn a lot.
During my residency, I tried once again for fellowship part 1 and couldn't make it the third time also (as per my track record :)
Handling a failure: I would like to share something here to let you see how did I handle THAT failure. I remember it very well because, it was one of the first failures which I handled without depression. 
I got to know about my result from a friend on my mobile while I was on a very hectic night call in the labour room. I felt sad only for a minute, then I asked myself. “Rubab, what if you had passed, what would you be doing in this very moment?” The answer was enough to calm me down. It was, “I would still be managing this eclamptic patient.” I continued my call without any second thoughts.
I dropped the idea of trying again for local fellowship exams. I focused on what I was already doing in my life. I finished my membership degree well in time. 

After local PG
I started practising Obs/Gyn at a senior level in my country. I decided that, one local PG is enough to practise in my country. If ever I wanted to go 4 another degree that would be MRCOG. But I knew that it was difficult to get this without having UK experience. I never fancied to go and work abroad. Anyways, I got busy in my life and was content with whatever I had in that particular time.
Then, there was a turn in my life and I got a chance to work in middle-east. But it was at a junior level as I didn't have required post grad experience after my membership. Still, I joined as offered incentives were attractive and because of my family commitments. I had a good work life balance over there unlike in my native country.

What did I really want to do & why?
After enjoying for a few years, I got bored of the same life. I felt depressed and stagnant with no professional growth. One day, I looked deeper inside me, asked myself “what did I really want to do in my professional life?”...
The answer was quite surprising as it was something I had forgotten long ago “I wanted to go 4 MRCOG”
I got excited at the idea. I sat down and jotted down points on a piece of paper to explore my “WHY”...

The Courier
I was working in a small hospital with no one to guide me. So I turned to my friend back home and discussed my plan with her. At that time she was in the process of getting her MRCOG part 2 training assessment approved. She was planning to get her documents attested in coming week. I requested her if she could get mine also. She agreed. I emailed my documents the same day. After a few days I dropped the idea. I thought it was an impulsive plan and I would not be able to do it. So, I didn't follow up my friend for this again.

After almost a month, I received a courier, which I didn't know would be life changing for me.

I was very surprised to see my attested documents. I called my friend the same moment and informed her that I had changed my mind. 

All she said was 
“Now that I have sent you these documents, please go 4 the exam.You never know what future holds for you, untill and unless you give it a try”. 

There was only a week left for the deadline to apply for MRCOG part 1. Just because of my friend’s motivation and encouragement, I applied for the exam.

I had only 3 months to prepare for the exam. I did have doubts that I might not be able to do it, as I had tasted failure three times for similar sort of exam in my country (which is considered way easier than MRCOG part1). The last failure in basic sciences was 10 years back. I had not touched those books for a decade. I didn’t have a proper guidance. All these factors were enough to discourage me but still, I decided to give it a try.

I promised myself, this would be the first and last time I would ever be taking MRCOG part1. If its in my destiny, I’ll get through; if not I’ll keep doing whatever I am already doing in my life. There was nothing to loose.

I worked really hard for the exam, building from basic concepts. I did all what was needed like collecting required material, organizing it, making a timetable. Above all giving it my 100% dedication. It was not very easy, but I started enjoying it once I understood the basics.

“I sat for the exam and I cleared it in my first attempt. Finally I was on the track of MRCOG”

I do not consider it passing in first attempt. The things I had studied a decade earlier, had finally paid off. Hidden behind this success were many failures and self doubts. Success never comes easy.

My Message
My motive of sharing all this is to make you see, how life can take turns and how little things can bring a major change. We do get chances in our life to change it. Just that we need to learn to live in present and get the maximum out of what ever is available to you in that very moment. Sometimes we may not see the outcome of our efforts instantly but somewhere its all being collected for us to be gifted in a more valuable form. 

How I see this experience of mine. 

Had I passed the local fellowship exam, I would have not gone for MRCOG.

Had I gone abroad on a senior post, I would have not found my WHY and motive for MRCOG.

And the most important of all..

Had I not got that courier, my life would have not changed.

Thanks for your valuable time.

Wish you all the best.
Dr. Rubab Khalid