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DRCOG syllabus

Modules for the RCOG's Diploma exam, the DRCOG

The DRCOG is an assessment of knowledge and clinical problem solving, and targets doctors who wish to cultivate their knowledge in obstetrics, gynaecology, sexual and reproductive medicine as applied to women's health.

The exam requires a level of knowledge appropriate for a competent general practitioner (GP) working in the UK.

You will need to demonstrate knowledge and its application in generating appropriate advice and management plans for the following areas in women's health:

 

Module 1: The individual seeking fertility regulation and sexual health assessment

You’ll need to demonstrate knowledge of:

  • The epidemiology, aetiology, symptoms, signs and management of sexually transmitted infections (e.g. chlamydia, gonorrhea, syphilis, genital herpes, genital warts, Hepatitis B and C, trichomoniasis, HIV and AIDS, molluscum, pubic lice)
  • The principles of STI screening and contact tracing
  • The assessment, causes and management of abnormal vaginal discharge (e.g. candida albicans, bacterial vagionosis, trichomonas vaginalis)
  • The use of vaccination (including the HPV vaccination programme) and pre- and post-exposure prophylaxis
  • The risks, benefits, side-effects and actions of emergency, reversible and irreversible contraceptive choices at various stages of fertile life including knowledge of the UK MEC guidance
  • The management of patients with contraceptive problems (e.g. unscheduled bleeding, mood changes, headaches, loss of libido, infection with IUCD, lost coil threads)
  • Cervical screening, HPV testing and the principles of assessment, management and follow-up of abnormal smear tests (dyskaryosis)
  • Strategies for assessment and management of sexual problems including dyspareunia
  • Assessment and management of gender dysphoria, transgender and non-binary individuals
  • The epidemiology, pathways and options for termination of pregnancy including medical, surgical and early medical abortion at home (EMAH).  A knowledge of the ethical and legal frameworks, and the risks and management of potential complications
  • The pathways and issues to consider for suspected rape, sexual assault and sexual abuse

 

Module 2: The couple with subfertility

You’ll need to demonstrate knowledge of:

  • The principles behind normal human fertility
  • The incidence, causes and epidemiology of subfertility
  • Investigations for the infertile couple
  • Management pathways for male and female subfertility
  • Ovulation induction
  • Understanding of assisted reproductive technologies (e.g. intrauterine insemination, in vitro fertilisation, intra-cytoplasmic sperm injection, donor insemination, egg donation, pre-gestational testing, surrogacy)
  • The social and psychological aspects of infertility

 

Module 3: The woman in early pregnancy

You’ll need to demonstrate knowledge of:

  • The principles of implantation and early pregnancy development
  • Causes, investigation and management of nausea and vomiting in early pregnancy
  • Causes and investigation of pain and bleeding in early pregnancy
  • The prognosis and management of threatened miscarriage
  • The definition, classification, risk factors and management of early pregnancy loss
  • The risk factors, management and prognosis of ectopic pregnancy
  • The management pathways for pregnancy of unknown location
  • Understanding of molar pregnancy, its presentation, management, prognosis and follow-up
  • The causes, investigation, outcomes and management of recurrent miscarriage
  • The psychological aspects of early pregnancy loss

 

Module 4: The pregnant woman

You’ll need to demonstrate knowledge of:

  • The principles of pre-conception care
  • The booking appointment and care planning with multidisciplinary teams
  • Antenatal screening and diagnosis of chromosomal abnormalities and structural defects
  • Routine antenatal care, pregnancy monitoring paradigms and prevention of rhesus isoimmunisation
  • The social aspects of pregnancy (e.g. substance misuse, obesity, problems associated with pregnancy at extremes of reproductive age, cultural differences, domestic violence)
  • The principles of safe prescribing and therapeutics in pregnancy
  • Multiple pregnancy and breech presentation and its associated risks and management pathways
  • The assessment and management of common pre-existing medical disorders in pregnancy (e.g. hypertension, diabetes, epilepsy, thyroid dysfunction, autoimmune disease, asthma, thromboembolism, haemoglobinopathies, mental health problems)
  • An understanding of problems developing in pregnancy, their impact, diagnosis, management and health consequences (e.g. pre-eclampsia, gestational diabetes, antepartum haemorrhage, placenta praevia, intrauterine growth restriction, pre-labour rupture of membranes, pre-term labour, late miscarriage, reduced fetal movements)
  • Relevant infections encountered in pregnancy, their risks and management (e.g. CMV, parvovirus, chickenpox, Hepatitis B and C, HIV, Group B Streptococcus, Zika virus, rubella)

 

Module 5: The peripartum woman and the neonate

You’ll need to demonstrate knowledge of:

  • Understand the indications for mode of delivery
  • The principles of induction and augmentation of labour
  • The options of anaesthesia and analgesia in labour and at delivery
  • The principles and management of normal delivery
  • Strategies for monitoring of fetal wellbeing
  • Infection control policies
  • An overview of common obstetric procedures (e.g. caesarean section, assisted delivery)
  • Understanding of the risks factors for and management of common obstetric emergencies (e.g. collapse, eclampsia, post-partum haemorrhage, shoulder dystocia, thromboembolism, stillbirth)
  • The routine postnatal check – the baby, maternal mental health and perineal care
  • Supporting breast-feeding and breast care including management of mastitis and abscess formation
  • The neonatal examination and common neonatal problems
  • The risks, symptoms, signs and management of postpartum psychiatric disorders

 

Module 6: The girl/woman presenting with emergency or urgent gynaecological problems

You’ll need to demonstrate knowledge of:

  • Understanding the ethical and legal framework of informed / valid consent and confidentiality (including Adults With Incapacity Act)
  • An appreciation of the importance of pre-operative evaluation, safe inpatient care, post-operative management, enhanced recovery pathways and post-operative advice in the community
  • The causes, investigation and management of acute lower abdominal and pelvic pain (including ovarian cysts, pelvic inflammatory disease and endometriosis)
  • The investigation of abdominal pain and bloating including recommendations for screening for ovarian malignancy with serum CA125 estimation
  • The epidemiology, risk factors, investigations and management of postmenopausal bleeding
  • The epidemiology, symptoms and signs, investigations, referral pathways and management of suspected ovarian, cervical, endometrial and vulval malignancy

 

Module 7: The girl/woman presenting with non-urgent gynaecological problems

You’ll need to demonstrate knowledge of:

  • The epidemiology and physiology or normal female pubertal development and its disorders
  • The causes, investigation, diagnosis, risks and management of primary and secondary amenorrhoea or oligomenorrhoea (e.g. polycystic ovary syndrome,  hypogonadotrophic hypogonadism, premature ovarian insufficiency, hyperprolactinaemia)
  • The identification and management of cervical ectopy and cervical polyps
  • The impact and legal framework involved in female genital mutilation (FGM) and the management of  FGM, including a knowledge of child protection issues
  • The causes, risks, assessment and management of abnormal uterine bleeding, including heavy menstrual, inter-menstrual and post-coital bleeding (e.g. uterine fibroids, endometrial and cervical polyps, endometrial hyperplasia, coagulopathy, cervical ectopy)
  • The causes and management of chronic pelvic pain
  • The epidemiology, causes, investigations and management of urinary symptoms including urinary incontinence
  • The causes, risk factors, diagnosis and management of uterovaginal prolapse
  • The diagnosis and management of pre-menstrual syndrome
  • The epidemiology, physiology and symptoms of the menopause and the use of management strategies -  including the use and risks of hormone replacement therapy, the management of atrophic vaginitis and management of osteopenia and osteoporosis
  • Identification, risks and management of vulval dermatoses
  • An overview of commonly performed gynaecological procedures and their risks (e.g. hysteroscopy, diagnostic laparoscopy, hysterectomy)