DRCOG syllabus

You’ll need to demonstrate knowledge of:

• The epidemiology, aetiology, symptoms, signs and management of sexually transmitted infections (e.g. chlamydia, gonorrhoea, 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 vaginosis, 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

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

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

You’ll need to demonstrate knowledge of:

• The principles of pre-conception care including management and optimisation of long term health conditions, provision of assistance in ceasing risky behaviours (e.g. smoking and alcohol excess), promotion of healthy behaviours and identification / counselling of women at increased risk of genetic abnormalities
• The booking appointment and care planning with multidisciplinary teams
• Antenatal screening including non-invasive pre-natal testing (NIPT) and invasive testing for 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, SARS Cov-2)

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) and their possible complications
• 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
• Confidential Enquiry into Maternal Deaths (CEMD) and Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across UK (MBRRACE – UK) – an overview

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

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 aetiology and management of primary and secondary dysmenorrhoea
• 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, investigation and management of chronic pelvic pain
• The investigation and management of ovarian pathology
• The epidemiology, causes, investigations and management of urinary symptoms including urinary incontinence and painful bladder syndrome
• 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 including their risks, benefits and complications (e.g. hysteroscopy, laparoscopy, hysterectomy)