8 top tips for passing MRCOG Part 1

To pass MRCOG Part 1, you have to clear a line you can't see in advance. The Royal College of Obstetricians and Gynaecologists (RCOG) sets a new pass mark for every sitting, based on a panel's judgement of each question. That translates into there being no fixed score for you to aim for and no guarantee that a good mock result will carry over to the exam.

What you can control is how reliably you answer questions that a borderline candidate would be expected to get right. You also need to maintain that accuracy across both papers of the MRCOG Part 1 exam, each containing 100 single best answer (SBA) questions and sat on the same day.

1. Understand how the MRCOG Part 1 pass mark is set

There is no fixed MRCOG Part 1 pass mark. The RCOG sets it for each sitting using Ebel's method. A panel of practising NHS obstetricians and gynaecologists classifies every question by difficulty (easy, medium or hard) and by relevance to ST3 practice (essential, important or acceptable). For each of the nine resulting categories, the panel estimates what proportion of questions a borderline candidate would answer correctly: someone with average clinical knowledge and reasonable preparation, just at the standard needed to pass. Those estimates produce the pass mark for that sitting.

The MRCOG Part 1 pass rate is difficult to pin down. The RCOG doesn't set a quota for how many candidates can pass, so the percentage can vary between sittings. Although the College reports examination pass rates to the GMC annually, it doesn't publish a pass rate for every MRCOG Part 1 sitting on its exam pages. Pass-rate figures found online can vary considerably and often don’t have a clear source to support them.

2. Secure the questions a borderline candidate gets right

Ebel's method expects a borderline candidate to answer most easy, essential questions correctly. Missing straightforward questions on core material therefore costs you more against the standard than missing a hard question on a rare topic. Before you spend an evening on an obscure enzyme deficiency, check that you can reliably answer the basics of placental transfer, the menstrual cycle, drugs commonly used in pregnancy and the anatomy of the pelvis.

This is worth remembering when reviewing your mock results too. Commercial mock exams don't use the RCOG's standard-setting process, so scoring 65% on a practice paper doesn't necessarily mean you'll pass or fail the real exam.

Your performance across individual subjects is more useful than your overall score. A reasonable average could hide a subject where you're answering fewer than half the questions correctly. And because the RCOG doesn't publish how many questions are allocated to each subject, you can't assume that a weaker area will have little effect on your final result.

3. Practise statistics calculations until the method becomes familiar

Epidemiology and statistics questions often follow a predictable structure. Once you're comfortable with the calculations, you can work through them systematically rather than relying on memory under exam pressure.

For questions about diagnostic tests, start by drawing a 2 × 2 table.

Suppose a screening test is used on 1,000 women. Of the 100 who have the condition, 90 test positive. Of the 900 without the condition, 20 also test positive.

You can then calculate:

• Sensitivity: 90 ÷ 100 = 90%

• Specificity: 880 ÷ 900 = 97.8%

• Positive predictive value (PPV): 90 ÷ 110 = 81.8%

• Negative predictive value (NPV): 880 ÷ 890 = 98.9%

Now imagine using the same test in another population of 1,000 women, but only 10 have the condition. With the same sensitivity and specificity, approximately 9 women with the condition will test positive, alongside 22 women who don't have it.

The positive predictive value falls to around 29%. In other words, fewer than one in three positive results now represents a genuine case.

The test hasn't become less accurate, but the condition is simply less common in the population being tested. That's the relationship between prevalence and predictive value that you need to recognise in screening questions.

Once you're comfortable with these calculations, apply the same systematic approach to relative risk, odds ratios and number needed to treat. Practise working them out by hand before introducing time limits.

4. Read the lead-in first, then answer before you look at the options

Every RCOG sample SBA offers five options and asks for the single most appropriate one. Some are short clinical scenarios, while others are a single factual question.

For scenario questions, read the lead-in before the stem. Knowing whether you're being asked for the most likely diagnosis, the mechanism of a drug or the most appropriate investigation tells you which details in the stem to look for. Then form your own answer before reading the options. If it's there, check that nothing in the stem rules it out and move on. If it isn't, you've either misread the question or reached the edge of your knowledge, and recognising which is more useful than picking the option that sounds most familiar.

5. Find the detail that separates the best answer

Even well-prepared candidates can lose marks by choosing an answer that seems reasonable rather than the best one. Often, a single detail in the question determines the correct answer. Pay particular attention to gestation, parity, the timing of symptoms and qualifiers such as "first-line" or "most likely".

When you narrow a question to two options, name the detail that makes one better than the other before you choose. If you can't name the detail, the gap is in your knowledge, and your review should compare the two options directly. For example, learn the actions of oestrogen and progesterone on the endometrium side by side, rather than as separate facts.

Apply the same discipline to changing answers. Change an answer when you can identify a specific fact or detail that makes your first choice wrong, not because a second reading makes you less sure of it.

6. Pace each paper with checkpoints

Each paper gives you 150 minutes for 100 questions. That’s an average of 90 seconds per question. Few candidates struggle with a single question at that pace. What is harder is keeping it up for two papers with a lunch break of about an hour between them.

Setting checkpoints slightly ahead of the average leaves you with some time to revisit flagged questions:

That leaves you with about 10 minutes for review. If a question is taking too long, choose your best answer, flag it and move on. This helps avoid a difficult question taking time from several easier ones later in the paper. Practise the checkpoints in full timed papers before the exam. Then use the lunch break to eat and rest rather than revise.

7. Choose your sitting with Part 2 in mind

Part 1 runs twice a year. For the 13 July 2027 sitting, the RCOG's key dates are an eligibility deadline of 16 March 2027 for new candidates, an expression of interest deadline of 30 March 2027 and a booking window from 20 April to 15 June 2027.

Two RCOG rules are worth checking before you commit to a date:

• Currency: once you pass MRCOG Part 1, you must attempt Part 2 within seven years of your exam date, or repeat Part 1.

• Attempts: candidates who intend to join the UK Specialist Register can have up to six attempts at Part 1. A further attempt requires supporting documentation from the Head of School. Other candidates have no limit.

Sitting before you're ready uses an attempt without giving you much information in return. If your timed practice shows a weak subject you can't realistically cover before the exam, a later sitting may be the better choice.

8. If you're resitting, start from your evidence

If you've sat Part 1 before, you don't need to repeat the eligibility application: the RCOG treats resit candidates as already eligible, so you can book directly for the sitting you choose.

But you should resist the urge to start your revision again from page one. Go back through your question practice and group your errors by cause. These might be subjects where you lacked the facts, questions where you misread the stem, and questions where you narrowed it to two options and chose the weaker one. Each needs a different fix. And if you knew the material but lost marks to pacing in the second paper, you might need more full timed papers rather than another pass through the textbooks.

Practise for MRCOG Part 1 with Pastest

A useful question bank gives you enough practice to identify weak topics, revisit the underlying knowledge and test yourself again. Pastest's MRCOG Part 1 online revision resource includes 1,300 question bank questions and two 100-question past papers based on the themes of previous exams. Each new question is medically reviewed before publication, and 305 textbook topics let you go from a question you've got wrong straight to the science behind it.

Get started today, or contact us to learn more.