GP Diplomas · Core Lens

DRCOG Core Lens

The women’s health knowledge that earns marks and keeps patients safe — sorted by topic, and by the three things the examiners actually test: the safety cue, the guideline point, and the trap.

Can’t-miss: the four that must never be missed

If you learn nothing else before the paper, learn these. They appear repeatedly, and in the exam — as in practice — missing them is the mistake with the biggest consequences.

  • 1. Ectopic pregnancy Any woman of reproductive age with abdominal or pelvic pain gets a pregnancy test. No exceptions, no assumptions, no “she says she can’t be pregnant”. A positive test with pain, and/or bleeding, means referral to the early pregnancy assessment service; haemodynamic compromise or significant pain or tenderness means emergency admission (NICE NG126).
  • 2. Pre-eclampsia New hypertension after 20 weeks with proteinuria (or other maternal organ dysfunction). Severe headache, visual disturbance, epigastric or right-upper-quadrant pain, vomiting, sudden oedema — these are the symptoms that turn a routine call into a same-day obstetric referral.
  • 3. Sepsis in pregnancy and the puerperium Pregnant and recently pregnant women deteriorate fast, and normal-looking observations can mislead. Fever, rigors, tachycardia, tachypnoea, offensive lochia, abdominal pain or simply “feels dreadful” — treat as sepsis until proven otherwise and arrange emergency admission. Do not wait to see if she improves.
  • 4. Postmenopausal bleeding = suspected cancer pathway Unexplained bleeding after the menopause is a suspected cancer pathway referral for endometrial cancer at 55 and over, and referral is considered under 55 (NICE NG12). It is not “probably atrophy” until it has been investigated as cancer.

The topics, through the lens

The first entry is open as a preview. The other 35 are for members.

Contraception & the UK MECPreview below

Combined hormonal contraception: who must not have it

Safety cueMigraine with aura at any age is a UK MEC category 4 for combined hormonal contraception — the risk of ischaemic stroke is unacceptable. So too are current breast cancer, a history of venous thromboembolism, and being 35 or over and smoking 15 or more cigarettes a day.

Guideline pointThe UK Medical Eligibility Criteria (UKMEC 2025, maintained by the College of Sexual & Reproductive Healthcare — CoSRH, formerly the FSRH) grade a method against a condition: 1 = no restriction, 2 = advantages generally outweigh risks, 3 = risks generally outweigh advantages (use only if no acceptable alternative, with specialist input), 4 = unacceptable health risk, do not use.

Exam trapConfusing category 3 with category 4. Category 3 is a “strongly relative” contraindication, not an absolute one — the correct answer is usually “discuss alternatives” or “specialist advice”, not “absolutely contraindicated”. Only category 4 means never.

Long-acting reversible contraception (LARC) and the progestogen-only optionsMembersEmergency contraceptionMembers
Sexually transmitted infections3 entriesMembersCervical screening & HPV2 entriesMembersTermination of pregnancy2 entriesMembersSubfertility2 entriesMembersMiscarriage & ectopic pregnancy3 entriesMembersAntenatal care & screening3 entriesMembersMedical disorders in pregnancy — hypertension, pre-eclampsia & gestational diabetes3 entriesMembersLabour & obstetric emergencies3 entriesMembersPostnatal & neonatal care3 entriesMembersAcute pelvic pain & gynaecological emergencies2 entriesMembersPostmenopausal bleeding & suspected malignancy2 entriesMembersMenstrual disorders & PCOS3 entriesMembersProlapse, incontinence, menopause & HRT2 entriesMembers

The rest of the DRCOG Core Lens is in the DRCOG package

35 more entries across 14 topics, each sorted into the safety cue, the guideline point and the exam trap — written and reviewed by practising UK doctors.

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