Think in pathways, not diagnoses

Most candidates revise by learning diagnoses. The DRCOG mostly asks about actions. The question is rarely “what has she got?” and almost always “what do you do next?” — and the options are a menu of behaviours: admit now, refer on the suspected cancer pathway, refer routinely, investigate, treat empirically, reassure and safety-net.

So revise each topic by finishing the sentence “and therefore I would…”. Postmenopausal bleeding at 55 or over — and therefore I would refer on the suspected cancer pathway. Suspected pelvic inflammatory disease — and therefore I would treat empirically today, before the swabs come back. Reduced fetal movements at 30 weeks — and therefore I would arrange same-day assessment in the maternity unit. Classic heavy menstrual bleeding with no red flags — and therefore I would offer the levonorgestrel intrauterine system, not a scan.

The four verbs to keep in your head are admit, refer, treat and safety-net. Nearly every correct answer is one of those, and the discriminating factor is usually urgency: is this a 999 call, a same-day assessment, a suspected cancer pathway referral, or a routine review with clear advice about when to come back?

Get the urgency right and you will get the question right, even when you are not certain of the diagnosis. That is not a shortcut — it is exactly how safe GPs work.

More DRCOG Core Wisdom →