Seven modules, one paper: what each one asks of a GP

The DRCOG is one written paper — 120 single-best-answer questions in three hours — drawn from seven syllabus modules. With only a handful of questions on any one topic, it rewards breadth: a candidate who is solid in all seven modules beats one who is brilliant in three. Here is what each module tends to ask of a GP, and where marks are usually lost.

1. Fertility regulation and sexual health

Contraception by the UK Medical Eligibility Criteria, emergency contraception, sexually transmitted infections, cervical screening and abortion care. The question is usually which method is safe for this woman, with this history, today? Know the category 4 conditions for combined hormonal contraception without looking them up, know that the copper IUD is the most effective emergency contraception, and read the timings in the stem twice.

2. Subfertility

The GP’s job is the first assessment and the timing of referral. NICE advises assessment after a year of regular unprotected intercourse without conception — and earlier specialist referral if the woman is 36 or over, or there is a known cause or a history that predicts a problem. First-line tests include a mid-luteal progesterone to confirm ovulation and a semen analysis. Lifestyle advice — weight, smoking, alcohol, folic acid — is always part of the answer.

3. Early pregnancy

Bleeding and pain in the first trimester, miscarriage, ectopic pregnancy and hyperemesis. The question is usually about the safe next step: who needs the early pregnancy assessment service now, who can be managed expectantly, and when a positive test with pain is an emergency.

4. The pregnant woman

Antenatal care and the medical problems of pregnancy: pre-conception advice (folic acid 400 micrograms for everyone, 5 mg for those at higher risk of a neural tube defect), medicines in pregnancy, hypertension, diabetes, thyroid disease, epilepsy, anaemia, infections, and the antenatal red flags. Expect a GP prescribing or referral decision: which drug to stop, switch or start, and who needs the maternity unit today.

5. The peripartum woman and the neonate

Labour and obstetric emergencies at the level of recognition and first action, then the postnatal period — the six-to-eight-week check, postnatal mental health, perineal problems, breastfeeding — and the newborn: jaundice (jaundice in the first 24 hours is never physiological), feeding and the newborn examination. Many GP candidates feel least sure here, which makes it the module most worth a deliberate week of revision.

6. Urgent and emergency gynaecology

Acute pelvic pain, postmenopausal bleeding and suspected gynaecological cancer. The first action is often the test everybody forgets — a pregnancy test for any woman of reproductive age with pain — and the answer is often a referral on the suspected cancer pathway: postmenopausal bleeding at 55 or over, for example, or a raised CA125 followed by an ultrasound that suggests ovarian cancer.

7. Non-urgent gynaecology

Heavy menstrual bleeding, polycystic ovary syndrome, prolapse, urinary incontinence, and the menopause and HRT. These are the most familiar topics to a GP — which is exactly why they get over-revised. Know the first-line steps, then move on: the levonorgestrel intrauterine system for heavy bleeding without significant pathology; supervised pelvic floor muscle training for at least three months for stress incontinence; bladder training for at least six weeks for urgency; and a clinical diagnosis of the menopause, without blood tests, in a woman over 45 with typical symptoms.

Using the modules

The Core Curriculum and Core Compass on this track follow the same seven modules, so you can rate each topic and see which is weakest; the Core 10 can then draw its questions from the topics you rate lowest. Sit the 120-question timed mock in the question bank early, to find the gaps, and again in the last fortnight, for pace.

The one-line version

Seven modules, one question each asks: what is the right first step for this woman in general practice? Revise all seven to that standard before going deep on any one.

More DRCOG Core Wisdom →