Difficulties for Overseas Candidate: My Experience with a Career Changing Exam

When I first “googled” this exam, I thought it is perhaps not for me. But when I scrolled through the RCOG website, I realized it is not as impossible as I first envisioned it. Slowly, I met the right people, spoke to and worked in places that practiced UK standards of medicine. I understood where to pick up the missing pieces from and complete the jig saw puzzle.

Here are some experiences I felt would be relevant for candidates taking up this exam:

Why Candidates Fail?

1. Attitude is everything

You need to have an inherent faith in yourself that you can achieve your goal and stand strong in the face of adversity. It is not just enough to believe in yourself, but, you need to  believe that you can conquer this exam.

2. Myths of the exam

2.1 Simple questions have a hidden trap

Setting an exam question is as hard for the examiner as preparation is for the candidate. Many a times, what you think as a trick is actually misreading on your part. So read the question again and ask yourself – What is the crux of this question? And that my friend, is usually what was intended by the examiner.

2.2 Exams are there to fail you

There is a standard expected out of this exam. If you are good enough, victory will be yours. Remember the exam doesn’t fail you unfairly.

3. The exam favors native English people

The exam is designed to test your capacity to practice medicine in the UK. There is no favoritism; if you are good enough you will pass.

4. Lack of understanding of the pattern of the exam

Spend some time reading the syllabus and understanding the five domains the exam will mark you against:

a. Patient safety
b. Communication with patients and their relatives
c. Communication with colleagues
d. Information gathering
e. Applied clinical knowledge

Part 2 and Part 3 are completely different exams, with different formats and emphases. It makes no sense in reading your long part 2 texts. But you need steady knowledge to come across as a confident clinician and present true facts to your patient.


To pass this exam you need to understand the nitty gritties of how health care system works in UK….

Many of us come from places where obstetrics is practiced single handedly. The fact is all over the world, teamwork is the buzz word. It is next to impossible to work in obstetrics without the back up of a well-structured and a smoothly-oiled engine of team dynamics. Many of the overseas candidates are privy to lack of knowledge of how teams work and how each person contributes in their own capacity to the ultimate goal of patient safety and well-being. You will need to pick up these facts like a sponge soaked in water. You must have realized by now the need to unlearn and relearn your vocabulary: miscarriage and not abortion, theatre and not OT, shared decision-making with the patient and not I know what is best for you…..

Differences in training system: Training in UK is based on direct consultant supervision, constructive feedback, strict working hours, annual appraisal and ARCP, accountability to GMC, and structured training and curriculum. Audits and quality improvement projects are more of a rule than exception. I can’t think of a single trainee going through his/ her years of training without having to write a statement for an SI (serious incident) they have been involved in. Acknowledging this and applying to the exam scenario is not easy but again not impossible.

Overwhelming feeling of being in a foreign land with an unknown culture:Although all of us can speak English comfortably well, we are known to be fast speakers .Slow down! It gives you time to think and phrase your words and enables the listener to comprehend your words better. Nothing can be as futile as knowing the answer, yet not getting marked because you can’t express it in the right way.

Pound rupee conversion: When I took the exam, one pound was 110 Indian rupee. You can imagine my anxiety, where I felt I bled money every time I pulled out my purse. Using a public toilet would cost 50 pence, which was roughly 50 rupees! As ridiculous as it sounds, the grave fact is, you are applying to write an exam in a country which has a mightier currency. It is not just the exam fee and course fee, you will need enough monetary support for you stay, travel and food. Make sure you have enough to sale you through the exam without the added stress of money to think about.


This is an exam not just for you, but for your family also!

And rightly so the College honors your family, and not just you during the membership ceremony. I still remember the agony of leaving my 1-year-old child behind for a month and a half to attend clinical attachment and take the exam in the UK. I couldn’t have done it without the staunch support of my husband and mother-in-law. Most of us are in the phase of our lives where we have small children and equally busy partners trying to chart out their career paths. It is a hard call and this makes the exam not just a physical exertion but also a challenge to the emotional state. You can imagine the sense of elation I had when I saw the result email the College sent; it said, “I am pleased to inform…..”, I didn’t read beyond it…I knew I had made it!


Do you need to do clinical attachment before taking up part 3?

I took a clinical attachment in Birmingham, but I know many of my colleagues who have sailed through this exam without any sort of extra attachment. Of late, the numbers have been very encouraging. As long as you can understand how the system works, it isn’t a Herculean task.

And finally, I too have had a roller coaster ride, motivated and enthused all along but also frustrated and exhausted at times. It has changed the way I practice medicine and has made the adage “light at the end of the tunnel” realistic. I feel satisfied that my medical practice is based on sound evidence and a firm-footed knowledge base. To anyone who is planning to or are in the process of taking up the exam, I would recommend that you take the plunge, enjoy the ride and share your success story with the world!

Authored by : Dr. Akshatha Kulkarni | MRCOG, MS, DNB, MBBS

Join her upcoming CG Workshop on March 10 — https://studymrcog.com/cg-registration/