Why candidates lose marks in the RANZCOG exams

RANZCOG examiner reports repeat themselves from sitting to sitting. Most marks are not lost on rare facts; they are lost on how answers are written and on the same core gaps. These are the themes that come up most.

1. SAQ answers written as an unstructured list: marks are awarded for structure (resuscitate, assess, cause, treat, escalate, follow up) as well as content.
2. Drugs named without dose, route and sequence, e.g. "give uterotonics" in a postpartum haemorrhage answer.
3. Time lost on early SAQs so the last questions in each part are left incomplete or in note fragments.
4. General textbook knowledge where the MCQ tests current RANZCOG and Australian guidance (SOMANZ, ADIPS, the National Cervical Screening Program, the anti-D guidelines).
5. Applying international thresholds instead of Australian ones, e.g. the old cytology-based cervical screening intervals or overseas abortion gestation limits.
6. Oral stations where sound knowledge is let down by poor communication, rapport and respect: the global domains penalise a candidate who lectures the role player or ignores her concerns.
7. Skipping consent, documentation, debrief and open disclosure in emergency and adverse-outcome stations.

What this looks like when it is marked

A SAQ question, an answer of the kind examiners see every sitting, and how a point-by-point marking guide scores it.

The content is not wrong, but it is an unstructured list with no doses. RANZCOG SAQ markers credit structure as well as content, and "give Syntocinon" earns nothing where the key asks for the agent, dose, route and sequence.

How to practise against these

Reading a list of mistakes changes little. What changes the score is writing or speaking answers under exam conditions and being marked against specific points, so you can see exactly which one you missed. Do that for every area, weakest first, and repeat the ones you got wrong until they stick.

Know the references examiners expect: RANZCOG College Statements and clinical guidelines; FRANZCOG Digital Curriculum (exams are blueprinted to it); National Cervical Screening Program (HPV-based, self-collection), NIPT and first-trimester combined screening, Australian Pregnancy Care Guidelines; SOMANZ hypertension in pregnancy guideline, ADIPS gestational diabetes criteria, anti-D prophylaxis guidelines (National Blood Authority / Lifeblood); Therapeutic Guidelines, PBS, TGA pregnancy categories, Australian Immunisation Handbook; State and territory abortion and consent law; Medicare items; ACSQHC Clinical Care Standards (heavy menstrual bleeding, third and fourth degree perineal tears); Te Whatu Ora and New Zealand guidance for NZ trainees.

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