FCPS Part 1 Paper 2 for Obstetrics & Gynaecology: what to study

How Paper 2 differs from Paper 1

Every FCPS Part 1 candidate sits the same Paper 1 on the general medical sciences. Paper 2 is specific to your specialty. For Obstetrics & Gynaecology, the CPSP prospectus describes it as the basic medical sciences that matter for the specialty: anatomy, physiology, biochemistry, pharmacology and pathology, with some statistics and biophysics.

So a Paper 1 question might ask about the blood supply of the uterus. A Paper 2 question puts you in theatre at a caesarean hysterectomy and asks which structure is at risk when the uterine artery is clamped.

Anatomy: the largest part

The bony pelvis and pelvic floor

• Pelvic types and diameters: inlet, cavity and outlet, which diameter is shortest where, and why it matters in labour.
• Pelvic floor: levator ani, perineal body, pudendal nerve, and how injury in childbirth leads to prolapse and incontinence.
• Supports of the uterus: cardinal, uterosacral and round ligaments, and which ones really hold the uterus up.

Pelvic organs, vessels and nerves

• Uterus, ovaries and tubes: parts, relations, peritoneal folds and the pouch of Douglas.
• Blood supply: internal iliac branches, uterine and ovarian arteries, and the vessels tied to control haemorrhage.
• The ureter: its course in the pelvis and its relation to the uterine artery, a favourite question.
• Lymph drainage: cervix, uterus, ovary and vulva drain to different nodes.
• Nerves: lumbosacral plexus, pelvic splanchnics and the pathways of labour pain.

Embryology and histology

• Development of the ovary, uterus and vagina from the Mullerian ducts, and the anomalies that follow (bicornuate uterus, vaginal agenesis).
• Development of the urinary tract and rectum.
• Histology of the ovary, endometrium through the cycle, cervix and transformation zone, breast, and urinary tract.

Breast and abdominal wall

Breast structure, blood supply and lymph drainage; the layers of the anterior abdominal wall and what you cut in a Pfannenstiel incision.

Physiology

• The hypothalamic-pituitary-ovarian axis: GnRH, FSH, LH and feedback.
• The menstrual cycle: ovarian and endometrial phases, and the LH surge.
• Puberty and menopause, including precocious and delayed puberty.
• Pregnancy: maternal changes in each system (plasma volume, cardiac output, renal function, respiration), placental hormones and fetal circulation.
• Labour and lactation: mechanism of parturition, oxytocin and prostaglandins, prolactin and milk ejection.
• Also listed: thyroid and calcium in pregnancy, control of blood pressure and cardiac output, gas transport, pain pathways and the micturition reflex.

Biochemistry

The prospectus keeps this short: energy metabolism (glycolysis and the citric acid cycle), regulation of metabolic pathways, enzyme kinetics, and the roles of insulin and glucagon, which link to diabetes in pregnancy.

Pharmacology

• Anaesthesia and analgesia: local and general anaesthetics, spinal and epidural blocks in labour.
• Drugs in pregnancy and breastfeeding: teratogens, placental transfer, and which drugs are safe.
• Oxytocics and prostaglandins: oxytocin, ergometrine, carboprost and misoprostol.
• Tocolytics: calcium channel blockers and beta-2 agonists.
• Hormones: contraceptives, HRT and ovulation induction.
• Antihypertensives and magnesium sulphate in pre-eclampsia.
• Insulin and oral hypoglycaemics in pregnancy.
• Chemotherapy: methotrexate for ectopic pregnancy and trophoblastic disease.

Pathology

• Septic shock and DIC, ARDS and amniotic fluid embolism.
• Immunology: hypersensitivity, rhesus isoimmunisation, autoimmune disease and immunodeficiency.
• Neoplasia: risk factors for cancers of the female genital tract, HPV and cervical neoplasia, endometrial and ovarian tumours, grading and staging.
• Genetics: inheritance patterns, amniocentesis and common congenital anomalies.
• Blood: anaemia in pregnancy (iron, folate and B12) and perinatal white cell changes.
• Jaundice in pregnancy.
• Infection: organisms in puerperal and postoperative infection, genital tuberculosis, hepatitis B and C, HIV, and parasites such as malaria.

Statistics and biophysics

Study designs and screening, maternal and perinatal health data for Pakistan, and the physics of ultrasound, X-ray, CT, MRI, isotopes and lasers, with the biological effects of heat, cold, sound and radiation.

A suggested order

1. Pelvic anatomy first: bony pelvis, pelvic floor, uterine supports, vessels and the ureter.
2. Reproductive physiology: the axis, the cycle, puberty and menopause.
3. Physiology of pregnancy, labour and lactation.
4. Drugs in pregnancy, linked to the physiology you have just read.
5. Pathology: genital tract neoplasia, then infection, then the obstetric emergencies (DIC, embolism, sepsis).
6. Embryology, histology and biophysics last, as short, high-scoring topics.

Common mistakes

• Studying it as clinical obstetrics from a labour ward handbook. Paper 2 asks about the science behind obstetric practice, not management protocols.
• Skipping embryology. Mullerian anomalies and urogenital development are short and keep coming up.
• Ignoring biophysics. Ultrasound and radiation questions are easy marks once you know the basics.

Where FCPS-1 Prep fits

The [FCPS-1 Prep question bank](/fcps/?bank=gyn) has an Obstetrics & Gynaecology Paper 2 set alongside the shared Paper 1, mapped point by point to the CPSP syllabus. Every question explains each option and links to a full topic review. You can try sample Gynaecology Paper 2 questions first, or read how we write the questions.

Read next: FCPS Part 1 complete guide · Embryology high-yield · Study plan

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