FCOG(SA) Intermediate: The Complete Guide

The FCOG(SA) Intermediate is the middle step of the Fellowship of the College of Obstetricians and Gynaecologists of South Africa, set by the Colleges of Medicine of South Africa (CMSA). It was introduced when the fellowship moved to a three-examination structure of Primary, Intermediate and Final, and it bridges the gap between the basic sciences of the Primary and the clinical depth of the Final. This guide explains what the Intermediate tests, how the paper is built, who can sit it, and how to prepare efficiently while working as a junior registrar.

What is the FCOG(SA) Intermediate?

The Intermediate examination covers clinical obstetrics and gynaecology together with the basic medical sciences that are relevant to O&G practice. In practice it asks whether a registrar with around a year of training can assess, diagnose and plan management for the common and important problems they meet on the labour ward, in the gynaecology clinic and in theatre. Passing it is required before you can be admitted to the Final examination.

FCOG(SA) Intermediate format and structure

The Intermediate is a single written examination with no oral component. The College's regulations and blueprint describe it as follows:

• One digital written paper of 3 hours.
• 150 single best answer (SBA) questions; the College confirmed a move to a fully SBA format for the Intermediate written paper.
• Questions are blueprinted across 13 content areas, from general gynaecology to ethics and medico-legal practice.
• The blueprint deliberately weights the paper towards higher-order thinking: roughly 110 of the 150 questions are classed as applying, analysing or evaluating, and about 40 as lower-order recall and understanding.
• Set and administered by the CMSA on its digital examination platform.

The College describes its blueprint as a guideline rather than a fixed allocation, because topics overlap. Confirm the current format, standard-setting arrangements and any notices on the CMSA website when you apply.

Who can sit the FCOG(SA) Intermediate?

To enter the Intermediate you need evidence that you have passed the FCOG(SA) Primary and that you have completed at least 12 months in a registrar training post in an accredited department approved by the CMSA. The regulations also include transitional rules for candidates who passed the older Part IA or Part IB examinations: depending on which of those you passed, you may be eligible for the Intermediate, required to write the Primary first, or exempt from the Intermediate altogether. If you trained under the older structure, check exactly which rule applies to you with the CMSA before you plan your next sitting.

FCOG(SA) Intermediate syllabus: where to focus

The College publishes both a syllabus and a blueprint for the Intermediate, and the blueprint tells you where the marks are. General gynaecology carries the largest share (around 35 questions), followed by general obstetrics (around 21) and complicated obstetrics (around 20). Oncology carries around 16, critical care around 11 and technical O&G around 10, with smaller allocations for genetics, the fetus, paediatric gynaecology, urogynaecology, endocrine and reproductive health, statistics, and ethics and medico-legal practice. High-yield territory includes:

• Acute and chronic pelvic pain, pelvic infection, ectopic pregnancy, miscarriage, heavy menstrual bleeding and endometriosis.
• Antenatal care to South African maternity guidelines, normal labour, partogram use, CTG interpretation and the puerperium.
• Complicated labour, antepartum and postpartum haemorrhage, hypertensive disorders including pre-eclampsia and HELLP, preterm birth and infections in pregnancy.
• Cervical screening policy in South Africa, CIN, gestational trophoblastic disease and the pathology of genital tract tumours.
• Technical O&G: perioperative fluids and blood gases, electrical safety, laparoscopy and hysteroscopy principles, and obstetric ultrasound.
• HIV in gynaecology and pregnancy, and South African law relevant to O&G, such as the Choice on Termination of Pregnancy Act and consent.

A realistic FCOG(SA) Intermediate study plan

Most candidates prepare over a few months while working on a busy rotation. Use the blueprint to divide your time in proportion to the marks.

• Phase one, the big three. Work through general gynaecology and general and complicated obstetrics first, since together they make up about half the paper. Read a topic against the syllabus objectives, then answer questions on it the same day.
• Phase two, fill the blueprint. Cover oncology, critical care and technical O&G, then the smaller areas. Statistics and ethics are only around five questions each, but they are among the most learnable marks on the paper.
• Phase three, simulate. Sit timed, mixed blocks so that 150 questions in three hours feels routine, review your weakest content areas, and finish with focused revision of guidelines and local law rather than new reading.

Exam technique that earns marks

With 150 questions in three hours you have around 70 seconds per question, so pacing matters more here than in most CMSA papers. Read the lead-in first, then the scenario. Because most questions test higher-order thinking, expect stems where several options are reasonable and you must choose the most appropriate next step for this woman at this gestation, in this setting. Answer from South African guidance where it differs from international practice. If a question stalls you, choose your best option, flag it and move on, so that you reach the end of the paper with time to review.

The best way to revise for the FCOG(SA) Intermediate

A single SBA paper rewards high-volume, well-explained question practice above everything else. Look for questions written to the CMSA blueprint and to South African maternity and gynaecology guidance, with explanations that tell you why each distractor is wrong, and analytics that show how you are performing across the 13 blueprint areas.

Passmed's FCOG(SA) Intermediate question bank is written by qualified doctors, mapped to the CMSA Intermediate blueprint, and pairs clear explanations with performance tracking across every content area. Explore the FCOG(SA) Intermediate question bank →

Frequently asked questions

What is the format of the FCOG(SA) Intermediate?

One 3-hour digital paper of 150 single best answer questions, with no oral or clinical component, blueprinted across clinical obstetrics, gynaecology and the relevant basic sciences.

When can I sit the Intermediate?

Once you have passed the FCOG(SA) Primary and completed at least 12 months in an accredited registrar training post. Confirm the transitional rules with the CMSA if you passed the older Part IA or IB.

Which topics carry the most marks?

The College's blueprint gives the largest share to general gynaecology, followed by general and complicated obstetrics, then oncology, critical care and technical O&G.

Is the Intermediate mainly recall?

No. The blueprint classes most questions as higher-order thinking, so expect applied clinical scenarios that ask you to interpret, prioritise and manage rather than simply recall facts.

Exam format details were checked against the Colleges of Medicine of South Africa (accessed October 2026). Regulations, dates and fees change, always confirm the current details on the CMSA website before you sit.