FCOG(SA) Primary: The Complete Guide

The FCOG(SA), Fellowship of the College of Obstetricians and Gynaecologists of South Africa, is the specialist qualification for obstetrics and gynaecology awarded by the Colleges of Medicine of South Africa (CMSA). The Primary, the first of the three examinations, is the basic-and-applied-science foundation that registrars sit early in their training. This guide explains the format, what it covers, who can sit it, and how to prepare efficiently for a first-time pass.

What is the FCOG(SA) Primary exam?

FCOG(SA) Primary is the entry examination for the fellowship, testing the basic and applied sciences that underpin safe practice in obstetrics and gynaecology. It confirms that a trainee has the scientific grounding, anatomy, physiology and the related sciences relevant to the specialty, needed before progressing through the rest of the O&G training pathway.

FCOG(SA) Primary format and structure

The Primary is a single written paper of three hours, containing 150 single-best-answer multiple-choice questions. The content focuses on the basic and applied science relevant to obstetrics and gynaecology, and the single-best-answer format tests applied understanding rather than simple recall.

• One three-hour written paper.
• 150 single-best-answer multiple-choice questions.
• Content focused on the basic and applied science of obstetrics and gynaecology.
• Set and administered by the Colleges of Medicine of South Africa (CMSA).

Note that the FCOG(SA) structure was updated in 2024 to include three examinations, Primary, Intermediate and Final, with the Intermediate becoming available after a year of registrar training. Confirm the current structure and the exact specification of the Primary on the CMSA website when you apply.

Who can sit FCOG(SA) Primary?

Eligibility requires a post-internship qualification to practise medicine that is registered or registrable with the HPCSA. Candidates typically sit the primary early in their O&G training, since it is the gateway to the later examinations. As entry criteria are set by the CMSA and can change, confirm the current requirements before registering.

FCOG(SA) Primary syllabus: where to focus

The paper draws on the basic and applied sciences relevant to obstetrics and gynaecology. High-yield areas typically include:

• Applied anatomy of the pelvis, reproductive tract and related structures.
• Reproductive, maternal and fetal physiology, and the physiology of pregnancy.
• Endocrinology relevant to the menstrual cycle, fertility and pregnancy.
• Relevant pharmacology, microbiology, pathology and genetics as applied to the specialty.

A realistic FCOG(SA) Primary study plan

Most candidates prepare over three to four months alongside clinical work.

• Weeks 1–6, build coverage. Work through the basic and applied sciences topic by topic, answering questions as you go and reading every explanation.
• Weeks 7–10, consolidate through a question bank, doing questions in tutor mode and logging your weak areas to revisit.
• Weeks 11–14, simulate. Sit timed, exam-style papers of 150 questions to build pacing and stamina, review your analytics, and taper in the final week.

Exam technique that earns marks

With 150 single-best-answer questions in three hours, disciplined technique protects your score. Read each stem fully before the options, and commit to an answer before scanning the choices so they do not lead you astray. Where two options look plausible, choose the single best answer for the scenario described. Flag anything that stalls you and return with fresh eyes rather than burning minutes, and keep a steady rhythm so you reach the end of the paper. Because there is no negative marking, every question deserves an answer.

The best way to revise for FCOG(SA) Primary

As an entirely multiple-choice paper, the FCOG(SA) primary rewards a question bank that mirrors the CMSA style and difficulty, explains the reasoning behind each option, and tracks your performance so you can target your weakest basic-and-applied-science topics.

Passmed's FCOG Primary question bank is written by qualified doctors, mapped to the CMSA basic-and-applied-science syllabus, and includes timed exam simulation with a dashboard that highlights your weakest topics. Explore the question banks →

Frequently asked questions

How many questions are in FCOG(SA) Primary?

150 single-best-answer multiple-choice questions in a single three-hour written paper, covering the basic and applied science of obstetrics and gynaecology.

Has the FCOG(SA) exam structure changed?

Yes. The structure was updated in 2024 to include Primary, Intermediate and Final examinations, with the Intermediate available after a year of registrar training. Confirm the current structure with the CMSA.

How long should I study for FCOG(SA) Primary?

Three to four months of consistent, question-led preparation suits most candidates working alongside clinical duties.

Exam format and scoring details were checked against the official examining bodies (accessed July 2026). Specifications, dates and fees change, always confirm the current details on the CMSA website before you sit.