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100+ Free RCPSC Obstetrics and Gynecology Practice Questions

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2026 Statistics

Key Facts: RCPSC Obstetrics and Gynecology Exam

2 MCQ papers

Written component is Paper 1 and Paper 2, each ~80-90 single-best-answer questions

RCPSC - Format of the Examination in Obstetrics and Gynecology

3 hours per paper

Each written MCQ paper is 3 hours, for 6 hours of written testing

RCPSC - Format of the Examination in Obstetrics and Gynecology

70%

Pass score required for each component, written and applied

RCPSC - Format of the Examination in Obstetrics and Gynecology

OSCE

Applied component is a structured oral OSCE exam

RCPSC - Format of the Examination in Obstetrics and Gynecology

C$5,130

2026 comprehensive objective exam fee covering written and applied components

RCPSC - Assessment and exam fees 2026

Decoupled

Passing the written but not the applied does not require retaking the written

RCPSC - Format of the Examination in Obstetrics and Gynecology

100

Free original single-best-answer practice questions here

OpenExamPrep

The Royal College Certification Examination in Obstetrics and Gynecology is Canada's national certifying exam for specialist ObGyns, administered by the Royal College of Physicians and Surgeons of Canada. The written component has two single-best-answer MCQ papers (~80-90 questions each, 3 hours per paper), and the applied component is a structured oral examination of about 2 hours; the written must be passed before the applied. The pass score is 70% for each component. 2026 registration is C$5,130 for the comprehensive objective exam (or C$2,565 per component), with a separate assessment fee. This 100-question bank provides original single-best-answer practice across the official blueprint, built on SOGC guidelines.

Sample RCPSC Obstetrics and Gynecology Practice Questions

Try these sample questions to test your RCPSC Obstetrics and Gynecology exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old G1P0 at 39 weeks gestation presents in active labor. Fetal heart rate monitoring is Category I. According to SOGC guidelines, what is the recommended frequency for intermittent auscultation during the active phase of the first stage of labor?
A.Every 15 to 30 minutes, immediately following a contraction, for at least 60 seconds
B.Every 5 to 15 minutes, during a contraction, for at least 30 seconds
C.Every 30 to 60 minutes, between contractions, for at least 15 seconds
D.Every 10 to 20 minutes, immediately following a contraction, for at least 30 seconds
Explanation: According to the SOGC Fetal Health Surveillance guidelines, for low-risk women in active labor (first stage), intermittent auscultation should be performed every 15 to 30 minutes. Auscultation must occur immediately after a contraction for at least 60 seconds to detect any late decelerations.
2A 32-year-old G2P1 at 38 weeks gestation has continuous electronic fetal monitoring (EFM) in labor. The tracing shows a baseline of 145 bpm, moderate variability, and late decelerations associated with more than 50% of uterine contractions. What is the most appropriate initial management step?
A.Perform intrauterine resuscitation, including lateral positioning, IV fluid bolus, and discontinuation of oxytocin
B.Perform emergency cesarean delivery immediately
C.Perform fetal scalp blood sampling for pH
D.Apply internal fetal scalp electrode
Explanation: This EFM tracing shows late decelerations with moderate variability, which is classified as an atypical/abnormal pattern depending on overall features (Category II). The initial action is always intrauterine resuscitation to improve uteroplacental blood flow, which includes maternal positioning, fluid boluses, stopping oxytocin, and correcting maternal hypotension.
3A 24-year-old nulliparous patient in active labor has been dilated at 6 cm for the last 4 hours despite ruptured membranes and adequate uterine contractions (confirmed by intrauterine pressure catheter showing 250 Montevideo units). What is the diagnosis?
A.Active phase arrest
B.Active phase protraction
C.Latent phase prolongation
D.Normal labor progression
Explanation: According to modern obstetric definitions (such as SOGC and ACOG consensus), active phase arrest is defined as cervical dilation of 6 cm or greater with ruptured membranes and no cervical change for 4 or more hours of adequate uterine activity (e.g., >200 Montevideo units), or 6 or more hours of inadequate contractions.
4A 29-year-old G1P0 at 37 weeks gestation is diagnosed with gestational hypertension. Her blood pressures are consistently 145/95 mmHg, and she has no proteinuria or severe features. What is the most appropriate management plan?
A.Initiate induction of labor
B.Admit for bed rest and initiate oral labetalol
C.Schedule elective cesarean delivery at 39 weeks
D.Continue outpatient expectant management with delivery at 40 weeks
Explanation: For patients with gestational hypertension without severe features at 37+0 weeks gestation or greater, delivery is recommended because the risks of continuing the pregnancy outweigh the benefits of expectant management, according to SOGC and international guidelines.
5Which of the following clinical findings meets the SOGC criteria for preeclampsia with severe features (severe preeclampsia)?
A.New-onset headache refractory to acetaminophen or visual disturbances
B.Proteinuria of 3 g in a 24-hour urine collection
C.Systolic blood pressure of 150 mmHg on two occasions 4 hours apart
D.Fetal growth restriction at the 9th percentile
Explanation: According to the SOGC guidelines, severe features of preeclampsia include neurological symptoms such as new-onset refractory headache, visual disturbances, or hyperreflexia with clonus, as well as severe hypertension, thrombocytopenia, hepatic dysfunction, renal insufficiency, or pulmonary edema.
6A 34-year-old G3P2 at 35 weeks gestation presents with severe preeclampsia and a blood pressure of 175/115 mmHg. According to SOGC guidelines, what is the recommended target blood pressure range when administering acute antihypertensive therapy?
A.Systolic 130-155 mmHg and Diastolic 80-105 mmHg
B.Systolic 110-120 mmHg and Diastolic 70-80 mmHg
C.Systolic 140-160 mmHg and Diastolic 90-110 mmHg
D.Systolic 120-130 mmHg and Diastolic 80-90 mmHg
Explanation: In patients with severe preeclampsia, the goal of acute antihypertensive therapy is to prevent maternal cardiovascular and cerebrovascular accidents. The target is a non-severe range of SBP 130-155 mmHg and DBP 80-105 mmHg to maintain uteroplacental perfusion while reducing maternal risk.
7What is the standard dosing regimen for magnesium sulfate when used for seizure prophylaxis in a patient with severe preeclampsia?
A.4 g IV loading dose over 15-20 minutes, followed by a maintenance infusion of 1-2 g/hour
B.6 g IV loading dose over 30 minutes, followed by a maintenance infusion of 3 g/hour
C.2 g IV loading dose over 10 minutes, followed by a maintenance infusion of 0.5 g/hour
D.5 g IM loading dose in each buttock, followed by 5 g IM every 2 hours
Explanation: The standard regimen for seizure prophylaxis in severe preeclampsia is a 4 g IV loading dose administered over 15-20 minutes, followed by a continuous maintenance infusion of 1-2 g/hour. The infusion is continued for 24 hours postpartum.
8A patient receiving magnesium sulfate for preeclampsia develops loss of deep tendon reflexes, a respiratory rate of 8 breaths/minute, and urine output of 10 mL over the last hour. What is the immediate management step?
A.Stop the magnesium sulfate infusion and administer 1 g of calcium gluconate IV
B.Decrease the magnesium sulfate infusion rate by half and obtain a serum magnesium level
C.Administer a fluid bolus and place a foley catheter
D.Administer intravenous furosemide to promote magnesium excretion
Explanation: This patient exhibits clinical signs of magnesium sulfate toxicity (loss of DTRs, respiratory depression, and oliguria). The infusion must be stopped immediately, and the antidote, calcium gluconate (1 g IV over 5-10 minutes), must be administered to reverse respiratory depression.
9According to Canadian guidelines, what is the recommended gestational age range for screening pregnant patients for Group B Streptococcus (GBS) colonization?
A.35 to 37 weeks gestation
B.28 to 30 weeks gestation
C.32 to 34 weeks gestation
D.38 to 40 weeks gestation
Explanation: SOGC guidelines recommend universal screening for vaginal-rectal GBS colonization between 35 and 37 weeks gestation (specifically 35+0 to 37+6 weeks). If colonization is identified, intrapartum antibiotic prophylaxis is indicated to prevent early-onset neonatal GBS sepsis.
10A G1P0 at 38 weeks gestation is GBS-positive and in active labor. She reports a history of a severe penicillin allergy characterized by anaphylaxis. Her GBS isolate is resistant to clindamycin and erythromycin. Which antibiotic is the most appropriate for intrapartum GBS prophylaxis?
A.Vancomycin
B.Cefazolin
C.Clindamycin
D.Erythromycin
Explanation: For patients with a high risk of anaphylaxis to penicillin, clindamycin is the first alternative if the GBS isolate is susceptible. If the isolate is resistant to clindamycin, vancomycin is the recommended agent because it provides reliable GBS coverage without cross-reactivity.

About the RCPSC Obstetrics and Gynecology Exam

The Royal College Certification Examination in Obstetrics and Gynecology is the national certifying exam for specialist obstetricians and gynecologists in Canada, administered by the Royal College of Physicians and Surgeons of Canada. It assesses readiness to enter unsupervised specialist practice and consists of a written component (two MCQ papers of about 80-90 single-best-answer questions each, 3 hours per paper) followed by an applied structured-oral component of about 2 hours. The pass score is 70% for each component. Most questions assess the Medical Expert role, with some assessing intrinsic CanMEDS roles, and content follows a blueprint covering obstetrics, general gynecology, and subspecialties. The exam follows SOGC guidelines and other Canadian standards of care.

Assessment

Two-component exam. Written: Paper 1 (~80-90 single-best-answer MCQs) and Paper 2 (~80-90 single-best-answer MCQs). Applied: structured oral, about 2 hours. The written must be passed before the applied.

Time Limit

Written: 3 hours for Paper 1 and 3 hours for Paper 2 (6 hours MCQ total). Applied: structured oral, about 2 hours.

Passing Score

70% passing score on written component. Decoupled format.

Exam Fee

2026 exam registration (CAD): comprehensive objective exam C$5,130 (written and applied together) or C$2,565 each component separately, plus a separate assessment-of-eligibility fee (e.g. C$850 for Canadian residency specialty training). All fees in Canadian dollars. (Royal College of Physicians and Surgeons of Canada (RCPSC))

RCPSC Obstetrics and Gynecology Exam Content Outline

40%

Normal and Complicated Obstetrics

Covers normal and complicated obstetrics, antepartum care, intrapartum care, postpartum care, and related fetal and maternal health monitoring.

40%

General Gynecology and Urogynecology

Covers pediatric and adolescent gynecology, abnormal uterine bleeding, pelvic pain, endometriosis, contraception, menopause, and pelvic floor disorders.

20%

Subspecialties (REI, Gynecologic Oncology, Maternal-Fetal Medicine)

Covers reproductive endocrinology and infertility (infertility evaluation, PCOS, amenorrhea), gynecologic oncology (cervical, endometrial, ovarian cancers), and maternal-fetal medicine (FGR, alloimmunization, medical complications of pregnancy).

How to Pass the RCPSC Obstetrics and Gynecology Exam

What You Need to Know

  • Passing score: 70% passing score on written component. Decoupled format.
  • Assessment: Two-component exam. Written: Paper 1 (~80-90 single-best-answer MCQs) and Paper 2 (~80-90 single-best-answer MCQs). Applied: structured oral, about 2 hours. The written must be passed before the applied.
  • Time limit: Written: 3 hours for Paper 1 and 3 hours for Paper 2 (6 hours MCQ total). Applied: structured oral, about 2 hours.
  • Exam fee: 2026 exam registration (CAD): comprehensive objective exam C$5,130 (written and applied together) or C$2,565 each component separately, plus a separate assessment-of-eligibility fee (e.g. C$850 for Canadian residency specialty training). All fees in Canadian dollars.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

RCPSC Obstetrics and Gynecology Study Tips from Top Performers

1Prioritize SOGC clinical practice guidelines, as they are the primary source for Canadian clinical standards tested on the exam.
2Understand the criteria and timelines for induction, fetal surveillance, and severe preeclampsia management.
3Practice single-best-answer technique: pay close attention to terms like MOST likely, INITIAL, NEXT, and BEST indicator.
4Know the staging and management of gynecologic malignancies according to FIGO guidelines.
5Familiarize yourself with the POP-Q system and the management of urinary incontinence.
6Review the SOGC guidelines on contraception and the management of abnormal uterine bleeding.

Frequently Asked Questions

How many questions are on the Royal College ObGyn written exam?

The written component has two papers of multiple-choice questions: Paper 1 has about 80-90 single-best-answer MCQs and Paper 2 has about 80-90, for roughly 160-180 MCQs in total. Each paper is 3 hours.

What is the passing score for the Royal College ObGyn exam?

The pass score is 70% for each component (written and applied), determined through a standard-setting process. Paper 1 and Paper 2 are combined into one overall written score, so you pass the written component overall rather than each paper individually.

Is the exam written-only or does it have an oral component?

It has two components. The written MCQ component comes first, and only candidates who pass it are invited to the applied component, which is a structured oral OSCE examination.

How much does the Royal College ObGyn exam cost?

For 2026, the comprehensive objective exam (written and applied) costs C$5,130, or C$2,565 per component if registered separately. A separate assessment-of-eligibility fee also applies, for example C$850 for Canadian residency specialty training. All fees are in Canadian dollars.

What guidelines does the exam follow?

The exam follows SOGC clinical practice guidelines, choosing wisely Canada, and standard textbooks such as Williams Obstetrics and Comprehensive Gynecology.

Are these official Royal College practice questions?

No. These are original OpenExamPrep questions modelled on the official blueprint and single-best-answer format. The Royal College provides its own guidelines and format documents separately on royalcollege.ca.