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Exam Review

Key Facts: FCOG(SA) Primary Exam

1 paper

Online SBA paper (no oral for Primary)

FCOG(SA) Regulations Dec 2024

150

SBA questions on the official Primary paper

FCOG(SA) Primary Blueprint Jan 2024

3 hours

Time allowed for Primary

FCOG(SA) Primary Blueprint Jan 2024

14 domains

Syllabus components with published % weights

FCOG(SA) Primary Blueprint Jan 2024

Standard set

Pass mark method (no fixed published %)

FCOG(SA) Primary Blueprint Jan 2024

R12,150

Primary fee incl. VAT (SS2025/FS2026 schedule)

CMSA Examination Fees Schedule

HPCSA

Post-internship qualification required

FCOG(SA) Regulations Dec 2024

100

Free practice SBAs on OpenExamPrep

OpenExamPrep

FCOG(SA) Primary is one 3-hour online SBA paper of 150 questions on O&G basic and applied sciences, with domain weights published in the CMSA Primary Blueprint (January 2024). Pass is by standard setting (no fixed published %). Fee R12,150 incl. VAT on the SS2025/FS2026 schedule (confirm current diet). This free bank has 100 practice SBAs across the 14 blueprint domains.

Sample FCOG(SA) Primary Practice Questions

Try these sample questions to review concepts for the FCOG(SA) Primary exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During hysterectomy, the ureter is most vulnerable to injury where it passes closest to the uterine artery. Where does this relationship occur?
A.Where the ureter crosses the ovarian vessels in the infundibulopelvic ligament
B.About 1.5–2 cm lateral to the cervix at the level of the internal os, where the ureter passes beneath the uterine artery
C.As the ureter enters the bladder at the vesicoureteric junction
D.At the pelvic brim where the ureter crosses the common iliac vessels
Explanation: The ureter passes under the uterine artery ('water under the bridge') roughly 1.5–2 cm lateral to the supravaginal cervix at the level of the internal os — the classic site of ureteric injury during hysterectomy. Recognising this surgical anatomy is a core FCOG Primary anatomy outcome.
2Which artery is the principal arterial supply to the body of the uterus?
A.Inferior epigastric artery
B.Uterine artery from the anterior division of the internal iliac artery
C.Internal pudendal artery
D.Ovarian artery arising from the abdominal aorta
Explanation: The uterine artery arises from the anterior division of the internal iliac artery and is the main supply to the uterine body, anastomosing with the ovarian artery. This arterial anatomy underpins safe hysterectomy and uterine artery ligation.
3Lymphatic drainage from the cervix predominantly follows which first-echelon nodal pathway?
A.Inguinal nodes via the round ligament
B.Internal mammary nodes along the superior epigastric vessels
C.Para-aortic nodes exclusively, bypassing the pelvis
D.Parametrial and obturator/external iliac nodes along the uterine vessels
Explanation: Cervical lymphatics drain primarily to parametrial, obturator, external iliac and common iliac nodes along the uterine vascular pedicles. This pattern informs radical hysterectomy and cervical cancer staging.
4Which nerve provides the principal somatic sensory innervation to the perineum and is most relevant to pudendal nerve block for perineal procedures?
A.Pudendal nerve (S2–S4)
B.Obturator nerve
C.Genitofemoral nerve
D.Ilioinguinal nerve
Explanation: The pudendal nerve (S2–S4) supplies somatic sensation to the perineum and is the target of pudendal nerve block for perineal repair and some operative vaginal deliveries. Knowing its course around the ischial spine is clinically essential.
5Which structure forms the principal ligamentous support of the uterus at the level of the cervix (transverse cervical / cardinal ligaments)?
A.Utero-ovarian ligaments alone
B.Median umbilical ligament
C.Condensations of endopelvic fascia containing vessels and connective tissue at the base of the broad ligament
D.Round ligaments alone
Explanation: The cardinal (transverse cervical) ligaments are condensations of endopelvic fascia at the base of the broad ligament transmitting uterine vessels and providing major cervical support. They are critical surgical landmarks in hysterectomy and prolapse surgery.
6The ovarian artery typically arises from which vessel?
A.Anterior division of the internal iliac artery
B.External iliac artery
C.Abdominal aorta below the renal arteries
D.Inferior mesenteric artery
Explanation: The ovarian arteries arise directly from the abdominal aorta, usually just below the renal arteries, and travel in the suspensory (infundibulopelvic) ligament. This origin differs from the uterine artery's internal iliac origin.
7Which anatomical description best characterises the pelvic ureter's relation at the pelvic brim?
A.It crosses over the bifurcation of the common iliac artery (near the sacroiliac joint) as it enters the pelvis
B.It pierces the obturator membrane with the obturator nerve
C.It runs within the inguinal canal
D.It crosses anterior to the uterine fundus
Explanation: At the pelvic brim the ureter crosses the bifurcation of the common iliac artery near the sacroiliac joint before descending on the pelvic sidewall. This landmark helps identify the ureter during laparoscopic and open pelvic surgery.
8Which statement correctly describes lymphatic drainage of the ovaries?
A.Exclusively to inguinal nodes
B.Only to obturator nodes
C.Primarily along ovarian vessels to para-aortic (lateral aortic) nodes
D.Directly to mediastinal nodes
Explanation: Ovarian lymphatics accompany the ovarian vessels to para-aortic (lateral aortic) nodes at the level of the renal vessels, with additional pathways to pelvic nodes. This explains why ovarian malignancy staging includes para-aortic assessment.
9The vaginal artery most commonly arises as a branch of which vessel?
A.Uterine artery or directly from the internal iliac artery
B.Superior mesenteric artery
C.External iliac artery
D.Inferior epigastric artery
Explanation: The vaginal arteries usually arise from the uterine artery or directly from the internal iliac artery and supply the vagina with anastomoses to uterine and internal pudendal branches. This vascular anatomy is relevant to vaginal surgery and postpartum haemorrhage.
10Which muscle contributes to the pelvic diaphragm and is a key component of pelvic floor support?
A.Latissimus dorsi
B.Sartorius
C.Rectus abdominis
D.Levator ani
Explanation: The levator ani (pubococcygeus, puborectalis, iliococcygeus) forms the bulk of the pelvic diaphragm and supports pelvic organs. Understanding pelvic floor anatomy is fundamental to prolapse and incontinence pathophysiology.

About the FCOG(SA) Primary Exam

FCOG(SA) Primary is the basic-and-applied-sciences examination of the Fellowship of the College of Obstetricians and Gynaecologists of South Africa. Candidates sit one 3-hour online SBA paper of 150 questions covering anatomy, embryology, physiology, endocrinology, immunology, cell biology, technical gynaecology/physics, public health, pathology, microbiology/virology, pharmacology, pathophysiology, statistics and bioethics. Eligibility requires a post-internship medical qualification registered or registrable with the HPCSA. As of 2024 the pathway is Primary → Intermediate → Final. This free bank offers 100 SBAs covering topics from the official CMSA Primary blueprint for revision.

Exam sponsor: College of Obstetricians and Gynaecologists of South Africa (CMSA). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

One online single best answer (SBA) paper of 150 questions (150 marks) covering basic and applied sciences for obstetrics and gynaecology. Domain weights follow the official FCOG(SA) Primary Blueprint (January 2024). Marks are subject to standard setting. No oral examination for Primary.

Time Limit

3 hours (one online paper)

Passing Score

Standard-set cut score per diet (no fixed published percentage for Primary)

Exam / Certification Fees

R12,150 incl. VAT on the CMSA SS2025/FS2026 fees schedule for FCOG(SA) Primary (written only); confirm the current diet fee (college page has also listed R12,950)

Exam sponsor website

Reported exam pass rate: Not published as a fixed percentage. CMSA uses standard setting for the Primary SBA paper; a public fixed pass-rate percentage for FCOG(SA) Primary is not published on the college materials reviewed. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

13%

Anatomy

Pelvis, genital tract, urinary tract, perineum, breast, pregnant uterus, endocrine organs, surgical relations

5%

Embryology

Fertilisation, twinning, placenta, organogenesis, sexual differentiation, Müllerian anomalies, fetal adaptation

10%

Physiology

Reproductive physiology, pregnancy adaptations, labour, puerperium, blood, renal/GIT, fluid–electrolyte balance

10%

Endocrinology

Hormone classes, HPO axis, steroidogenesis, menstrual cycle, pregnancy hormones, gland regulation

5%

Immunology

Immune response, maternal–fetal immunology, hypersensitivity, vaccine immunity

5%

Cell Biology

Membrane, organelles, protein synthesis, cell cycle, mitosis/meiosis, DNA

5%

Basic Physics / Technical Gynaecology

Ultrasound and Doppler physics; basic pre- and postoperative care

4%

Public Health

Women's health determinants, GBV, vulnerable populations, SRHR, adolescent risk

10%

Pathology

Injury, inflammation, healing, thrombosis, neoplasia, shock, transfusion pathology

10%

Microbiology / Virology

Flora, STIs, TORCH, HPV, HIV, TB, GBS, asepsis, vaccines, infection control

5%

Pharmacology

PK/PD in pregnancy, oxytocics, tocolytics, misoprostol, contraception, antimicrobials

10%

Pathophysiology

Applied mechanisms linking basic science to obstetric and gynaecological disease

4%

Statistics

Study design, hypothesis testing, diagnostic test metrics, EBM appraisal

4%

Bioethics

Autonomy, beneficence, non-maleficence and justice in reproductive care

Preparing for the FCOG(SA) Primary Exam

What You Need to Know

  • Passing score: Standard-set cut score per diet (no fixed published percentage for Primary)
  • Assessment: One online single best answer (SBA) paper of 150 questions (150 marks) covering basic and applied sciences for obstetrics and gynaecology. Domain weights follow the official FCOG(SA) Primary Blueprint (January 2024). Marks are subject to standard setting. No oral examination for Primary.
  • Time limit: 3 hours (one online paper)
  • Exam / certification fees: R12,150 incl. VAT on the CMSA SS2025/FS2026 fees schedule for FCOG(SA) Primary (written only); confirm the current diet fee (college page has also listed R12,950) Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

FCOG(SA) Primary: Suggested Study Strategy

1Map revision hours to the official Primary blueprint weights — anatomy, physiology, endocrinology, pathology, microbiology and pathophysiology together make up the majority of the paper.
2Use the CMSA Primary syllabus learning outcomes (pelvic surgical anatomy, pregnancy physiology, HPO endocrinology, STI/TORCH microbiology) as your checklist rather than generic textbooks alone.
3Practise timed SBA blocks at roughly 72 seconds per question to approximate the official 150 questions in 3 hours.
4Link anatomy to procedures (ureter–uterine artery relation, perineal innervation, lymphatic drainage of the cervix) because Primary emphasises clinical O&G relevance.
5For pharmacology, focus on oxytocics, tocolytics, misoprostol, mifepristone, contraception and antimicrobial stewardship in pregnancy and lactation.
6Confirm fees, diet dates and online exam logistics on cmsa.co.za before applying.

Frequently Asked Questions

What is the format of the FCOG(SA) Primary examination?

Primary consists of one online single best answer (SBA) paper of 150 questions lasting 3 hours. There is no oral examination for Primary. Questions assess basic and applied sciences for obstetrics and gynaecology according to the published CMSA Primary blueprint.

What is the pass mark for FCOG(SA) Primary?

CMSA does not publish a fixed percentage pass mark for Primary. The Primary Blueprint states that marks are subject to standard setting for each diet.

How much does FCOG(SA) Primary cost?

The CMSA SS2025/FS2026 examination fees schedule lists FCOG(SA) Primary (written only) at R12,150 including VAT (R10,565 excluding VAT). The college webpage has also listed R12,950 — always confirm the fee for your specific First or Second Semester diet.

Who is eligible to sit FCOG(SA) Primary?

Candidates must hold a post-internship qualification to practise medicine that is registered or registrable with the Health Professions Council of South Africa. CMSA may review professional and ethical standing.

What domains does the official Primary blueprint cover?

The January 2024 Primary Blueprint weights Anatomy 13%, Physiology 10%, Endocrinology 10%, Pathology 10%, Microbiology/virology 10%, Pathophysiology 10%, Embryology 5%, Immunology 5%, Cell biology 5%, Basic physics/technical gynaecology 5%, Pharmacology 5%, Public health 4%, Statistics 4% and Bioethics 4%.

How does Primary fit into the FCOG(SA) pathway since 2024?

As of 2024, FCOG(SA) comprises Primary, Intermediate and Final examinations. After Primary, candidates complete a minimum of 12 months in an accredited registrar post before sitting Intermediate, then proceed to Final after completing required training.