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IMM OBGY 2026: Complete Guide to the Theory Exam & TOACS

IMM OBGY 2026: Complete Guide to the Theory Exam & TOACS

By MedHome Global OBGYN Academy | Updated 2026

The Intermediate Module in Obstetrics & Gynaecology (IMM OBGY) is a major milestone for FCPS trainees, forming a mandatory eligibility requirement before candidates can sit FCPS-II. This guide breaks down the theory exam structure, the TOACS clinical assessment, and a topic-by-topic prep strategy.

Note: Exact station timings and the obstetrics/gynaecology station split can vary by exam cycle. Always cross-check current-year specifics against your official CPSP circular before your exam.

Exam Structure Overview

Candidates must pass the written theory examination before becoming eligible for TOACS.

Theory Examination

  • Paper I — 100 SBA MCQs (Obstetrics-weighted)
  • Paper II — 100 SBA MCQs (Obstetrics-weighted)
  • Overall syllabus weighting: Obstetrics 70% / Gynaecology 30%

TOACS (Task-Oriented Assessment of Clinical Skills)

  • Interactive stations, each supervised by a single examiner
  • Assesses history-taking, examination technique, counselling, procedural knowledge, and clinical reasoning
  • Station distribution broadly follows the 70:30 Obstetrics:Gynaecology weighting

Gynaecology Syllabus (30%)

Core topics candidates must master:

  • Congenital anomalies of the female genital tract
  • Amenorrhoea, PCOS, hirsutism & virilisation
  • Endometriosis, PID, Bartholin gland disorders
  • Vaginal discharge & STIs
  • Menstrual disorders — menorrhagia, dysmenorrhoea, PMS, DUB
  • Early pregnancy problems — miscarriage, ectopic pregnancy, GTD
  • Menopause & HRT
  • Pelvic organ prolapse & pelvic floor disorders
  • Infertility, contraception, sterilisation
  • Pre-op/post-op assessment, cervical smear, pessary insertion, HSG, gynae ultrasound
  • Minor operative gynaecological procedures

Basic-knowledge-only areas: gynaecological oncology, radiotherapy, endoscopy, urinary fistula.

Obstetrics Syllabus (70%)

1. Normal Pregnancy, Labour & Puerperium

Preconception counselling, folic acid, rubella vaccination, genetic counselling, antenatal/intrapartum care, maternal & fetal monitoring, labour analgesia/anaesthesia, postpartum care, breastfeeding, normal puerperium, prenatal diagnosis.

2. Abnormal Pregnancy, Labour & Puerperium

Malpresentation/malposition, dysfunctional labour, CPD, obstructed labour, third-stage complications, induction of labour, preterm labour, surgical emergencies in pregnancy (appendicitis, acute abdomen, pancreatitis, cholecystitis, renal colic), neonatal resuscitation.

3. Medical Disorders in Pregnancy

Cardiac, renal, endocrine, liver, GI, haematological disease, VTE, psychiatric, neurological, dermatological disorders, and malignancy in pregnancy.

How to Prepare for TOACS

History Stations

Introduce yourself → confirm identity → consent → focused history → summarise → likely diagnosis → investigations → management → safety-net.

Examination Stations

Introduce → consent → explain the examination → perform systematically → present findings → differentials → management plan.

Counselling Stations

Demonstrate empathy, clear communication, shared decision-making, balanced risk-benefit discussion, and appropriate follow-up advice.

High-Yield TOACS Topics

Obstetrics: antenatal counselling, hypertensive disorders, gestational diabetes, reduced fetal movements, CTG interpretation, labour management, shoulder dystocia, PPH, instrumental delivery counselling, VBAC, previous CS, preterm labour, PROM/PPROM, multiple pregnancy, FGR, stillbirth, breastfeeding counselling.

Gynaecology: abnormal uterine bleeding, amenorrhoea, PCOS, endometriosis, infertility, menopause & HRT, contraception (incl. emergency), pelvic organ prolapse, urinary incontinence, ovarian cysts, ectopic pregnancy, miscarriage, PID.

Time Management in an Interactive Station

  • Read the task & plan
  • Introduction and consent
  • Core history / examination / counselling
  • Diagnosis, investigations, and management
  • Summary and safety-netting

Final Preparation Tips

Success in IMM OBGY comes from combining sound theory with safe clinical practice and effective communication. Focus on:

  • Evidence-based management (NICE, RCOG, FIGO where applicable)
  • Structured history & examination approaches
  • Patient-centred counselling
  • Common obstetric emergencies
  • Core gynaecological conditions
  • Timed TOACS practice

Prepare with MedHome Global OBGYN Academy
Structured IMM OBGY theory + TOACS courses, SBA banks, and mock stations.
📱 WhatsApp: +92 301 4843695

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