Candidates will be expected to demonstrate a broad and detailed understanding of Reproductive Science theory and practice. Candidates whose practice is slanted towards a certain part of clinical embryology practice, e.g. andrology, pre-implantation genetic diagnosis, may wish to advise us of this. However, knowledge across the whole discipline is expected.
Candidates must be aware that the examination is structured towards UK practice. While there are differences in aspects of practice and notably regulations in different countries and geographical areas, these will not be considered an acceptable alternative to knowledge of the UK framework for practice.
The examination will cover all aspects of Reproductive Science, including aetiology, diagnosis and definitions of infertility, investigation and treatment options, practical skills and insight into embryology, problem solving, communication, professional matters, ethics and regulation.
The Part 1 examination is the major test of a clinical embryologist’s knowledge and analytical and interpretive skills across the whole field of practice, and candidates are advised to prepare themselves accordingly.
A detailed and up-to-date knowledge of the following subjects is required:
- the biological basis of fertility in men and women
- the structure and function of gametes and embryos
- the menstrual cycle
- the clinical manifestation of particular aetiological problems with fertility
- factors impacting upon fertility
- infertility investigation and diagnosis
- semen analysis and standardisation
- treatment options and appropriate use
- issues of gamete and embryo donation
- practical techniques routinely used in clinical embryology laboratories
- normal and abnormal expected outcomes of treatment
- factors affecting embryo quality
- identification of actions that are prohibited by regulations
- ethical conduct
- action in event of emergencies and incidents
- record keeping
- auditing frozen materials
- identity checking and witnessing.
A general knowledge of the following areas is required:
- basic principles of tissue culture and sterile technique
- troubleshooting investigations
- legal and regulatory framework
- emerging methods and specialist treatments
- genetic factors in infertility
- quality management
- drugs used for infertility treatment
- reproductive tourism and regulations elsewhere
- screening requirements and timeframes
Candidates should have experience in:
- the interpretation of results
- the compilation of reports
- sensitive communication with patients
Candidates should also have knowledge of the administrative aspects of laboratory safety and basic laboratory management principles including audit, quality control, risk assessment, health and safety and good laboratory practice. Candidates should maintain awareness of current research and development within the field.
The written examination consists of two papers of three hours each, taken on the same day. The first will require written answers to four out of five questions, in short notes or essay format. The second paper will comprise several short answer questions.
Paper 1: This will require detailed answers on selected topics and may include basic science, but will be more focussed towards the application of the science in the Reproductive Science setting.
Paper 2: Short answer questions. This will be a wide ranging paper, covering the whole of Reproductive Science theory and practice.
Consistency of standards is achieved through the use of two examiners, with one examiner shared between two successive examinations. The examiners mark the questions independently and submit their results to the examination department. Any discrepancy in marking will be reviewed by a third examiner.
The questions are set and agreed by a Panel of Examiners. Candidates’ answers will be marked against standardised marking plans which specify minimum criteria for achieving a pass grade. Essay questions will be marked using the College’s ‘closed’ marking scheme which uses a limited range of marks as follows:
Mark awarded Category
15 (maximum) Excellent pass
14 Clear pass
12 Borderline fail
11 Clear fail
10 (minimum) Bad fail
Two examiners mark the written papers independently. Their marks for each question are averaged and the average marks for each of the four questions are totalled. Candidates are advised to try to obtain an average mark of about 13 per answer, i.e. to manage their time across all four answers per paper and to try to give relevant, informative and balanced answers to each question attempted.
The number of marks for short answer questions will be equal across all 20 questions and are marked on an open system against a pre-agreed model answer. Each question answered correctly will attract a number of points that together will form a total mark. The range of marks will be moderated. The pass mark will be set using the Angoff method. Candidate are advised to manage their time across each section as a pass in 17 out of 20 sections is required. Marks from one paper can compensate for a slight underperformance on the other paper. If the marks awarded by the pair of examiners result in different outcomes (i.e. pass, fail, borderline) the scripts will be moderated by the Chair of the Examiners’ Panel.
In all examinations the entire performance of the candidates will be assessed for egregious errors that suggest dangerous, harmful or unethical practice, or lack of specialist knowledge that is sufficiently serious to fail the candidate irrespective of an average mark above the pass mark.
The written component of Part 2 will be one of the following 3 options:
1. A minimum of three published peer reviewed papers; where the applicant is the first author and had involvement in the experimental design. With multi-author publications proportionately more publications would be required, the number depending upon the extent and significance of the contributions made by the candidate. The papers should be accompanied by a narrative placing the papers in context with the applicant’s practice and relevant surrounding literature. The narrative would be expected to be approximately 5000 words with at least 30 references cited. In the case of multi-authored papers, the candidate should explain exactly his/her contribution to the work. For each paper the applicant should outline the research question, describe how the question was addressed, the main findings and how these could advance the field.
2. A dissertation or PhD/MD thesis; normally completed during the training period. The research work used for the basis of a dissertation or PhD thesis should be in the field of Reproductive Science. The PhD should also be up to date. A recent PhD thesis that has been approved by a University may be submitted without further work. However, a PhD obtained before the attainment of the Part 1 examination will probably not be acceptable for submission alone. In this situation, an update addendum to the thesis can be submitted together with an older PhD thesis. The update addendum should bring the thesis results and subject matter up to date in the light of current research and publications, and should explain relevance to current clinical embryology practice, such an addendum would be expected to be approximately 5000 words with at least 30 references cited.
3. A casebook; consisting of eight cases. The word limit of each case should be in the region of 2000 words
Candidates must submit 8 cases in the casebook, which must provide an overview of Reproductive Science practice. At least four cases must include a substantial laboratory component. All cases must provide discussion of the context, review of published literature or relevant practice, and evidence of reflective learning.
Cases 1-4 should be clinical with description of a single patient or group of patients with regard to investigation, diagnosis or management. Cases should be non-related and drawn from a broad range of subject areas across the field of practice. The candidate must demonstrate a substantial personal role in the clinical management and / or laboratory investigation of at least two of these cases.
Case 5 should be audit based and describe the review of a specific aspect of clinical or laboratory practice
Case 6 should cover an area of laboratory practice such as trouble shooting, introducing new equipment, culture systems. The report should reference quality management required for the selected case study.
Case 7 Should address management or communication. This could involve a business plan for introducing a new service for patients, addressing new regulation guidelines, evidence of effective patient communication or communication with non-specialists.
Case 8 Should cover and area of research and development. This could involve producing, presenting and communicating results from experimental work or critically appraising results in light of existing knowledge supported with statistical analysis.
While some clinical case reports may describe new or unusual information, novelty is not an essential requirement of the Casebook case reports. Each case report should include an initial background page with a title and contributors. The candidate must state exactly who did what; they must demonstrate that they have been responsible for the majority of the work to be awarded a pass.
For clinical case reports each case report should have an abstract that succinctly summarises key issues in the main text, an introduction that provides the subject, purpose and merit of the case report including references where applicable. A description of case study with inclusion of any relevant laboratory results. The case presentation section should be in enough detail for the reader to understand the main learning points of the case. A final discussion and conclusion section which summarises the reasons underpinning the conclusions and the main learning points.
For the audit case report elements of design, data collection and data analysis and an acceptable rationale for the audit should be provided. The audit must be conducted using professional standards where applicable with a description of the method and rational of the sample selection which should be appropriate to the purpose of the audit. An interpretation of results should be given with identification and implementation of changes or actions that resulted from the audit.
For the Laboratory Practice case report the assessment / troubleshooting / introduction of a new standard operating procedure that is being addressed must be clearly defined. A clear and structured assessment and action plan should include evidence that relevant alternatives have been considered. An analysis and interpretation of analysis must be given, with valid interpretation of results. Discussion of quality management should demonstrate detailed, clinically appropriate and critical review of relevant internal QC and external quality assurance procedures. Identification and implementation of any changes required should be given
For the Management and Communication case report a rational and background for the case should be given to show how this fits with the aims of a department, its aims,objectives and implementation and delivery within the workplace. Evidence of consideration of alternative options, risk assessment, financial costings and implications should be included
The Research and Development case report should demonstrate producing, presenting and communicating results from experimental work or critically appraising results in light of existing knowledge supported with statistical analysis. The ability to develop an experimental protocol to meet the aims and objectives and to provide reliable and robust data should be described. The results should be logically presented and critically appraised with reference to the formulation of further research questions.
Candidates who have previously passed the Part 1 Practical examination will proceed to the Part 2 examination in this format. Candidates will not be allowed to sit the oral examination until a proposal for a written option has been submitted and approved by the examiners.
The aim of the oral examination is to establish that the candidate has demonstrated a level of competence appropriate for independent practice at consultant level.
The examination will test the candidate’s:
- Scientific knowledge relevant to clinical embryology, including recent relevant literature
- Ability to apply basic knowledge successfully and appropriately in a clinical context
- Understanding of laboratory organisation and direction, including principles of budget control, quality control, safety and staff management
- Practice in terms of ethics, regulations and standards.
Each of these areas will occupy approximately one quarter of the examination. The candidate should pass in all four areas.
There will be two examiners. An observer examiner from another specialty may be present. The examination will last about 1 hour.
Candidates who have passed the Part 1 written examination but not the Part 1 practical examination will proceed to the Part 2 in this format.
Candidates will not be permitted to sit the oral and practical examination until the proposal for the written option has been submitted and approved by the examiners. The examination will consist of two papers: a three hour OSPE followed by a one hour oral. The aim of this examination is to establish that the candidate has demonstrated a level of competence appropriate for independent practice at consultant level. The examination will test the candidate’s:
• Scientific knowledge relevant to clinical embryology, including recent relevant literature
• Ability to apply basic knowledge successfully and appropriately in a clinical context
• Understanding of laboratory organisation and direction, including principles of budget quality control, safety and staff management
• Practice in terms of ethics, regulations and standards.
Each of these areas will occupy approximately one quarter of the examination. The candidate should answer all questions and pass in all areas. The oral and objective structured style practical examination contains a mixture of analytical, problem-solving, interpretative tasks. These may include interpreting laboratory results, devising and communicating a patient management plan, evaluating the design or feasibility of a research project, or discussing areas of specialist practice and regulation. Tasks will involve data, images, reports, and simulations that do not make use of live human or animal gametes or embryos.
There will be two examiners. An observer examiner from another specialty may be present.
Guidelines for the standard expected of the written options of the Part 2 examination are outlined in the general examination regulations and guidelines available on the Exams section of the College website.
The written component is independently marked by two examiners and awarded a pass, fail or a conditional pass subject to further work or modification.
The oral and objective structured style practical examination is conducted by two examiners, usually different to those who examined the written component, and is awarded either a pass or fail mark. Each candidate within the same examination is asked the same questions in relation to the different subject areas of the examination. Candidates are required to pass both the OSPE and oral to pass overall.