← Full lesson and references Paired practice cardsSt Emlyn’s · FRCEM

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Gynaecological examination

FRCEM · Paired examination practice

Your task

Using a clinical skills model, explain and demonstrate an indicated gynaecological examination. Agree the examination with the simulated patient and discuss subsequent care.

Starting information

Practise with a suitable clinical skills model; no intimate examination is performed on a partner.

Suggested practice time: 5–7 minutes. This is a practice suggestion, not an official examination timing.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeCandidate card

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Examiner / observer

Gynaecological examination

Tick the actions you observe. Discuss any step that was not needed for this examination; unchecked boxes are not a score.

Examiner / observer · 1 of 3

Gynaecological examination

Preparation · History and consent

Use a pelvic skills model, suitable speculum, light, lubricant, gloves and teaching equipment with a trained facilitator. Agree a retained-object teaching scenario only if a model and appropriate supervision are available. No speculum or bimanual examination is performed on a peer.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 1 of 3

Examiner / observer · 2 of 3

Gynaecological examination

Model preparation · Bimanual examination when indicated

Model preparation

Prepares an appropriately sized speculum, lubricant, light, gloves and suitable equipment, arranging assistance if needed.

Provides a supported position, cover and privacy and agrees a stop signal.

External and speculum examination

Inspects external genitalia for relevant lesions, inflammation, discharge or trauma.

Renews permission, demonstrates gentle speculum insertion on the model and visualisation of cervix and vaginal walls.

Selects samples only when indicated.

Discusses removal of a clearly seen object only when trained and confident, stopping and seeking help if difficult or painful. Key step

Checks for retained material and removes the speculum carefully without tissue entrapment.

Bimanual examination when indicated

For an indicated bimanual examination, obtains separate consent and describes cervical, uterine and adnexal assessment; does not use reassuring findings to exclude ectopic pregnancy.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 2 of 3

Examiner / observer · 3 of 3

Gynaecological examination

Aftercare and urgent concerns · Finish

Aftercare and urgent concerns

For a retained condom, considers pregnancy testing, emergency contraception and STI assessment according to timing and risk.

For a retained tampon, explains fever, rash, gastrointestinal symptoms, dizziness or severe illness as reasons for urgent assessment for toxic shock.

For pregnancy-related bleeding or tissue, assesses stability and pain, considers pregnancy location/ectopic pregnancy and seeks urgent input for bleeding, instability or uncertainty. Key step

Agrees early-pregnancy follow-up and explicit safety-netting only when discharge is appropriate.

Finish

Thanks the patient.

Restores comfort and offers help with dressing where needed.

Ask the candidate

Which examination is indicated, and why? Separates the speculum and bimanual questions, consent and expected contribution; does not perform either by routine.

What would change the urgency of care? Haemodynamic instability, significant bleeding, possible ectopic pregnancy or suspected toxic shock require prompt assessment and escalation.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 3 of 3

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