Objectives: To evaluate the performance of international medical graduates in the MRCOG Part 1 and Part 2 written examinations. Study design: Using the database of the Royal College of Obstetricians and Gynaecologists, a retrospective analysis was performed of the performance of overseas candidates who appeared for the first time in the Part 1 (n = 11,863) and Part 2 written (n = 5336) MRCOG examinations between 2000 and 2010. Candidates were grouped according to the RCOG geographical bands. Results: In the Part 1 MRCOG examination the graduates of band E (India and Pakistan) and band B (Australia, New Zealand and Canada) performed well (pass rate 41.2% and 39.3% respectively) but the candidates of band C (East Africa 27.1%) and bands J and A (Europe 29.9%, Ireland 17.9%) underperformed. In the MRCOG Part 2 written examination the medical graduates of band D (Singapore and Hong Kong) and band B (Australia, New Zealand and Canada) performed well (pass rates 65.9% and 54.8%), but the candidates of band H (Middle East, pass rate 8.5%) and band C (Africa West, pass rate 12.7%) performed worse than the remaining cohort. The greatest number of candidates in the Part 2 written examinations appeared from India and Pakistan (n = 2999, pass rate 22.2%). Conclusion: Our results have shown that there is variation in performance among the IMG from different geographical regions in the Part 1 and Part 2 written MRCOG examinations. (c) 2012 Elsevier Ireland Ltd. All rights reserved.