The Diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH) is the benchmark qualification for clinicians delivering contraceptive and non-specialist sexual health care in UK primary care and community settings. It is open to doctors, nurses, midwives, pharmacists, and physician associates — and it is increasingly expected by employers for anyone providing contraception services.
The qualification involves four assessment components completed over up to two years. Understanding each component, the order in which to tackle them, and the preparation required is the difference between a smooth journey and a frustrating one.
The Four Components
1. Independent Learning Portfolio (ILP). A structured self-guided learning programme combining topic investigations, case discussions, reflective entries, and patient feedback. The ILP builds the theoretical and clinical foundation for the other assessments. It runs throughout your DFSRH period and is typically completed alongside clinical placements and the other components.
2. Online Theory Assessment (OTA). A 50-question multiple-choice assessment taken online. 1 hour. Tests breadth of theoretical knowledge across contraception, the UKMEC (UK Medical Eligibility Criteria for Contraceptive Use), prescribing for specific populations, and basic STI management. Fee: £85 per attempt. A practice assessment is available.
The OTA is where most candidates start their formal assessment. It tests whether you have the theoretical foundation to apply in clinical settings — and it is the component where dedicated Q-bank practice makes the biggest difference.
3. Summative Clinical Assessments (SCAs). Five workplace-based clinical assessments conducted during your clinical placements. These test your ability to deliver contraceptive care in real clinical settings — taking histories, counselling patients, and managing clinical scenarios under observation. You need a registered FSRH trainer to conduct these assessments.
4. Assessment Half Day (AHD). The final summative assessment. Consists of a 1-hour written paper (MCQs, diagram labelling, short answers) and 4 VIVA/OSCE-style stations where you rotate through case scenarios, answering examiner questions and demonstrating clinical reasoning. Can be face-to-face or virtual depending on the provider. Fee: approximately £260.
All four components must be passed. You have two years from formal acceptance onto the programme to complete everything.
The Realistic Timeline
Months 1-3: Complete the ILP foundation modules. Begin OTA preparation with the iatroX DFSRH Q-Bank — 850+ curriculum-mapped questions with adaptive spaced repetition. Learn the UKMEC categories thoroughly. Start clinical placements if available.
Months 3-6: Sit the OTA. Continue clinical placements and begin SCAs. Deepen your STI knowledge and contraceptive counselling skills.
Months 6-12: Complete the remaining SCAs. Continue ILP entries. Prepare for the AHD.
Months 12-18: Sit the AHD. Complete any remaining ILP requirements. Submit the portfolio.
This timeline is achievable alongside clinical work. Many candidates complete the DFSRH in 12-18 months rather than the full 24-month window.
How to Prepare
The iatroX DFSRH Q-Bank provides 850+ curriculum-mapped questions covering contraception, UKMEC, STIs, early pregnancy, cervical screening, and clinical decision-making. The adaptive spaced repetition targets your weakest areas — whether that is UKMEC Category 3/4 distinctions, STI management algorithms, or emergency contraception eligibility. A single subscription at iatroX Boards includes access to multiple Q-banks.
Ask iatroX provides instant clinical reference during study and — critically — during your clinical placements and SCA assessments. When a patient asks a contraception question you are unsure about, the guideline-grounded answer is available in seconds on your phone.
The FSRH e-SRH e-learning modules (free for UK healthcare professionals) provide the theoretical foundation. Combine these with iatroX Q-bank practice and you have comprehensive preparation for the OTA and AHD.