The Assessment Half Day is the final summative assessment of the DFSRH — and it is the component that candidates find most anxiety-provoking. It combines a written paper with face-to-face (or virtual) clinical stations, testing not just your knowledge but your ability to apply it in simulated clinical scenarios.
The Format
Part 1 — Written Paper (60 minutes). Based on the DFSRH curriculum. Includes multiple-choice questions, diagram labelling (anatomy of reproductive organs, IUD/IUS positioning), and short-answer questions. This tests knowledge depth and detail — including areas that the MCQ-only OTA does not cover, such as anatomy, device mechanisms, and clinical reasoning expressed in writing.
Part 2 — Four VIVA/OSCE Stations. You rotate through four stations, each with a case scenario. Before each station, you have a short reading time to understand the scenario. Inside the station, an examiner asks structured questions about the case — similar to a viva or structured oral examination. One station typically involves a simulated patient interaction (history taking or counselling).
The stations test clinical reasoning, contraceptive decision-making, UKMEC application, STI management, communication skills, and professional judgement. You must demonstrate that you can think through clinical scenarios systematically, not just recall facts.
What Examiners Look For
Structured clinical reasoning. When presented with a case, the examiner wants to see a systematic approach: identify the clinical issue, consider the relevant factors (medical history, UKMEC category, patient preferences), discuss the options, justify your recommendation, and address safety-netting. Jumping straight to an answer without showing your reasoning scores poorly.
Accurate UKMEC application. The examiners will present cases where UKMEC categorisation directly determines the management. You must correctly identify the relevant conditions, assign the UKMEC category for each contraceptive method, and explain the clinical implications. Getting the UKMEC category wrong in a station is a significant error.
Patient-centred communication. The simulated patient station tests whether you can explain contraceptive options clearly, explore the patient's preferences and concerns, and support informed decision-making. Lecturing the patient about methods without exploring their perspective scores poorly. Use the FSRH's patient-centred approach: ask what matters to the patient, then tailor your counselling.
Safe STI management. Stations may present STI scenarios requiring correct investigation, treatment, partner notification, and follow-up planning. Know the current BASHH guidelines for first-line management.
Safeguarding awareness. Any scenario involving a young person, a vulnerable adult, or a disclosure of risk should trigger appropriate safeguarding responses. Recognise when to ask, when to act, and when to escalate.
How to Prepare
Practise speaking through clinical scenarios out loud. The VIVA format requires you to articulate your reasoning verbally — which is a different skill from selecting the correct MCQ option. Practise with colleagues: one reads a case scenario, the other talks through their approach while the first person provides feedback.
Review the UKMEC table until it is automatic. Under exam pressure, you cannot afford to deliberate on whether CHC in a 37-year-old smoker is Category 3 or 4. It must be immediate. The iatroX DFSRH Q-Bank includes UKMEC scenario questions that build this automaticity through spaced repetition.
Practise diagram labelling. The written paper may include anatomy diagrams (female reproductive anatomy, IUD positioning, implant insertion site). Draw them from memory during revision until the anatomy is accurate.
Review your SCA cases. The scenarios in the AHD are similar to the clinical situations you encountered during your SCAs. Reflecting on your SCA experiences and the clinical reasoning you applied prepares you for the AHD stations.
Use Ask iatroX during your preparation period to verify clinical decisions — STI management, contraceptive eligibility, and safeguarding responses. The instant guideline reference builds confident, accurate clinical reasoning.