The Diploma of the Faculty of Sexual and Reproductive Healthcare is the benchmark qualification for clinicians delivering contraceptive and sexual health care in UK primary care and community settings. Open to doctors, nurses, midwives, pharmacists, and physician associates, it is increasingly expected by employers for comprehensive contraception provision.
The DFSRH is not a single exam. It is a portfolio qualification with four assessment components — and the written components (OTA and AHD) are where adaptive Q-bank preparation makes the biggest difference.
Understanding the DFSRH — What It Actually Consists Of
Independent Learning Portfolio (ILP). Self-guided learning: topic investigations, case discussions, reflective entries, patient feedback. Runs throughout your 2-year DFSRH window.
Online Theory Assessment (OTA). 50 MCQs, 1 hour, online. Tests contraception, UKMEC, prescribing for specific populations, basic STI management. Fee: £85. Practice assessment available.
Summative Clinical Assessments (SCAs). Five workplace-based assessments during clinical placements with a registered FSRH trainer.
Assessment Half Day (AHD). Final summative: 1-hour written paper (MCQs, diagram labelling, short answers) + 4 VIVA/OSCE stations. Fee: approximately £260.
All four must be passed within 2 years of programme acceptance.
Written Exam Content
Domains tested: All contraceptive methods with detailed prescribing scenarios. UKMEC categories for every method-condition combination. STI management (BASHH guidelines). Early pregnancy. Cervical screening. Safeguarding (Fraser/Gillick). Menopause and HRT. Psychosexual medicine. Special populations (adolescents, disabilities, post-bariatric surgery).
Guidelines tested: FSRH guidelines (primary source), NICE, UKHSA/PHE, BASHH.
The UKMEC — Comprehensive Examination
The DFSRH tests UKMEC at greater depth than the DRCOG. You cannot just know the headlines.
High-yield population groups: Adolescents (Fraser/Gillick competence), postpartum and breastfeeding (specific timing for each method), older women (cumulative cardiovascular risk), migraine with and without aura, hypertension (threshold-dependent categories), diabetes with and without complications, DVT/PE history, liver disease, current breast cancer.
Emergency contraception UKMEC: Timing windows by method, efficacy comparisons, BMI/weight considerations for levonorgestrel, enzyme-inducing drug interactions for ulipristal, and copper IUD eligibility.
Hormonal IUD vs copper IUD: Different UKMEC profiles — know the specific differences.
STI Management
BASHH guidelines are the primary source — not NICE for most STIs.
High-yield: Chlamydia (NAAT, doxycycline first-line, partner notification), gonorrhoea (resistance, ceftriaxone IM, test of cure), trichomoniasis (metronidazole), bacterial vaginosis, syphilis (staging, benzathine penicillin, serological monitoring). HIV: PrEP, PEPSE, antiretroviral basics, testing protocols.
Best DFSRH Written Exam Resources in 2026
iatroX FSRH Adaptive Q-Bank
iatroX Boards provides 850+ adaptive questions mapped to the FSRH curriculum — the most comprehensive adaptive DFSRH resource. UKMEC-focused question sets, FSRH guideline integration, performance dashboard by domain. A single subscription includes DFSRH alongside DRCOG, DGM, DipIMC, FFICM, and other banks.
FSRH e-SRH Learning
The FSRH's own online learning platform. Maps to the curriculum. Essential for LoC components. Limitations for the written exam: learning modules, not question practice.
FSRH and BASHH Guidelines Directly
Download current FSRH guidance on contraception and BASHH guidelines for STIs. The exam tests the current guideline — outdated resources lead to wrong answers.
Letters of Competence — Practical Preparation
LoC IUC: Intrauterine contraception fitting (copper IUD and hormonal IUS). LoC SDI: Subdermal implant insertion (Nexplanon). Both require observed procedures, FSRH-approved trainer sign-off, and logbook completion.
LoC training takes months — begin in parallel with written exam preparation. This is practical skills training through local sexual health services, not Q-bank territory.
10-Week Written Exam Revision Plan
Weeks 1-2: iatroX baseline + UKMEC intensive. Weeks 3-4: CHC, POP — mechanisms, efficacy, side effects, missed pill rules, quick-starting. Week 5: IUC and SDI — theoretical knowledge. Week 6: STIs — BASHH guidelines, partner notification, resistance. Week 7: Menopause, HRT/MHT (NICE NG23, FSRH guidance). Week 8: Emergency contraception, psychosexual medicine, special populations. Weeks 9-10: Mixed adaptive sessions, mock exams, AHD VIVA practice.
Career Value
One of the highest-ROI GP diplomas. Community SRH contracts frequently require DFSRH. NHS enhanced services (coil fitting, implant services) typically require DFSRH or LoC. Pathway to MFSRH for SRH specialty careers.
Start at iatroX Boards — 850+ adaptive DFSRH questions.