The Faculty of Sexual and Reproductive Healthcare awards several qualifications, and the relationship between them confuses many clinicians. The three most common — DFSRH, LoC SDI, and LoC IUT — overlap in content but differ in what they qualify you to do.
DFSRH (Diploma)
What it covers: Comprehensive contraceptive care including all methods (hormonal, barrier, emergency), UKMEC application, basic STI management, cervical screening, early pregnancy, and safeguarding. It is the broadest SRH qualification below specialist level.
What it qualifies you to do: Deliver contraceptive consultations, prescribe all non-procedural methods, provide sexual health counselling, and manage basic STIs. It does not qualify you to fit implants or IUDs — those require additional LoC qualifications.
Who needs it: Any clinician delivering contraception services in primary care, community clinics, sexual health services, or general practice. Increasingly expected by employers for GP trainees, practice nurses, and sexual health nurses.
Assessment: ILP + OTA (50 MCQs, online) + 5 SCAs + AHD (written + 4 stations).
LoC SDI (Letter of Competence — Subdermal Implants)
What it covers: Insertion and removal of subdermal contraceptive implants (Nexplanon). Includes e-learning, clinical training, and practical assessment.
What it qualifies you to do: Insert and remove subdermal implants independently.
Who needs it: Clinicians who want to provide implant services — typically GP practice nurses, sexual health nurses, and GPs offering LARC in primary care.
Assessment: OTA (if not already passed for DFSRH) + clinical training + practical assessment.
LoC IUT (Letter of Competence — Intrauterine Techniques)
What it covers: Insertion of IUDs and IUS. Includes e-learning, clinical training sessions, and practical assessment. Requires competence in bimanual examination.
What it qualifies you to do: Insert and remove intrauterine devices and systems independently.
Who needs it: Clinicians providing IUD/IUS services — sexual health doctors, GPs with a special interest, and nurses in dedicated contraception clinics.
Assessment: OTA (if not already passed) + clinical training sessions + practical assessment.
Which Do You Need?
If you are delivering contraception consultations but not fitting devices: DFSRH alone. It covers everything you need for non-procedural contraceptive care.
If you want to fit implants: DFSRH + LoC SDI. The diploma gives you the knowledge foundation; the LoC gives you the procedural competence.
If you want to fit IUDs/IUS: DFSRH + LoC IUT. Same principle — knowledge foundation plus procedural competence.
If you want to provide comprehensive LARC services: DFSRH + LoC SDI + LoC IUT. This is the full qualification set for a clinician offering all contraceptive methods including procedural LARC.
Preparation Across All Qualifications
The OTA is shared between the DFSRH and the LoC qualifications — if you pass it for the DFSRH, you do not need to retake it for LoC SDI or IUT. The clinical knowledge tested is the same across all qualifications.
The iatroX DFSRH Q-Bank with 850+ curriculum-mapped questions prepares you for the OTA that all these qualifications require. Ask iatroX provides the clinical reference for contraceptive decision-making that supports both exam preparation and day-to-day clinical practice. A single subscription at iatroX Boards gives you access to the DFSRH Q-Bank alongside other specialty Q-banks.