If you are a GP, GP trainee, or a practice or sexual-health nurse preparing the DFSRH electronic Knowledge Assessment (eKA), you have almost certainly bought a commercial question bank and are quietly trusting its percentage. This article is a calibration method, not a ranking: read the FSRH official resources for question style, cognitive level and domain emphasis, then audit your commercial bank against them. It covers the eKA knowledge gate only — not the supervised clinical experience — and its principal limitation is that official material is finite, so it calibrates style, not stamina.
What FSRH's official resources give you right now
Current state, last checked 21 July 2026. Figures are FSRH-reported unless flagged, and you should re-check them on the day you read this, because the Faculty is mid-transition (see the exam anchor below).
- The eKA itself is the official assessment and the closest thing to an official specimen of the real house style. The format is 100 single-best-answer questions, five options each, up to two hours, computer-based, no negative marking, and an immediate pass/fail decision with no score breakdown.
- Fee and window: £75.00 per attempt, with 28 days to sit the online exam once you have paid; payments are non-refundable (FSRH-reported).
- Recommended learning: the e-SRH e-learning programme (produced with the College of Sexual and Reproductive Healthcare and e-Learning for Healthcare) is the FSRH-endorsed knowledge resource — free to NHS employees, with a fee for non-NHS learners.
- Curriculum and guidance: the diploma learning outcomes, the published subject list, and the eKA candidate guidance pages.
- AI / adaptive features: none. The eKA is a fixed, linear assessment. FSRH does not sell an adaptive practice engine, and it does not publish a large practice-question bank. Official practice volume is deliberately small.
- Standard-setting: items are reviewed by two experienced FSRH members and difficulty-rated by around ten trained question-writers using the modified Angoff method (FSRH-reported); over 3,000 candidates have sat it in three years (FSRH-reported).
The single most important thing on that list is what is absent: there is no official 800-item practice bank. That gap is by design, and it is precisely why calibration — reading the small amount of genuinely official material carefully and using it to grade everything else — is the highest-yield thing you can do.
The DFSRH pathway and where the eKA sits
The eKA is one component, not the whole diploma. The full DFSRH requires the e-SRH e-learning, a Course of Study, and supervised Clinical Experience signed off by a registered trainer, in addition to passing the knowledge assessment. The eKA is the knowledge gate; the clinical work is where competence is actually demonstrated.
One live housekeeping point worth stating plainly: the Faculty of Sexual & Reproductive Healthcare (FSRH) is transitioning to become the College of Sexual and Reproductive Healthcare (CoSRH), and the diploma is being renamed from DFSRH to DCSRH. During this transition they refer to the same qualification and the same eKA; if you land on a page badged "DCSRH" or "CoSRH", you are in the right place. Confirm the current name and fee on the official site before you pay.
The eKA blueprint is contraception-weighted. Its published subject areas span the main contraceptive methods and their UK Medical Eligibility Criteria (UKMEC), emergency contraception, sexually transmitted infection and vaginal-discharge assessment, asymptomatic STI screening, HIV testing, and the assessment and onward management of unplanned pregnancy — plus the consent, confidentiality and safeguarding themes that run through sexual and reproductive healthcare. Because this is contraception and hormonal prescribing, your factual sources are the SmPC on the eMC for individual products, sitting under FSRH clinical guidance, UKMEC, and NICE CKS — not a formulary handbook.
What actually counts as "official"
Before you can audit a commercial bank against the official material, you have to separate the genuinely official from the merely endorsed or the frankly commercial. For the DFSRH, the genuinely official layer is narrow and worth naming:
- The eKA candidate guidance and any demonstration/sample items FSRH publishes — the only sanctioned window onto the real question style.
- The published subject list and learning outcomes — the blueprint you audit coverage against.
- The e-SRH e-learning — FSRH-endorsed content that reflects examiner emphasis and terminology.
- FSRH clinical guidelines and UKMEC — the primary sources the correct answers are written from.
Everything else — third-party question banks, revision courses, unofficial "mock eKAs", crib sheets — is preparation, not specimen. Some of it is excellent. None of it is the exam. A commercial bank that says it is "mapped to the FSRH curriculum" is making a claim you can and should test, not a fact you should accept.
The signals to extract from the official material
When you sit an official sample item or work through an e-SRH knowledge check, you are not just checking whether you got it right. You are reading the construction so you can grade your commercial bank against it. Extract these signals deliberately:
- Stem length and shape. eKA-style stems tend to be short-to-moderate clinical vignettes with the decision-relevant facts (age, UKMEC-relevant history, current method, key result) and little padding.
- Option construction. Five options, single best answer, with plausible distractors drawn from real practice — not one right answer and four absurdities.
- Cognitive level. The target is application — choosing the right method, the right UKMEC category, the right next step — rather than isolated recall of a fact you could look up.
- Image and data use. Occasional data interpretation (for example a set of results guiding STI management), but this is a text-and-decision exam, not an image bank.
- Timing. Up to two hours for 100 items is roughly 72 seconds each — comfortable if you are decisive, tight if you deliberate.
- Negative marking. None — so leaving a blank is never correct strategy; a reasoned guess is always right.
- Domain emphasis. Contraception and UKMEC dominate; STI/HIV, unplanned pregnancy and safeguarding are consistently represented.
A side-by-side calibration matrix
You do not need to copy any item text to run this audit — indeed you must not. You compare dimensions. Sit the official sample once, note its signals, then pull a random handful from your commercial bank and score them on the same axes.
| Calibration dimension | FSRH official signal | Your commercial bank | Action if they diverge |
|---|---|---|---|
| Cognitive level | Application / next-step | Recall-heavy? | If your bank is more factual, add case-based reasoning practice |
| Stem length | Short–moderate vignette | Very short or bloated? | Re-time your practice to ~72s/item to match |
| Option plausibility | Five realistic options | Obvious distractors? | Treat easy blocks as warm-ups, not readiness signals |
| Domain weighting | Contraception/UKMEC-led | Over-indexed elsewhere? | Re-quota toward the official emphasis |
| Guidance currency | Current UKMEC/FSRH/CKS | Older thresholds? | Verify a stratified sample against live guidance |
| Timing pressure | 2h / 100 items | Untimed by default? | Always practise timed once past the learning phase |
Reading the discrepancies diagnostically
The point of the matrix is not to declare your bank "good" or "bad" but to characterise how it differs, because each difference implies a different fix. If your commercial bank is harder than the official style, that is usually fine for training but means its percentage will understate your readiness — do not panic at a low score. If it is easier or more factual, its percentage will overstate readiness, which is the dangerous direction. If it is narrower — heavy on combined pills, thin on emergency contraception or STI management — you have a coverage gap to fill, not a knowledge deficit. If it is differently worded, testing the same facts through unfamiliar phrasing, that is actually valuable transfer practice, provided you have first learned the concept from the official-style material. As the iatroX pillar on why bank completion is not blueprint coverage argues, a high completion percentage tells you how much of one bank you have seen, not how much of the blueprint you have mastered.
Preserve the calibration value of official material
Official material is a scarce, single-use calibration asset. The discipline is simple and strict: sit it unseen, timed, and once. The moment you rehearse an official sample item three times, you stop testing reasoning and start testing recognition — and recognition of a specimen you will never see again is worthless. Log the result the first time, use it to calibrate your commercial bank, and then leave it alone. Save re-testing for the large commercial and iatroX banks, where item volume means a repeat is genuinely a fresh retrieval rather than a memory of last Tuesday.
Translating findings into quotas and conditions: a seven-day plan
Here is a worked week for a clinician who has diagnosed, using the matrix above, that their commercial bank is contraception-strong but STI-thin and mostly recall-level. The official resources do one defined job — calibration and concept-building — and iatroX does another: unseen, timed transfer practice on a fresh block. No proprietary algorithm is implied; this is disciplined manual scheduling.
| Day | FSRH official / commercial job | iatroX job (unseen measurement) |
|---|---|---|
| 1 | Sit the official sample once, timed; record signals | 20-item timed baseline block, note domains missed |
| 2 | e-SRH module on STI/HIV assessment (your thin domain) | 15 fresh STI/sexual-health items, timed |
| 3 | Commercial bank: contraception/UKMEC set, learning mode | Retest only the concepts you got wrong on Day 1 |
| 4 | e-SRH module on emergency contraception + drug interactions | 15 fresh EC/interaction items, timed |
| 5 | Read one FSRH guideline you keep missing (verify on eMC/CKS) | 20-item mixed block under strict 72s/item timing |
| 6 | Rest or light review of error log | 15 fresh items across your two weakest domains |
| 7 | Sit a full 100-item mixed mock, unseen, timed, once | Review analytics; set next week's quotas from gaps |
Notice that the official material is never re-sat, iatroX supplies the volume the finite official set cannot, and quotas are driven by measured gaps rather than by finishing a bank.
Three mistakes this audit is designed to stop
Mistake one: trusting the commercial percentage as an exam-readiness score. A bank's percentage measures your performance on that bank, under whatever conditions you chose, against its own difficulty. It is not an eKA prediction. iatroX's standing caveat, Your Q-Bank Percentage Is Not Your Exam Score, is the canonical statement of why. Mistake two: mistaking recognition for reasoning by re-drilling the same items until you remember the answer position rather than the clinical logic. Mistake three: over-indexing on the easy, high-volume domain — usually combined pills — because it feels productive, while the thin domains that will actually decide a borderline pass go unrehearsed.
Decision checklist: continue, supplement, switch or stop
Base the decision on measurable gaps, never on novelty or the sunk cost of a subscription you have half-finished.
- Continue with your commercial bank if the matrix shows it matches the official cognitive level and domain weighting, and your unseen timed scores are trending up.
- Supplement with a second, differently-worded bank if you can complete the first without a gap in a domain the blueprint emphasises, or if your bank is factual and you need application practice. This is the two-Q-bank rule: add the second bank for coverage, not comfort.
- Switch if a stratified sample of your bank is materially out of step with current UKMEC/FSRH guidance — outdated is worse than thin.
- Stop adding banks and move to full timed mocks when you are covering the blueprint and your ceiling is stamina and calibration, not knowledge.
The bottom line
FSRH official resources are the gold standard for what the eKA rewards — application-level, contraception-weighted, guideline-anchored decision-making under mild time pressure — but they are deliberately low-volume and cannot give you the repetition a knowledge exam demands. That is the correct division of labour: use the official material once, unseen, to calibrate and to build concepts; use a well-audited commercial bank and iatroX for the volume and the unseen, timed transfer practice that turns knowledge into a reliable pass. Audit before you trust, and let measured gaps — not a completion bar — drive the plan.
Frequently asked questions
Is FSRH Official Resources enough for DFSRH on its own? For the eKA knowledge component, the official resources are necessary but not sufficient on their own, because the deliberately small volume of official practice material cannot deliver the repeated, timed retrieval a 100-item single-best-answer exam demands. The e-SRH e-learning and curriculum are the right foundation and the correct calibration reference, but most candidates pair them with a higher-volume question bank for practice. Critically, the official resources also cannot deliver the supervised Clinical Experience and Course of Study that the full diploma requires — those are separate, in-person components, not knowledge revision.
Which DFSRH component does FSRH Official Resources not reproduce well? No revision resource, official or commercial, reproduces the supervised Clinical Experience or the practical assessment of competence — the parts of the DFSRH where you demonstrate contraceptive counselling, method fitting and safe practice under a registered trainer. The official knowledge material calibrates the eKA well because it is the exam body's own content, but it is designed to teach and to certify knowledge, not to simulate a consultation or a fitting. Treat the clinical pathway as a distinct workstream that revision cannot shortcut.
How many FSRH Official Resources questions should I complete per day for DFSRH? Because the genuinely official practice volume is small, the honest answer is that you should not try to hit a daily count from official items at all — you should sit any official sample once, unseen and timed, and preserve it as a calibration asset rather than a daily drill. For daily volume, most candidates work through one or two e-SRH modules and around 20–40 practice questions from a commercial or iatroX bank, adjusting to the weeks remaining and the domains their audit flagged as weak, rather than to an arbitrary target.
When should I stop using FSRH Official Resources and move to mixed mocks? You should stop using official items as practice the moment you have extracted their calibration signals — realistically after a single timed sitting — because rehearsing a small, finite set converts reasoning into recognition. Move to full, mixed, timed 100-item mocks once your audited bank shows you are covering the blueprint and your remaining limitation is timing and stamina rather than knowledge, typically in the final two to three weeks before your booked eKA window.
How should I combine FSRH Official Resources with iatroX without duplicating practice? Give each a distinct, non-overlapping job: use the official resources once for calibration and concept-building, and use iatroX for unseen, timed transfer practice on fresh items you have not met, so that no question is doing double duty. In practice that means you never re-sit an official sample, you drive your iatroX quotas from the domains the official audit exposed as thin, and you read your iatroX analytics as a measure of transfer — not as an exam prediction. Keep the two layers separate and each stays honest.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 21 July 2026. Figures for the eKA fee, window and standard-setting are FSRH-reported and may change — verify the current fee, exam window and diploma name (DFSRH/DCSRH) on the official site before you rely on them. Disclosure: iatroX operates a UK question bank that competes with commercial DFSRH banks; in this article iatroX is confined to the eKA knowledge and unseen-MCQ measurement layer only, and it does not provide the Course of Study, supervised Clinical Experience or practical assessment the diploma requires. Corrections are welcome via the feedback route on iatrox.com.
References: FSRH electronic Knowledge Assessment (eKA) candidate pages and "The FSRH eKA — the gateway to FSRH qualifications", fsrh.org; e-SRH e-learning via the College of Sexual and Reproductive Healthcare and e-Learning for Healthcare (e-lfh.org.uk); UKMEC and FSRH clinical guidance; NICE CKS Contraception; product SmPCs via the eMC. Internal: Your Q-Bank Percentage Is Not Your Exam Score; completion is not coverage; the iatroX comparison hub; the iatroX DFSRH question bank.