The DFSRH OTA is 50 MCQs in 60 minutes — and the question topics follow a predictable pattern. Understanding what comes up allows you to focus your preparation on the highest-yield areas.
The Most Common Question Categories
UKMEC application (approximately 25-30% of questions). Clinical scenario: a patient with a specific medical condition wants contraception. Which methods are Category 1, 2, 3, or 4? The OTA heavily tests the Category 3/4 boundaries — particularly for CHC (combined hormonal contraception) in conditions like migraine with aura, smoking over 35, BMI >35, and VTE history.
Contraceptive method selection (approximately 20-25%). Given a clinical scenario (patient preferences, medical history, lifestyle factors), which contraceptive method is most appropriate? These questions test your ability to integrate UKMEC categories with patient-centred decision-making.
Emergency contraception (approximately 10-15%). Eligibility for levonorgestrel vs ulipristal acetate vs copper IUD based on timing, drug interactions (enzyme inducers), BMI, and clinical circumstances. The copper IUD as the most effective emergency method and its contraindications.
STI management (approximately 15-20%). First-line treatment for common STIs, testing protocols, partner notification principles, and management in pregnancy.
Practical prescribing scenarios (approximately 10%). Quick-starting contraception, bridging methods, switching between methods, managing missed pills (and the different rules for different pill types), and drug interactions affecting contraceptive efficacy (enzyme-inducing drugs).
Safeguarding, consent, and professional practice (approximately 5-10%). Fraser/Gillick competence, under-16 consultations, mandatory reporting triggers, and confidentiality in sexual health settings.
The Scenarios That Catch Candidates Off Guard
The enzyme-inducing drug interaction. A patient on carbamazepine (or rifampicin, phenytoin, etc.) wants contraception. Which methods are affected? CHC, POP, and emergency levonorgestrel/ulipristal are all affected by enzyme inducers. Depo-Provera injection, IUD, IUS, and implant (with caveats) are not. Know the specific interactions.
Quick-starting contraception. A patient wants to start contraception today but their pregnancy status is uncertain. When can you quick-start? What bridging advice do you give? What pregnancy test timing is appropriate?
The complex UKMEC patient. A patient with multiple conditions — e.g., BMI 33, smoker, aged 34 with well-controlled hypertension. Each condition alone might be Category 2, but in combination they may push toward Category 3. The OTA tests your ability to consider cumulative risk.
How to Prepare
The iatroX DFSRH Q-Bank with 850+ questions covers every category above with adaptive spaced repetition. The questions mirror the OTA format — clinical scenarios requiring UKMEC application, method selection, STI management, and prescribing decisions. Ask iatroX provides instant reference when Q-bank explanations leave gaps.