DCSRH questions and Diploma preparation.

Choose a topic for focused revision and check your plan against the official specification.

• Combined hormonal contraception (CHC) — CHC pill, patch, ring + UKMEC categories
• Progestogen-only contraception — POP, injectable, LARC implant counselling
• Intrauterine contraception — Cu-IUD, levonorgestrel IUS (52 mg, 19.5 mg, 13.5 mg) indications
• Emergency contraception — levonorgestrel, ulipristal acetate, copper IUD timing windows
• UKMEC categories 1–4 — population groups (adolescents, postpartum, breastfeeding, comorbidities)
• Sexually transmitted infections — BASHH guidelines (chlamydia, gonorrhoea, syphilis, HIV testing)
• Unplanned pregnancy — pregnancy choices counselling, abortion law (incl. Northern Ireland 2020 update)
• Menstrual disorders — HMB, dysmenorrhoea, premenstrual disorders, perimenopause
• Subfertility — primary care assessment, when to refer, basic investigations
• Vulval and vaginal symptoms — candida, bacterial vaginosis, vulval dermatoses, lichen sclerosus
• Cervical screening (NHS programme) — HPV primary screening, intervals, colposcopy referral
• Sexual health in special groups — adolescents (Fraser/Gillick), gender-affirming care, post-menopausal

Drawn from the FSRH clinical effectiveness guidance, UKMEC, BASHH STI guidelines and item density across the iatroX bank.

• UKMEC depth — the DFSRH tests UKMEC at greater depth than the DRCOG. High-yield categories: migraine with vs without aura (different CHC eligibility), hypertension thresholds, BMI thresholds for CHC, smoking + age + CHC, diabetes with vs without complications, VTE history, breast cancer (current vs past)
• Emergency contraception choice — levonorgestrel ≤72 hours (BMI/weight considerations, less effective >70 kg), ulipristal acetate ≤120 hours (avoid concurrent progestogens for 5 days, P450 inducer interactions), Cu-IUD ≤120 hours (most effective regardless)
• Postpartum and breastfeeding contraception — CHC restrictions in first 6 weeks postpartum (UKMEC 4 if breastfeeding, varies if not breastfeeding by VTE risk), POP and LARC safe immediately, IUD ≤48 hours or ≥4 weeks postpartum
• IUD/IUS counselling — failure rates, return to fertility, expulsion risk (highest first 3 months), perforation risk (1-2 per 1000 insertions), ectopic risk if conception occurs (relatively higher proportion but absolute risk low)
• BASHH STI management — chlamydia (NAAT, doxycycline first-line, partner notification, test of cure not routine), gonorrhoea (ceftriaxone 1g IM, resistance considerations, test of cure mandatory), syphilis (staging, treatment regimens, follow-up serology)
• CHC and migraine — migraine with aura is UKMEC 4 for CHC (absolute contraindication) due to stroke risk. Migraine without aura is UKMEC 2 for initiation, UKMEC 3 for continuation. Onset of new aura on CHC is UKMEC 4 and requires immediate switch.
• P450-inducing drugs — rifampicin, rifabutin, anticonvulsants (carbamazepine, phenytoin, phenobarbital, primidone, topiramate), modafinil, St John's Wort. Affect CHC efficacy and ulipristal — counsel about back-up methods or alternative methods.
• Adolescents and Fraser competence — providing contraception, abortion advice and STI testing to under-16s. Fraser specifically applies to contraception/sexual health; Gillick is broader competence framework. Cervical screening starts at 25 in the UK (varies in devolved nations).

Observations from UK SRH practitioners and recent DFSRH candidates. Verify against current FSRH guidelines and UKMEC.

Candidate-reported observations — not official guidance.

1. UKMEC Category 3 vs 4 distinctions — Category 3 means risks usually outweigh benefits (use only if no alternative, with careful counselling); Category 4 is absolute contraindication. Mixing these up is the single most common error.
2. Hormonal IUD vs Cu-IUD UKMEC differences — Cu-IUD is hormone-free and has different UKMEC profile than the LNG-IUS. For example, Cu-IUD is preferred over LNG-IUS in some scenarios (e.g. severe migraine), and vice versa. Know which is preferred in which condition.
3. Emergency contraception — BMI considerations for levonorgestrel (less effective at BMI >26 or weight >70 kg). Drug interaction considerations for ulipristal (5-day washout for progestogens, P450 inducers reduce efficacy).
4. Outdated revision sources — FSRH guidelines update regularly. CHC, POP, LARC, EC, postpartum contraception all have recent updates. Always check publication dates on revision materials.
5. Cervical screening intervals — HPV primary screening replaced cytology in 2019/2020. Intervals depend on age and HPV status. Negative HPV at 25-49 = 3 years; at 50-64 = 5 years; HPV-positive cytology-negative = 12-month recall. Older revision materials still teach pre-HPV intervals.
6. Abortion law — Northern Ireland decriminalised abortion in 2020 (different framework from rest of UK). The 1967 Abortion Act applies in England, Wales and Scotland with 24-week limit and grounds. NI uses different regulations.
7. BASHH for STIs vs NICE — for most STIs the primary reference is BASHH, not NICE. Many candidates over-rely on NICE and miss BASHH-specific recommendations (e.g. test of cure for gonorrhoea, partner notification timeframes).
8. OTA preparation — practise applying the relevant recommendation to the supplied case within the 50-question, one-hour open-book format. Use the Training Hub practice test for official familiarisation.

A suggested sequence to agree with your trainer within the two-year completion window.

1. Months 1–3

   Agree learning needs and the assessment sequence with your College Registered Trainer. Begin the ILP and arrange clinical opportunities. Use questions to identify theory distinctions needing review.

2. Months 4–6

   Work on identified knowledge gaps and the OTA practice test. Complete appropriate observed clinical assessments and record evidence on the Training Hub.

3. Months 7–9

   Complete and obtain sign-off for all five Summative Clinical Assessments before the AHD. Rehearse the written and observed activities that remain difficult.

4. Months 10–12

   Complete the remaining OTA, portfolio and AHD work in the sequence agreed with your trainer. Check all sign-offs and College completion steps within your actual two-year deadline.

Dedicated DCSRH question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

The current qualification is DCSRH, awarded by CoSRH. The iatroX /dfsrh address retains the legacy name. Check the College eligibility and enrolment requirements for your professional route.

Independent Learning Portfolio, Online Theory Assessment, five Summative Clinical Assessments and Assessment Half Day. Evidence is recorded on the Training Hub and signed off by a College Registered Trainer.

The College specifies two years from application approval to complete the four assessments. Agree the sequence with your trainer and book the activities that depend on other people early.

DCSRH is a trainer-supported sexual and reproductive healthcare Diploma with portfolio and observed assessments as well as theory. DRCOG is a separate RCOG written examination with a broader women's-health scope. Match the resource to the qualification and component you need.

Letters of Competence are separate procedural qualifications. Check the current College route, training and sign-off requirements for the procedure relevant to your role rather than treating a Diploma question-bank subscription as procedural authorisation.

The OTA contains 50 single-best-answer questions in one hour, open book on the Training Hub. The pass mark is 60% (30/50), with up to three attempts. Check the College rules for booking and additional attempts.

Full DCSRH bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.