loading exam hub…
loading exam hub…
The benchmark qualification for clinicians delivering contraceptive and non-specialist sexual health care in UK primary care — open to doctors, nurses, midwives, pharmacists and physician associates. A portfolio diploma combining e-learning, online theory assessment, clinical skills and reflective learning, completed over up to 2 years. Mapped to FSRH guidelines, UKMEC and BASHH guidance.
Self-guided learning programme combining topic investigations, case discussions, reflective entries and patient feedback. Runs throughout your 2-year DFSRH window. Builds the theoretical and clinical foundation.
50–64 single best answer items over 1 hour, delivered at Pearson VUE centres across the UK. Tests contraception, UKMEC, prescribing for specific populations, basic STI management. Standard-setting per diet using Angoff methodology.
A one-day clinical assessment day run by FSRH-registered trainers, where you demonstrate practical skills in contraception consultation, history-taking, examination, decision-making and patient communication.
LoC IUC (Intrauterine Contraception fitting — Cu-IUD and hormonal IUS) and LoC SDI (Subdermal Implant insertion — Nexplanon). Both require observed procedures, FSRH-approved trainer sign-off, and logbook completion. LoCs are typically pursued in parallel or after the DFSRH.
All DFSRH components must be completed within a 2-year window from registration. After passing, the DFSRH requires 5-yearly recertification (CPD-based) to remain in good standing.
OTA sittings are held throughout the year at Pearson VUE centres — typically rolling availability. Application via the FSRH website (fsrh.org/education-and-training/diploma/). Confirm current OTA dates, fees and the Course of 5 trainer directory on the FSRH website. Confirm the 2026 sitting and booking dates on the official awarding-body page before booking.
Approximate distribution across the DFSRH syllabus. The exam tests contemporary FSRH-aligned UK primary care and community SRH practice, with UKMEC and FSRH guidelines as the primary references.
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.
A pragmatic phased approach used by recent DFSRH passers, recognising the portfolio components (ILP, Course of 5, OTA) run in parallel.
A live item from the iatroX bank. Try it before launching a full session.
A 17-year-old requests EC after condom failure with a new partner. She has no symptoms and declines examination today. What is the most appropriate investigation?
Why iatroX is built differently for DFSRH.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the DFSRH bank plus every other premium iatroX exam bank.
Cancel anytime · 30-day money-back guarantee on annual
The DFSRH is open to doctors, nurses, midwives, pharmacists and physician associates with current registration with the relevant regulator. It is the benchmark qualification for clinicians delivering contraceptive and non-specialist sexual health care in UK primary care and community settings.
Four components: (1) Independent Learning Portfolio (ILP) — self-guided learning over 2 years; (2) e-SRH e-learning modules — 18 modules in total, 1-14 core plus 15 assessment, 16-18 optional/LoC theory; (3) Online Theory Assessment (OTA) — 50-64 SBAs at Pearson VUE; (4) Course of 5 — one-day clinical assessment with an FSRH-registered trainer.
All components must be completed within a 2-year window from registration. After passing, the DFSRH requires 5-yearly recertification (CPD-based) to remain in good standing.
DRCOG (Royal College of Obstetricians and Gynaecologists) covers a broader women's health curriculum including obstetrics, gynaecology and SRH. DFSRH focuses specifically and deeply on contraception, sexual health and pregnancy choices. UKMEC is tested at greater depth in DFSRH. Many GPs hold both diplomas.
LoC IUC and LoC SDI are separate add-on qualifications required to fit IUDs/IUS and implants. They are not part of the DFSRH itself but are commonly pursued in parallel. NHS contracts for LARC services typically require relevant LoC. Each LoC requires observed procedures, trainer sign-off, and logbook completion.
Criterion-referenced — set per diet using Angoff methodology by an FSRH standard-setting panel. There is no fixed percentage pass mark. The pass standard accounts for paper difficulty and aims to identify the standard expected of a safe primary care SRH practitioner.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the DFSRH bank alongside DRCOG, DGM, and every other premium iatroX exam bank. No add-ons or per-exam fees.
Other iatroX hubs you may find useful.
see how iatroX compares to PassMedicine, Quesmed, NICE CKS, BNF.
Reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.