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The Diploma in Geriatric Medicine — awarded by the RCP in collaboration with the BGS — validates competence in the assessment and management of older adults. Open since 2021 to doctors, nurses, AHPs, pharmacists and physician associates. Two-part exam: an online Knowledge-Based Assessment (KBA) and a four-station OSCE at The Spine, Liverpool. AI-adaptive question bank mapped to the published DGM syllabus and assessment framework.
Full DGM bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
100 best-of-five SBA questions · 3 hours · delivered online with remote proctoring via Orzone. Held once per year. AI and facial-recognition monitoring during the exam. Candidates must first pass the KBA before sitting the OSCE.
Four stations × 15 minutes each + 5 minutes reading time before each station. Format changed from November 2024. The four stations are: Integrated Clinical Assessment 1, Comprehensive Geriatric Assessment (CGA), Ethical and Legal Principles in Practice, and Integrated Clinical Assessment 2. Held at the RCP Assessment Centre at The Spine, Liverpool twice yearly (June and November).
Two examiners per station, ten marksheets total across the OSCE. Nominal pass mark: 29/40. Standard set per diet by the DGM Lead Clinical Examiner.
Open to all statutorily regulated healthcare practitioners (doctors, nurses, AHPs, pharmacists, physician associates on the managed voluntary register) currently registered and in good standing with the relevant regulator. At least 2 years' post-qualification experience and at least 4 months in a setting with high elderly patient contact.
Once you pass the KBA, you have 4 years to complete the OSCE. Maximum 6 attempts per component.
2026 OSCE dates: 1-2 June (additional dates same week may be added depending on application numbers) — results 1 July 2026. 3 November KBA sitting (typical pattern). 2-3 November OSCE — results 2 December 2026. Confirm current dates and application windows on the RCP DGM page.
Approximate distribution across the DGM syllabus. The exam emphasises common geriatric syndromes and the comprehensive geriatric assessment (CGA) framework — the organising principle of geriatric medicine.
Mapped to the published DGM syllabus and prioritised using item-density signals across the iatroX bank.
Comprehensive Geriatric Assessment (CGA) — the organising principle of geriatric medicine. Domains: medical (problem list, active diagnoses, medication review), functional (Barthel ADLs, IADLs), cognitive (4AT for delirium, MoCA/AMTS for cognitive assessment), psychological (Geriatric Depression Scale), social, nutritional (MUST). Evidence base from Cochrane.
Delirium — 4AT vs CAM differentiation, distinguishing from dementia (acute onset, fluctuating attention), TIME bundle for prevention, antipsychotic use in older adults (risks, indications, when avoided in DLB), 4AT score interpretation (0 unlikely, 1-3 cognitive impairment, ≥4 possible delirium)
Falls — multifactorial assessment per NICE NG161, postural hypotension thresholds (drop ≥20 mmHg systolic or ≥10 mmHg diastolic), medication review (anticholinergics, sedatives, opioids, antihypertensives), STEADI framework. Bone protection in fracture prevention.
Anti-dementia therapies — donepezil, rivastigmine, galantamine (AChE inhibitors), memantine (NMDA antagonist), when to start, when to stop. Emerging anti-amyloid therapies (lecanemab, donanemab) and ARIA-E/ARIA-H monitoring intervals, APOE-ε4 genotyping, eligibility (early symptomatic AD with biomarker confirmation).
STOPP/START version 3 (2023) — anticholinergic burden, drug-disease interactions, deprescribing thresholds. Differs from Beers criteria. Version 3 includes new categories for emerging medications.
Parkinson's disease management — levodopa wearing-off (entacapone, opicapone, safinamide, istradefylline), deep brain stimulation criteria, psychosis (quetiapine, clozapine, pimavanserin), end-of-life Parkinson's care including non-oral medication.
Mental Capacity Act — functional test (understand, retain, weigh up, communicate), best interests, IMCA referrals, attorneys (LPA-health-and-welfare) vs deputies. Liberty Protection Safeguards (LPS) framework rolled out from 2024 replacing DoLS — both are examined.
End-of-life prescribing — anticipatory medications, opioid oral-to-subcutaneous conversion (typically 2:1 ratio for oral morphine to subcutaneous), midazolam for terminal agitation, glycopyrronium for secretions, hyoscine alternatives.
Observations from UK trainees and recent DGM candidates. Verify against current NICE, BGS and MCA Code of Practice guidance.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent DGM passers, balancing the KBA knowledge with OSCE practical skill development.
A live item from the iatroX bank. Try it before launching a full session.
An 86-year-old woman is reviewed in a community geriatric clinic because of worsening urinary urgency, frequency and urge urinary incontinence. She has mixed Alzheimer’s and vascular dementia, chronic constipation and hypertension. She completed an adherent 8-week bladder-training programme, with reduced caffeine intake and optimisation of fluid intake, but remains troubled by urgency and leakage. She reports hesitancy, a weak urinary stream and a sensation of incomplete emptying. Urine dipstick is negative for blood, leucocytes, nitrites and glucose. Abdominal examination is unremarkable. A post-void bladder scan, repeated after a second attempt to void, shows 420 mL residual urine. Her blood pressure is 186/112 mmHg on two properly performed measurements. Regular medicines include donepezil, amlodipine and macrogol. What is the most appropriate next management step for her urinary symptoms?
Why iatroX is built differently for DGM.
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 DGM bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
Since 2021 the DGM has been open to all statutorily regulated healthcare practitioners — doctors, nurses, AHPs (allied health professionals), pharmacists, and physician associates on the managed voluntary register — currently registered and in good standing with the relevant regulator. Applicants need at least 2 years' post-qualification experience, with at least 4 months in a setting with high elderly patient contact.
KBA: once per year online. 2026 OSCE dates: 1-2 June (results 1 July 2026) and 2-3 November (results 2 December 2026). Additional dates in the same OSCE week may be added depending on application numbers. Confirm current dates on the RCP DGM page.
Two parts. Part 1 KBA: 100 BoF SBA questions over 3 hours, online with remote proctoring via Orzone. Part 2 OSCE: four stations × 15 minutes + 5 minutes reading, held at The Spine, Liverpool. The OSCE format changed in November 2024 — stations now are Integrated Clinical Assessment 1, CGA, Ethical and Legal Principles, and Integrated Clinical Assessment 2.
Yes. Candidates must first pass the KBA in order to be eligible to sit the clinical exam (OSCE). You have 4 years from KBA pass to complete the OSCE.
Maximum 6 attempts per component. Both Part 1 (KBA) and Part 2 (OSCE) must be passed. If you fail the KBA, the next sitting is the following year (KBA is once per year).
The DGM (Diploma) is open to GPs, AHPs and other MDT members in addition to doctors — and is pitched at the standard of a competent practitioner in older people's care. The SCE in Geriatric Medicine is a UK specialty trainee CCT requirement for geriatricians, with greater depth across all subspecialty areas. Many GPs with care-home interest hold the DGM; geriatrics trainees hold the SCE.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the DGM bank alongside DRCOG, DFSRH, and every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
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