Letter of Competence Intrauterine Techniques (LoC IUT)

This is a training programme aimed at Doctors, Nurses, Midwives and Physician Associates already working in general practice and community sexual health services who wish to develop the necessary knowledge, attitude and skills to support women seeking contraception. It will enable them to hold consultations, provide intrauterine contraception competently, and manage any complications or side-effects that may occur.

The training involves both theoretical knowledge and practical training. We recommend that you start by reading the Guidance Document and the Learning Outcomes for the LoC IUT. You may find our list of General Training terminology helpful to reference alongside these documents.

For those individuals that started the LoC IUT before July 2020 (using our previous version of Record of Training Form and the other previous requirements) we will still be accepting your completed applications. You simply need to upload the completed form via MyFSRH in the usual way. 

Entry Criteria

You must be one of the above FSRH approved healthcare professionals to undertake this qualification.  

Check our FAQs here to find out some common questions and answers about our Letters of Competence qualifications.

What/How do I study?

You must ensure you fulfil all the requirements for the Letter of Competence in Intrauterine Techniques (LoC IUT) to allow a successful application. Successful applicants must meet the following entry requirements: 


The entry requirements for the Letter of Competence in Intrauterine Techniques (LoC IUT)

Successful applicants must:

  • Be a Healthcare Professional registered with FSRH recongnised UK professional regulatory body and licenced to practice if required for that regulatory body (currently this is the UK GMC, the UK NMC and the physician associate managed voluntary register (PAMVR) managed by the Faculty of Physician Associates).
  • Either hold a current FSRH Diploma, MFSRH or FFSRH, OR have recently passed the eKA (Online Knowledge Assessment), Find out more about the eKA.
  • Have completed the e-SRH module 18 online learning in the month before starting clinical skills training on e-Learning for Healthcare (certificates of completion must be reviewed by the Primary Trainer).
  • Have the experience and skill to conduct a competent clinical consultation.
  • Be up-to-date with resuscitation and anaphylaxis training and ensure that this is maintained for the duration of training (training must be recognised by the UK Resuscitation Council).
  • Be competent in giving an intramuscular injection.
  • Have read the current FSRH guidance on intrauterine contraception.
  • Be up to date with Levels 1-3 safeguarding children and young people and ensure that level 3 is maintained throughout training.
  • Be competent in undertaking a speculum examination.
  • Be able to confirm, at the time of application for your FSRH qualification, that you have read the 6 principles of care as outlined in the “Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception” and agree to abide by them in practice. It is, therefore, important to have read this document prior to commencing training.


3. Find a Training Programme to Undertake Practical Training

Your practical training must be completed through a Faculty-recognised General Training Programme. You can find a list of these on our Find a Training Programme map which you can access before you apply. You can select your chosen qualification/s and search by postcode, or town / city name, up to a radius of 250 miles. 

Once you have found a training programme, get in touch with the contact detailed on the map to find out more.


2. The OTA (Online Theory Assessment)


Please note that you are no longer able to take our eKA (the electronic knowledge assessment) as it will be replaced by our Online Theory Assessment (OTA)

A pass in the eKA or OTA is required as a pre-requisite to our FSRH Letters of Competence including our LoC SDI-IR and LoC IUT. 


As the OTA (LoC) and the Contraceptive Counselling Course (CCC) are not yet available, we wanted to ensure that you are able to progress with their LoC journeys during this transition period. We have decided that the regulation of the OTA and CCC entry requirement will be relaxed. This means that LoC candidates who:

  • start their practical assessments between 1 October to 31 January will not be required to hold the OTA or the CCC at entry. They must pass the OTA and the CCC by the end of February 2021 to successfully achieve their LoC qualification.

  • start their practical assessments from 1 February 2021 onwards will be required to hold the OTA and the CCC at entry

This is a temporary change to our regulations and will not be extended. We hope this helps both trainers and candidates to progress with their LoC journeys during this transition period.

If you have any questions, please let us know at education@fsrh.org.


If you do not hold a current FSRH Diploma, MFSRH or FFSRH, you must pass the OTA (or have recently passed the eKA or OTA). Find out more about the OTA. 

If you hold a current FSRH Diploma, MFSRH or FFSRH, there is no need to take the OTA.


There are maximum timeframes allowed between completing the eligibility requirements and completing the Letter of Competence (LoC).

  • eKA/OTA pass and LoC application – 2 years

However, if you already hold one of our LoCs, the timeframe will increase to 5 years to allow you to submit your application for a second LoC.

3. Complete Module 18 of the e-SRH

You must complete Module 18 of the e-SRH, which is hosted on the e-LfH website. This module must have been completed in the month before starting clinical skills training. If you completed this module more than a month before starting your clinical skills training, a re-visit of Module 18 will be required.

This is an e-learning package, free to NHS professionals, which contains interactive learning modules on various topics. Each module lasts around 20 minutes.

Register and access the online learning here: e-Learning for Healthcare.

Click view button at top right hand corner of e-Learning for Healthcare website to see a list of all modules and you will need to login first in order to be able to see contents of the modules (certificates of completion must be reviewed by the Primary Trainer). Evidence will be required.

If you have previously registered on e-LfH site and have forgotten your details you can request a reset , or if you are having issues logging in you can contact e-LfH

4. Download LoC IUT Logbook and Undertake Clinical Training

You must document all your practical training using the Logbook and obtain the signature of your trainer when you competently complete each stage. You are not required to submit the Logbook routinely, however you may be asked to produce the Logbook as part of FSRH auditing and quality assurance processes and it is therefore recommenced that you retain this until the LoC IUT certificate is awarded. Download the LoC IUT Logbook.

5. Download LoC IUT Application Form

You must document all your practical training and obtain the signature of your trainer when you competently complete each stage. Please ensure all parts of your form are completed in full. If any part of your application is not complete or it does not meet the required standard, your application is likely to be delayed. Download LoC IUT application form.

6. Submit your LoC IUT Application Form

Once you and your Primary Trainer have completed all sections of your Application form, you should submit this form along with the supporting documents and LoC registration fee for a certificate award.


To do this, log into ‘My FSRH’ and then complete: 

1. Your LoC IUT application form 
2. The online evaluation of your training experience – you can find links to this in ‘MyFSRH’.  Your feedback will be shared with the FSRH's General Training Committee to help us improve our programmes.


Intellectual Property Rights

All intellectual property rights for any FSRH qualification including documents, materials and content belonging to and produced by the FSRH should not be used for purposes other than FSRH training. Should you wish to use any of the IPR for purposes other than FSRH training you must seek the FSRH’s approval in writing with your request via our copyright request form. We aim to respond to submissions of this nature within one working week.

Recertification & Membership

If you hold Letters of Competence in Intrauterine Techniques (LoC IUT), we require recertification every five years. This is to ensure that you have developed and maintained the knowledge, skills, attitude and behaviour needed to provide safe and effective sexual and reproductive health care (SRH).

As a member you can recertify free of charge, as this is a benefit included in your annual membership fee. However, you must have paid your membership fee continuously for the five years leading up to recertifying.

Experienced Practitioners - Please note, if you have undertaken training at another provider some time ago, and your initial qualification was not awarded by FSRH we are not able to recertify this for you.  However, there is a shortened pathway (less observed procedures) to achieving the Letters of Competence in Intrauterine Techniques and/or Subdermal Contraceptive Implant Techniques which takes into account past clinical experience . However, all parts of the programmes (including passing the eKA) need to be completed.

How do I apply for my LoC IUT Recertification?

You can apply for recertification by filling in the online form below. 

Before filling in the online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. You will also need a stable internet connection while completing the online forms:

Form for Recertifying Letter of Competence in Intrauterine Techniques (LoC IUT):

Please make sure to apply for recertification not more than six months before your recertification date and no later than six weeks afterwards.

To apply successfully for recertification, you need to demonstrate:

  • at least two credits of relevant CPD over the past five years 
  • completion of the relevant e-SRH module (for NHS professionals) or Faculty-approved distance learning (for non-NHS professionals) 
  • proof of basic life support and anaphylaxis training 
  • a log of IUT insertions 
  • a log of SDI insertions and/or removals

You can find more information on each of these requirements below. You can also find a calendar of CPD courses, meetings and events on this website.

Read some FAQs about Letters of Competence Recertification.

What are the CPD Requirements for my Letter of Competence recertification?

To recertify for either LoC IUT or LoC SDI, you need to collect at least two credits of CPD activity over the past five years. This activity must be relevant to IUT / SDI, and may be gained in the following ways.


  • Attendance at courses/meetings relevant to SDI
    Evidence: certificate of attendance, programme of meeting and brief reflection on how this will influence your future practice.
  • Reading of appropriate current peer reviewed publications e.g. JFPRHC, BMJ
    Evidence: reference of article, and brief reflection on how this will influence your future practice: 1 CPD credit per article
    Reading of FSRH CEU guidelines on subdermal contraceptive implant methods and completion of self-assessment questions Reading: 1 CPD credit and completion of self-assessment questions: 1 CPD credit. This may not be counted towards CPD if used to fulfil section 3.
    Evidence of reading: date read and brief reflection on how this will influence your future practice. Evidence of questions: mark sheet, date completed and brief reflection on how this will influence your future practice.

  • Peer observation: For LoC IR you can claim 1 CPD credit for observing a peer perform an insertion or removal and giving feedback afterwards, 1 CPD credit for being observed performing an insertion or removal by a peer and discussing feedback afterwards.

  • For LoC IO you can claim 1 CPD credit for observing a peer perform an insertion and giving feedback afterwards, 1 CPD credit for being observed performing an insertion by a peer and discussing feedback afterwards.

  • For LoC RO you can claim 1 CPD credit for observing a peer perform a removal and giving feedback afterwards, 1 CPD credit for being observed performing a removal by a peer and discussing feedback afterwards.The observer/person being observed must hold a current LoC SDI. Evidence: date and name of observer/person being observed and brief outline of what you learned from this, either as an observer or from being observed)
  • Audit of SDI – personal or local

Evidence: date, summary of audit, brief description of your role in audit: 1 CPD credit

What evidence of CPD do I need to submit?

You do not always need evidence of CPD activity when you are applying for recertification. However, the General Training Committee audits 10% of all applications and reserves the right to ask for supporting documentation for all your activity. 


What other requirements and resources are there for my ongoing CPD?

If you are an NHS professional, you must also complete e-SRH module 18 (for LoC IUT) or e-SRH module 17 (for LoC SDI) during the two years before your recertification date.

To access the e-SRH learning modules, please register with e-Learning for Healthcare (e-LfH).

If you are not an NHS professional, you may instead complete Faculty-approved distance learning e.g. the latest CEU IUT / CEU SDI guidance and self-assessment questions.

You should also be up-to-date with basic life support and anaphylaxis training in accordance with your employer’s policy.

Finally, please submit a log covering a consecutive 12 month period that started no more than 24 months before your recertification date. 

  • For LoC IUT, this log should show 12 insertions, showing at least two different types of IUT method in conscious women. 
  • For LoC SDI Insertion and Removal (LoC SDI-IR), the log should show 6 procedures including at least one insertion and one removal.
  • For LoC SDI Insertion only (LoC SDI-IO), for individuals who work in an abortion or maternity services, the log will need to show a minimum of 6 insertions.
  • For LoC SDI Removal only (LoC SDI-RO), for individuals who work in deep implant services, the log will need to show a minimum of 6 removals.

Women's Health Library

Bringing together national guidance, resources produced and accredited by the RCGP, and resources from the Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH), the Women's Health Library is a resource relevant to GPs and other primary healthcare professionals.

The Library is divided into four sections for ease of use with the free resources clearly marked:

  • Maternal Health
  • Sexual and Reproductive Health
  • Pre-Menopause
  • Peri/Post Menopause

Access the library here

I'm late for my recertification, what should I do?

If you apply for recertification more than six weeks after your recertification date, you must: 

1. gain the necessary CPD credits and the Basic Life Support and anaphylaxis training outlined above
2. complete the relevant e-SRH module no more than 12 months before your recertification application date  (as opposed to within 24 months of recertification date) 
3. provide a log (described above) covering a consecutive 12 month period within 24 months of your recertification application date (as opposed to recertification date)
4. stop training or supervising anybody working towards an LoC.

If you are absent for more than a year and wish to apply for an extension on your recertification date,  please fill in our extension request form and we will get back to you shortly

If it is 10 years or more since your qualification was awarded or last recertified, you will need to retake the full training programme for your qualification. For Letters of Competence, this may be via the experienced practitioner route, if appropriate.

I'm a lapsed FSRH member and I want to recertify my qualification, what should I do?

FSRH Council believes that membership of the FSRH – and therefore access to the latest clinical guidance, standards, Journal, CPD questions and regular updates – is an important part of the membership and recertification process. The rules surrounding back payment of subscriptions were tightened up in 2015 by FSRH Council. 

Recertification is free to current FSRH members.  Recertification is one of our member benefits and supports you professionally in a number of ways.

It helps you to:

  • demonstrate the learning outcomes achieved from your qualification(s) have been maintained
  • show you have the knowledge, skills, attitudes and behaviour needed to provide safe and effective sexual and reproductive health care (SRH)
  • meet the requirements of commissioners, who often require clinicians to have certified qualifications

If your membership has lapsed and you would like to re-join FSRH past the 31 March cut-off date for the current membership year or after one or more years, you will be required to pay back your 'missing' years to ensure you have continuous membership which is required for recertifying your primary qualification.

You can easily do this by contacting us by phone on 020 7724 5534 or by email to info@fsrh.org. We can take payment by phone using a debit or credit card, it will take a few minutes to do this for you.

You can also pay for a one-off recertification for Letters of Competence qualification. This is £368 per LoC. This option is not available for Diploma recertification. You can pay your Diploma membership back fees by telephone on the above number.

Read more about the recertfication requirements of our qualifications here

How much will I be paying if I'm a Member re-joining FSRH after a break of two or more years?

Membership Category

& Annual Fee amount (2020)

Amount Payable


Diplomate £108

2 years (2019 and 2020) - £216 

3 years (2018, 2019 and 2020) - £324 

4 years (2016, 2017, 2018 and 2019) - £432

5 years (2016, 2017, 2018, 2019 and 2020)- £540 

Associate £92

2 years (2019 and 2020) - £184

3 years (2018, 2019 and 2020) - £276

4 years (2017, 2018, 2019 and 2020) - £368

5 years (2016, 2017, 2018, 2019 and 2020)- £460

Member/Fellow £228

2 years (2019 and 2020) - £456

3 years (2018, 2019 and 2020) - £663

4 years (2017, 2018, 2019 and 2020) - £912

5 years (2016, 2017, 2018, 2019 and 2020) - £1140

If you think you might qualify for a reduced subscription on your back fees, please contact the FSRH office on 020 7724 5534 or by email at info@fsrh.org to find out how to claim. Or, you can fill in our form here to claim your reduced subscription on previous year's fees.


Contact Us 

If you need any more help with recertifcation, please contact us by calling us on: +44(0)20 7724 5620 or by emailing kwells@fsrh.org.

How to Apply

To start your application process for the Letter of Competence in Intrauterine Techniques, please click on the register button (if you do not already have a 'My FSRH' website account). Registration on this website is free, you will not be required to make any payment until you are ready to apply for your qualification.

If you already have a log in for 'My FSRH', please click on login and then navigate to 'Take a qualification/recertify' behind log in. 

FSRH Register here  Log in to 'My FSRH'

Not sure how to register on our website? Watch our video for some help.

(You'll need sound or earphones on your device) 


Associate Membership of FSRH includes the following Membership benefits. Your membership subscription is payable annually and your membership runs from 1 January to 31 December each year.

  • Access to 'My FSRH' a personalised area on our website which includes resources and personal details
  • Full online access to BMJ SRH - our quarterly peer-reviewed journal
  • Free webinars 
  • Regular e-bulletins with access to previous editions
  • Discounts to FSRH conferences
  • Access to our Members' Evidence Request

Read more about FSRH Membership here


Associated Fees and Costs for the Letter of Competence Intrauterine Techniques (LoC IUT)

*Join us as a member to benefit from a reduced application fee

You can apply to become an Associate member when completing your LoC training application online as part of the final step. This will allow you to qualify for the reduced member rate of £63 for each LoC application fee as well as giving you full access to all our membership benefits. 

The cost of full Associate membership annually is £92 (for initial LoC applications between 1 Jan – 30 June) or a reduced half-year subscription in your first year of membership of £46 (for LoC applications made between 1 July – 31 December).

The subsequent full annual Associate membership fee is due on 1 January 2020 and then the following years of your membership.

As an Associate member your recertification of your qualification is free of charge every 5 years, if you have retained and paid for your annual Associate membership each year. Recertification enables you to demonstrate you have retained the skills and knowledge required for your qualification. This evidence can be used in appraisals and for revalidation.

Electronic Knowledge Assessment (eKA). 

£75 (per attempt) - Payable to FSRH

Clinical Training (Costs are set locally)

Between £300-£400 depending on location and provider

Letter of Competence Registration fee - Current FSRH Members (Associate, Members, Fellows and current holds of the FSRH Diploma)


Non-FSRH members

£63 - Payable to FSRH


£368 - Payable to FSRH

Total (approximate)

FSRH Members


Non-FSRH Members


£488 (approximate - depending on clinical training costs)


£850 approximately

Is your trust paying by invoice?

If your trust is making payment by invoice, we will need the following information in order to raise a purchase order: invoice address (accounts payable), a purchase order number (only if your trust requires one), and a finance/accounts payable email address. Please note, your trust can opt to pay for several individuals in a bulk payment if required. 

Please share this information with our Finance Manager, at finance@fsrh.org to raise the invoice or you can fill in our form online with all the information to raise the invoice.

Start your qualification now, by clicking on 'How to Apply' which will enable you to register for a free account on the FSRH website, no fees are payable until you are ready to start your application process.