Letter of Competence Intrauterine Techniques (LoC IUT)

Our Letter of Competence Intrauterine Techniques (LoC IUT) provides you with the necessary knowledge, attitude and skills to support women seeking contraception. It will enable you to provide intrauterine contraception competently, and manage any complications and side-effects that may occur. 

Who can apply?

This training programme is aimed at healthcare professionals already working in general practice and community sexual health services.

"An excellent learning environment to appreciate the benefits of IUT but experience at the Priority Access Clinic furthered my knowledge by encountering women who had complications following IUD/CuIUD insertion. I gained confidence in managing these patients to an extent that I would be happy to do this as the first point of contact in my regular job.”

- Healthcare professional that has completed the LoC IUT


Ready to take the next step on gaining your LoC IUT qualification?

The first step is to find a Faculty Registered Trainer to help support your learning. Use our interactive map to connect with a trainer near you.

Trainer map

For more information on our LoC IUT, browse the tabs below. 

LoC IUT Information

Below we share some information on entry requirements and the next steps to achieving your qualification. 

Training for the LoC IUT 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.

Step 1: Check the entry requirements

Entry requirements for the LoC IUT

In order to apply for the FSRH LoC IUT, you will need to meet all of the following entry requirements: 

You must....

  • ...be registered with a UK or Irish medical professional regulatory body and have a license to practice if that is required by your regulator.

We recognise the following regulatory bodies: 

  • The General Medical Council (UK)
  • Irish Medical Council
  • The Nursing & Midwifery Council (UK)
  • Nursing & Midwifery Board of Ireland
  • General Pharmaceutical Council (UK)
  • The Pharmaceutical Society of Ireland
  • Physician Associate Managed Voluntary Register (UK)
  • Health and Care Professions Council (UK)


  • 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.

Nursing Associates:

If you are registered as a nursing associate with the Nursing Midwifery Council (NMC) please be mindful you are not currently eligible to take the FSRH Diploma or LoCs. 

The ability to undertake a comprehensive patient assessment independently is a fundamental requirement for holders of the DFSRH or LoC which differs from the requirement “to contribute to ongoing assessment” specified in the NMC Standards of proficiency for Nursing Associates (NMC 2018). For this reason, the FSRH Diploma and LoCs qualifications are not currently accessible if you are a registered Nursing Associate. 

Candidates from Republic of Ireland doing FSRH qualifications in the UK

Healthcare professionals from the UK or the Republic of Ireland who wish to undertake any FSRH training that does not involve direct contact/treatment of patients in a UK health facility, will be required to be registered/ licenced and in good standing with the relevant UK or Irish regulatory body. For example, doctors wishing to undertake the DFSRH with remote assessments will need to be registered with the General Medical Council or the Irish Medical Council. Please ensure this is considered when joining a training programme.

Healthcare professionals from the UK or the Republic of Ireland who wish to undertake any FSRH training that involves direct contact/treatment of patients in a UK health facility, will be required to be registered/licenced and in good standing with the relevant UK regulatory body. For example, doctors from the UK or the Republic of Ireland wishing to undertake the FSRH Letters of Competence will need to be registered with the General Medical Council. Please ensure this is considered when joining a training programme.

The FSRH currently recognises the following regulatory bodies:  

  • The General Medical Council (UK)
  • Irish Medical Council
  • The Nursing & Midwifery Council (UK)
  • Nursing & Midwifery Board of Ireland
  • General Pharmaceutical Council (UK)
  • The Pharmaceutical Society of Ireland
  • Physician Associate Managed Voluntary Register (UK)
  • Health and Care Professions Council (UK)

Apply via the Experienced Practitioner Route

You may apply for this Letter of Competence via the Experienced Practitioner Route: 

  • If your initial Letter of Competence (LoC) qualification was not registered with or awarded by FSRH
  • If you attained a local LoC certification and now wish to register or recertify it with FSRH
  • If you have not recertified FSRH LoC for more than 10 years, but have been fitting/removing implants for last 12 months

For all above scenarios, you may be eligible to undertake a shortened pathway which takes into account past clinical experience. The FSRH’s General Training Committee requires that, in order to obtain FSRH certification, this training would need to be completed. 

The General Training Committee is unable to offer exemptions to its published criteria. However, experienced practitioners can complete a shortened pathway in respect to the clinical component but all other parts of the programme, included the OTA pass, would need to be completed.

The training involves both theoretical knowledge and practical training.

Theoretical knowledge includes e-SRH theory learning and scenario-based discussions with your trainer.

The experienced practitioner must demonstrate competence in insertion on a model uterus before competence is assessed in live patients.

The candidate must provide details and dates of previous relevant training or experience. A log of previous procedures must also be provided. For LoC IUT this log must show five self-certified procedures within the last 6 months to include one Cu-IUD, one LNG-IUS and at least two different insertion mechanisms.

The primary trainer must observe at least two insertions performed competently in a conscious patient. 

We recommend that all theory learning be undertaken before live training with women. 

Please follow the steps below and complete relevant sections of LoC IUT application form if you are applying via experienced practitioner pathway.

Step 2: Find your trainer

Find a FSRH Registered Trainer

The first step to gaining your LoC qualification is to find a FSRH Registered Trainer to help support your learning. Your trainer will be your primary contact throughout your training, and is responsible for confirming that you meet the entry requirements and have successfully completed all assessments.

Each FSRH Registered Trainer works within a General Training Programme. Use our Find a Training Programme map to find a General Training Programme near you, or where you wish to train. Please use the contact details listed on the General Training Programme to find out if they are able to undertake the training and assessment with you. 

Step 3: Begin your learning journey

Purchase and take the OTA (Online Theory Assessment)

Once you have found a Trainer, you are now able to purchase our Online Theory Assessment (OTA) which has replaced the previous eKA (the electronic knowledge assessment).

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.   

How to purchase and take the OTA

To enrol on the OTA, you will need to have a MyFSRH account. You can register for free or login to your existing account. You can then access the OTA via the button below:  

Access the Online Theory Assessment 

Alternatively, you can also search for 'Online Theory Assessment OTA (for LoCs only)’ under 'Browse Courses' on the FSRH Training Hub.

Do I need to take the OTA?

  • If you hold a current FSRH Diploma, MFSRH or FFSRH, you will not be required to take the OTA. Find out more about the OTA. 
  • If you have previously passed the eKA as part of another qualification which has been awarded within five years of starting the new qualification, you will not be required to take the OTA.
  • If you have previously passed the eKA (without achieving another FSRH qualification) within two years of starting the new qualification, you will not be required to take the OTA.

Complete Module 15 of the e-SRH

You must complete Module 15 of the e-SRH, which is hosted on the e-LfH website. This module must have been completed in the three months before starting clinical skills training. If you completed this module more than three months before starting your clinical skills training, a re-visit of Module 15 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 the 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

Download the LoC IUT application form and logbook

During your training, you must document all your practical training 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 recommended that you retain this until the LoC IUT certificate is awarded.

Please ensure all parts of your application 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 your logbook

Download the application form

Please note: the logbook is for the usage of you and your FRT (Faculty Registered Trainer), and does not need to be submitted alongside the application form. 

Step 4: Apply for your certificate

Submit your application

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

To submit your application, please log in to your MyFSRH account, and click the button below. 

Submit your LoC IUT application

You can also search for the application on our FSRH Training Hub - just search for ‘Letter of Competence in Intrauterine Techniques (LoC IUT Application)’ under the 'Browse courses' section.   

On the application page, you’ll be also able to complete an online evaluation of your training experience. Your feedback will be shared with the FSRH’s General Training Committee to help us improve our programmes.

From submitting your application, it can take up to 7 working days to review your submission. At this time, we may contact you requesting additional information to support your application. If you meet all the required criteria we will award your LoC within 14 working days.

Please note failure to provide all required evidence, payment or correct information may delay or prevent the processing of your application.
Please note that due to GDPR and security concerns regarding patient data, identifying information etc, we do not accept postal submissions. If you have any questions about your submission, contact our Member Support Team.


For our Letter of Competence qualifications, we have two payment options available. 

Option 1: Associate membership

Join us as a member to benefit from a reduced LoC application fee and free recertification every 5 years.

You can apply to become an Associate member when you submit your LoC application. This will allow you to qualify for a reduced member rate* of £115 for each LoC application fee as well as giving you full access to all our member benefits

*The full annual Associate membership fee is due the subsequent year and then the following years of your membership. 

Member rate per LoC application: £226 (Associate annual membership £111 + LoC registration £115) for LoC applications between 1 Jan – 30 Jun

Member rate per LoC application: £171 (Associate annual membership £56 + LoC registration £115) for LoC applications between 1 Jul – 31 Dec 

Option 2: Non-member rate

The non-member rate per LoC application is £475, this fee will cover you for next 5 years.

Table of associated fees and costs for the Letter of Competence:

Online Theory Assessment (OTA)

£85 (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

£115-Payable to FSRH


£475-Payable to FSRH

Total (approximate)

FSRH Members


Non-FSRH Members


£550 (approximate - depending on clinical training costs)


£910 approximately

Is your trust/employer paying by invoice?

If your trust/employer 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. 

Refund Policy:

Please read the Refund Policy thoroughly before purchase.


Completion of our Letter of Competence qualification can result in Associate membership of FSRH and includes the following membership benefits:

  • Free five-yearly recertification of your qualification
  • Access to our FSRH Training Hub which is regularly updated with the latest SRH resources and content to help and support your SRH practice
  • Access to our quarterly peer-reviewed BMJ SRH Journal
  • Free SRH webinars and recordings to watch on-demand based on our latest clinical guidance
  • Discounts to FSRH conferences and events
  • Access to our Members' Evidence Request where you can search our database for the latest advice, guidance and information on case-specific topics

See Associate membership benefits in full here.

Your membership subscription is payable annually and your membership runs from 1 January to 31 December each year.


If you hold our Letter of Competence qualification, we require you to recertify every five years. 

Recertification 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 

Recertification is one of our member benefits and free to current FSRH members.  

Find out how to recertify your Letter of Competence here.