Letter of Competence Subdermal Contraceptive Implants Techniques Insertion and Removal (LoC SDI-IR)

To successfully apply for the LoC SDI-IR, you will need to be able to meet all of the following entry requirements below.

Successful applicants must:

1. 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)

2. Be competent in consultation skills

3. Have resuscitation and anaphylaxis training in line with current UK guidelines 

You will need to upload evidence such as a current certificate or screen grab/scan of email or letter from training provider when you submit your application.

4. Able to give intramuscular injections

Healthcare professionals are asked to self-verify that this skill has been acquired during their undergraduate training or by specific postgraduate training. FSRH does not require any other verification but does regard this self-verification as a matter of probity.

5. Have read the current FSRH guidance on subdermal implants

You will need to have read the current FSRH guidance on subdermal implants and be conversant with its content.

6. Be able to confirm you have read the 6 principles of care

At the time of application for your FSRH qualification, you must be able to confirm 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.

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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. 

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 and removal on a model arm 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 SDI this log must show six self-certified procedures within the last 12 months to include one insertion and one removal.

The primary trainer must observe at least one insertion and one removal 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 SDI application form if you are applying via experienced practitioner pathway.

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. 

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.

To take the LoC SDI-IR, you must then complete Module 14 of the e-SRH, which is hosted on the e-LfH website. This is an e-learning package, free to NHS professionals, which contains interactive learning modules on various topics. Each module lasts around 20 minutes.

For access you will need to register with e-Learning for Healthcare (e-LfH).

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.

The e-SRH is free to anyone holding a nhs.net email address. 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. 

During your training, 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 the application form  

Download your logbook

We also recommend that you download the training requirements document, which contains appendices for the assessments. 

Please note: the Application Form was previously referred to as the Record of Training.

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 SDI-IR application

You can also search for the application on our FSRH Training Hub - just search for ‘Letter of Competence in Subdermal Implant Insertion & Removal (LoC SDI-IR 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.