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

RCGP Accredited Course LogoThis is an RCGP accredited training programme aimed at doctors and nurses already working in general practice and community sexual health services who want to develop the necessary knowledge, attitude and skills to support women seeking contraception. It will enable them to provide and remove subdermal implants 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 training requirements and the learning outcomes for the LoC SDI. You may find our list of General Training terminology helpful to reference alongside these documents.

Qualify LoC SDI-IR

Experienced Practitioners - Please note, if you have undertaken training at another provider some time ago, you may be eligible to undertake a shortened pathway which takes into account past clinical experience. However, all parts of the programme below (including passing the eKA) need to be completed. Page 4 of the Training Record should be completed in this instance. 


Entry Requirements

FSRH Diploma or LoCs - requirement for anaphylaxis training - provide evidence

The entry requirements for the DFSRH, LoC SDI and LoC IUT include the need for trainees to provide evidence that they are up to date with Basic Life Support and Anaphylaxis Training in accordance with their employer’s local policy. Trainees are encouraged to access local training where available. In the rare instances where this is unavailable, online updating which follows the UK Resuscitation Council standards may be deemed acceptable; there are a number of websites which offer e-learning for a fee. Trainers may choose to accept certificates of completion as suitable evidence. Doctors who register with doctors.net.uk can access free on-line learning through this website.

1. Pass Module 17 of the e-SRH & Read the 6 Principles of Care Guidance:

Everybody must complete Module 17 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). This e-SRH is free to anyone holding an 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

At the time of application for your FSRH qualification, you need to confirm 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.

2. Purchase and Take the eKA 

If you do not hold a current FSRH Diploma, MFSRH or FFSRH, you must pass (or have recently passed) our online knowledge assessment (the ‘eKA in SRH’). Find out more about the eKA

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

Please note that the duration of the eKA was extended by 15 minutes from 2 January 2019, based on user feedback. This will give you two hours to complete the assessment. For more details, read our news story.


3. Find a Trainer to Undertake Practical Training 

 Trainees must first use a model arm to practice inserting and removing subdermal implants. This practice can take place as part of the Course of 5 for the FSRH Diploma, or in a separate training session.

The training then moves to live volunteers: you must complete as many supervised insertions and removals as necessary until your trainer is satisfied that you are competent.

Please note: 
Your practical training must be completed through a Faculty-recognised General Training Programme – you can find a list of them on our 'Find a Trainer' page when you register or log into 'My FSRH' and click on 'Take a Qualification' behind log in.

4. Download LoC SDI Record of Training

You must document all your practical training and obtain the signature of your trainer when you competently complete each stage / insertion. Download a training record.

5. Submit your Record of Training

Once you have completed both parts of your training, you may apply for your LoC SDI. To do this, log into ‘My FSRH’ and then complete: 
1. Your LoC SDI training record / application form 
2. The online evaluation of your training experience – you can find links to this in ‘My FSRH’.  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.


If you hold Letters of Competence in Intrauterine Techniques (LoC IUT) and/or Subdermal Contraceptive Implant Techniques (LoC SDI), 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.

How to apply

You should apply for recertification via the forms from our website which you can download for printing and saving. Or, you can also submit your recertification via our online form. Read more here.

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 / SDI insertions and removals

You can find a calendar of suitable courses on our events page under the type of 'External Meetings and Educational Meetings', you can also search by region.

How to Apply

To start your application process for the Letter of Competence in Subdermal Implants Insertion and Removal, 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 Subdermal Implants Insertion and Removal (LoC SDI-IR)

*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 £89 (for initial LoC applications between 1 Jan – 30 June) or a reduced half-year subscription in your first year of membership of £45 (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.


Contact Us

Contact Us

If you have questions regarding applying for the Letters of Competence including e-KA queries, please contact the Education Development Officer by phone on: +44(0)20 7724 5647 or by email to EDofficerLoC@fsrh.org.



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