Application for Recertification of the Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI)

Before filling in this 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. 

 

Recertification requirements

 

1. Personal beliefs guidance:

Please see the recertification section of the FSRH website to read the “Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception”. This was introduced at the FSRH in May 2017 and you should read this before submitting your recertification application. You are asked below to confirm you have read the guidance and will abide by the principles in it in your practice. This is part of the Faculty’s conditions for recertifying a FSRH qualification.

2. Recertification is free for members who have paid their annual subscription fee or £368.00 for non-members.

3. At least 2 CPD credits relevant to subdermal contraceptive implant techniques, gained from any of the following activity:

Please note: evidence of CPD activity does not need to be submitted upon application. However, the General Training Committee will audit 10% of all applications and reserves the right to ask for supporting documentation for all activity. See below for examples of acceptable evidence.

  • 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 Guidance on subdermal contraceptive implant methods and completion of self-assessment questions 

    • Reading of CEU guidance: 1 CPD credit 
    • Completion of self-assessment questions: 1 CPD credit.

 

 

This CPD activity may not be counted towards CPD if used to fulfil section ‘Option 2 (b)’ on the below form.

 

    • 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

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form.

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

 

 

 

* Indicates a required field.

Personal Details

Please complete all parts of this section.

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

Record of CPD Activity

You can record your CPD activities below. Please note, for each activity, you will be asked to provide:

  • A description of the activity
  • The date it was completed
  • The number of CPD credits

A minimum of two CPD credits are required. Please record your CPD in full in the boxes provided. 

Please ensure you enter any dates in this format: dd.mm.yy 

Completion of either of the following items

Option One 
a) e-SRH module 17 (mandatory for NHS professionals). Please register for access at the e-SRH website

Please enter the date of completion of e-SRH module 17. It must be within the last two years.

OR

Option Two

b) FSRH approved distance learning e.g. latest CEU SDI guidance and self-assessment questions (for non NHS professionals).

  • Please enter the date the guidance was read.
  • Please enter the date of completion of self-assessment questions in the guidance.
  • Please provide a brief reflection on how this will influence your future practice.

 

 

a) Option One - e-SRH module 17 completion

a) e-SRH module 17 (mandatory for NHS professionals). Please register for access at the e-SRH website

Provide date of completion which must be within the last 2 years. 

Please use this format to enter dates: dd.mm.yy

b) Option Two - FSRH-approved distance learning

b) FSRH approved distance learning e.g. latest CEU SDI guidance and self-assessment questions (for non NHS professionals).

  • Please enter the date the guidance was read.
  • Please enter the date of completion of self-assessment questions in the guidance.
  • Please provide a brief reflection on how this will influence your future practice.

Please use this format to enter dates: dd.mm.yy

Show that you are up-to-date with Basic Life Support and Anaphylaxis Training in accordance with employer policy

Please use this format to enter dates: dd.mm.yy

Your insertion procedures log for the last 12 month period

A log of insertion procedures covering a consecutive 12 month period within 24 months of the date of re-certification.

This log will need to show a minimum of 6 procedures to include at least 1 insertion and 1 removal.

Please complete the log of insertion procedures in date order.
Do not include any personal data in the log of procedures as to do so is a breach of confidentiality and the Data Protection Act 1998.

Please use this format to enter dates:  dd/mm/yyyy

Please indicate which qualification you wish to re-certify*
Your removal procedures log for the last 12 month period

A log of removal procedures covering a consecutive 12 month period within 24 months of the date of recertification. This log will need to show a minimum of 6 procedures to include at least 1 insertion and 1 removal.

Please complete the log of removal procedures in date order.

Please use this format to enter dates: dd.mm.yy

Data Protection Statement and Confirmation

The Data Protection Act (1998) requires organisations or agencies collecting personal data on individuals to gain their consent before collecting, storing, publishing or analysing their data.

 

By completing and signing this application form you are giving consent for your data to be stored on databases used by the Faculty of Sexual and Reproductive Healthcare (FSRH) of the RCOG for the purposes of administrating its membership database. All data will be treated with the strictest confidence and will only be used for legitimate FSRH purposes.


Self-certification

I confirm that the details on this form are correct. I understand that recertification is self-certified and that the FSRH reserves the right to audit randomly chosen applications received and that I may, therefore, be requested to provide documentary evidence of my activities.

 

Verification

Please click the box to indicate you are a human rather than an automated system completing this form.

Last step