#DTMH Strategies: An Introduction to the Test

The Royal College of Physicians, London, administers the examination for the award of the Diploma in Tropical Medicine and Hygiene, to examine and certify physicians who “wish to practice medicine effectively in developing countries.” I recently took the exam, and managed to clear it. This year, I am serving as a Moderator for the students in the Global Health and Humanitarian Medicine course, run by Medecins Sans Frontieres, qualifying which enables one to be eligible to sit for the exam.

Who can take the exam?

According to the eligibility criteria mentioned on the RCP’s website:

Candidates for the Diploma in Tropical Medicine and Hygiene must hold a primary medical qualification recognized by the Royal College of Physicians of London (RCP). The RCP will accept applications from candidates who are in the process of completing, or have completed within the last 5 years, the approved tropical medicine courses in the following locations (which are recognized as appropriate training centers for the examination):

  • Glasgow Diploma in Tropical Medicine and Hygiene course
  • Sheffield Diploma in Tropical Medicine and Hygiene course
  • Oxford University MSc course in International Health and Tropical Medicine
  • Liverpool School of Tropical Medicine: DTMH course, MSc in Tropical and Infectious Diseases, or MSc in Tropical Paediatrics
  • London School of Hygiene and Tropical Medicine: DTMH course or MSc in Tropical Medicine and International Health
  • Médecins Sans Frontières Course in Global Health and Humanitarian Medicine (GHHM)
  • ASTMH-approved diploma courses satisfying the requirements for CTropMed.

Confirmation of attendance on one of the appropriate tropical medicine courses (as above), and of proficiency in microscopy (requiring a minimum of 12 hours of microscopy / practical parasitology teaching) within the last 5 years will be required for each candidate before taking the examination.

Examination Structure

The examination is marked out of 500 marks. The break up for the marks is as below

Morning Exam Session

100 ‘best of five’ questions to be answered in 3 hours. Of these, 16 will be based on clinical images designed to test the candidate’s knowledge of tropical medicine and hygiene over a wide area. Each question carries 2.5 marks and the whole paper is for 250 marks (50% of total). No negative marks for any answer which is marked incorrectly. After the BOF paper, the lunch break is scheduled, which is usually for about a hour.

Afternoon Exam Session

The afternoon exam session is for 2.5 hours and consists of two separate examination papers: Preventive Medicine and Parasitology/Entomology.

The Preventive Medicine short answer paper lasts for 1 hour. The candidate has to choose 5 questions from a total of 10 questions. Each question is valued at 20 marks, and may consist of multiple sub-questions and sub-sub-question, for which additional break-ups in marks will be given. The total value of the paper is 100 marks (20% of total).

The Parasitology/Entomology short answer paper lasts for 1.5 hours. This paper usually takes place after a short break after the Preventive Medicine paper. The paper consists of 50 very short answer questions, carrying a total of 150 marks (30% of total). The questions usually consist of three parts, all inter-related, and often with an image with or without a clinical vignette to go along. The answers need to be inscribed in really small boxes – so there is no space or time for fluff.


Roughly, about 60% marks need to be scored overall, to gain a passing score. In addition, one has to secure passing marks (50%) on the Best of Five paper and the Preventive Medicine+Parasitology/Entomology papers. So, for the afternoon exam sessions, there is some leeway in that if one of them is an utter disaster, one still has a chance to recover from it.

Exam results are declared after 6 weeks or so, and the diploma is sent by ordinary post. So, if your area has iffy postal services, be prepared for a long wait. They do communicate the results by email, and I have been told that the attached attestation that you have passed the exam is credible enough for prospective employers who know the value of the examination.

Source for Featured Image: MSF Transformational Investment Capacity

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