©FSRH J Fam Plann Reprod Health Care 2010: 36(2) Background There is widespread acknowledgement that the UK has poor levels of sexual health compared to our immediate European neighbours. The reasons for this are deep seated, complex and not easily amenable to change. One important part of the solution is to raise and sustain a high quality of community-based clinical sexual and reproductive health (SRH) services within the National Health Service (NHS); services which until recently suffered from a low priority and major disinvestment. Sexual health strategies from all four devolved UK nations have supported the concept of strong clinical leadership for multidisciplinary and multiprofessional SRH teams within the NHS in order to achieve targets such as reducing teenage pregnancy, abortion and sexually transmitted infection rates. Leadership of effective specialist SRH services is only possible if clinicians have received an appropriate and ‘fit for purpose’ training. The first tranche of consultants appointed in the late 1980s were largely from an obstetrics and gynaecology (O&G) background. More recent consultant appointments have been to individuals, who again trained in O&G, but who had acquired specific knowledge and skills by undertaking the subspecialty training in sexual and reproductive health of the Royal College of Obstetricians and Gynaecologists (RCOG). All recent workforce census figures have shown a serious shortage of appropriately trained consultants to meet the current vacancies and those likely to arise in the near future. In addition, subspecialty posts in SRH are often unfilled because of a lack of suitable trainees with a genuine commitment to the specialty. As trainees have to complete 5 years of mainstream O&G with in-depth obstetrics before undertaking subspecialty training, they have often missed the opportunity to be exposed to the challenges and breadth of SRH. One other significant factor has strongly impacted on the situation. SRH now has a solid core of doctors working in the specialty who have consolidated their specialist knowledge by achieving the Membership examination of the Faculty of Sexual and Reproductive Healthcare (MFSRH). Some will also have undertaken structured Faculty training as career grade trainees. These doctors have great difficulty applying to the Postgraduate Medical Education Training Board (PMETB) for equivalence of training to lead to a Certificate of Completion of Training (CCT) because the current criteria are determined by the core specialty of O&G. A separate ‘fit for purpose’ training programme in SRH would pave the way for these clinicians to apply for assessment of equivalence in the new specialty, which would lead to eligibility for a Certificate of The new specialty training for future consultants in sexual and reproductive health