At least two of these had to be in First Aid to the Injured, but the third could be in either Home Nursing or Home Hygiene. Date labels were introduced in 1905 and were earned for each successive re-examination. In 1916, specialist pendants were introduced for the first time for those who had successfully re-examined in subjects other than first aid. These were for Home Nursing, Home Hygiene, Sanitation and, from 1946, Child Welfare.

It was common to take the examinations, obtain the medallion, and not be a member of St John Ambulance.

Medallions were usually produced in bronze and could be purchased for two shillings (10p). Silver medallions were available for seven shillings and sixpence (37.5p) and in 18 carat gold for £2/10s (£2.50). A miniature version could also be purchased. At a time when the weekly wage of a working man was between 30/- (£1.50) and £2, it would take a considerable sacrifice to obtain this symbol of competency to render first aid. It is a tribute to their pride in obtaining the qualification that so many men and women committed their earnings to the purchase of a medallion.

While it was not compulsory to purchase and wear a medallion, its purpose was to prove, when necessary, the competence of the holder. As a measure of security each example carried the medallion number and name of the recipient engraved on the plain reverse. It could be carried in the pocket or handbag or worn as an ornament, but never worn as a decoration. A favourite position for men was on the watch chain.

Since its introduction, the design of the medallion has undergone a number of changes and unfortunately it is not possible to assign an exact date range to each new style. There have been at least four different designs of the Re-examination Medallion, and a fifth for those examined in Wales.

In 1992 medallions ceased to be issued. The total number issued up to this date is not known, but up to 1945 634,000 medallions, 1,2109,000 labels and 169,000 pendants had been issued in the United Kingdom and the Commonwealth.

Records of recipients of the Re-examination Medallion were not kept after 1885, and the Museum regrets they are unable to provide any further information on specific Re-examination Medallions, but it may be possible to confirm if the recipient served with St John Ambulance through the Museum's enquiry service. The number on the back, despite saying “Registered at St John’s Gate Clerkenwell” does not correspond with any records held, apart from the very earliest: numbers 1-2722, all awarded before 1885.