Edinburgh City Hospital ,Silver Certificated Nurse pendant medal

A small silver pendant medal from the Edinburgh City Hospital,for Nurse training in the 1920s.It features the arms of the city with the motto Nisi Dominus Frustra- Except the Lord in Vain above the title Edinburgh City Hospital .The scroll at the bottom bears the title Certificated Nurse.The rear is inscribed M E Ingham Sept 1921 to Sept 1924.Hallmarked for WHH Birmingham 1922.Height 31 mm
I am unsure is this medal was worn from a suspension bar or a

Code: 51080