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The medal was established on 14 October 1914. It was the Other Ranks ' equivalent to the Distinguished Service Cross , which was awarded to commissioned officers and Warrant Officers , although it ranked below that decoration in order of precedence, between the George Medal and the Military Medal after those medals' respective establishments in 1940 and 1916. Recipients of the Distinguished Service Medal are entitled to use the post-nominal letters "DSM". In 1993, the DSM was discontinued, and since then the Distinguished Service Cross has been available for award to personnel of all ranks.