If you are considering a career in medicine, it is important to familiarise yourself with the various exams and assessments that you may need to take. One such exam is the MSRA (Multi-Specialty Recruitment Assessment), which is now used as part of the application process for many medical specialties in the UK. In this article, we'll provide a comprehensive guide to the MSRA, answering all the important questions you may have.

What is the MSRA?

The MSRA exam was first introduced in 2013 as part of the selection process for core medical training, and has since been expanded to cover a wide range of specialties.

The aim of the exam is to assess the aptitude and knowledge of applicants for these specialties, and to ensure that only the best candidates are selected. The exam is an online assessment, which means that it can be taken from anywhere with an internet connection.

Overall, the MSRA is an important part of the selection process for many medical specialties in the UK, and it is important to prepare thoroughly if you are planning to take the exam. There are many resources available to help you prepare, including online courses and practice tests from Pastest. With the right approach, it is certainly possible to achieve a good score on the MSRA and to progress towards a rewarding career in medicine.

Which specialties require the MSRA exam?

It is currently used for entry in postgraduate medical training for the following specialities:

- General Practice

- Core Psychiatry Training 

- Clinical Radiology

- Ophthalmology

- Obstetrics and Gynaecology

- Community Sexual and Reproductive Health

- Neurosurgery

- Nuclear Medicine

- ACCS Emergency Medicine

- Anaesthetics

- Core Surgery Training

In 2022, the performance of candidates in the MSRA was the sole basis for assessment and ranking in General Practice and Core Psychiatry Training. We are currently waiting for confirmation if this will be the case for 2023. For Obstetrics and Gynaecology, the MSRA score was used to shortlist the lowest scoring applicants while the highest scoring candidates were offered direct offers. We expect the same process to be followed this year as well. However, the MSRA is no longer used for recruitment in Paediatrics.

What is the MSRA exam format?

The exam is divided into two components: the Professional Dilemmas/SJT paper and the clinical problem-solving test (CST). The Professional Dilemmas paper is designed to assess your ability to respond to ethical and professional scenarios, and to make appropriate decisions in difficult situations. The CST is designed to measure your ability to apply clinical knowledge to solve problems, and to demonstrate your understanding of the principles of clinical practice.

Professional Dilemmas Paper/SJT

The Professional Dilemmas Paper consists of 50 scenarios and is divided into two sections, including:

Part 1 - Ranking:

- Candidates are presented with scenarios and asked to evaluate the appropriateness of four or five independent actions in response to the situation.

- They must rank the actions in order from the most to the least appropriate response.

Part 2 - Multiple Choice:

- Candidates are given eight plausible actions for each scenario and must select the three most appropriate actions.

- They must consider the appropriateness of each individual action and select three responses which, when used in combination, will fully resolve the situation.

Clinical Problem-Solving Paper

The paper consists of 97 questions that are presented in a multiple-choice format. There are two types of questions in this paper: Extended Matching Questions (EMQs) and Single Best Answer (SBA) questions.

EMQs require the candidate to select the most appropriate answer(s) from a list of options for a given scenario. Each EMQ typically includes a stem and a number of related options. The stem may describe a clinical scenario, a diagnostic test result, or a piece of clinical data. The options may include different diagnoses, management options, or further investigations.

SBA questions present a clinical scenario and ask the candidate to select the single best answer from a list of options. Each SBA question usually requires the candidate to apply clinical knowledge and reasoning skills to identify the most appropriate diagnosis or management option for the given scenario.

The Clinical Problem Solving paper is timed, and candidates have 75 minutes to complete it. Although there is no negative marking, candidates are advised to answer all questions to maximize their chances of obtaining a high score.

The paper covers a wide range of medical scenarios across various topics including:

- Cardiovascular

- Dermatology/ENT/Eyes

- Endocrinology/Metabolic

- Gastroenterology/Nutrition

- Infectious Disease/Haematology/Immunology/Allergies/Genetics

- Musculoskeletal

- Paediatrics

- Pharmacology

- Psychiatry/Neurology

- Renal/Urology

- Reproductive/Respiratory

In addition to testing medical knowledge, the exam assesses important core competencies such as investigation, diagnosis, emergency management, prescribing, and non-prescribing management. Candidates are required to demonstrate their ability to evaluate symptoms, identify possible conditions, assess patient risks, and recommend appropriate treatment plans, including the use of medication or non-drug related approaches.

Overall, the MSRA exam format is designed to assess a candidate's ability to apply medical knowledge in real-life situations, rather than simply testing their recall ability. Candidates should prepare thoroughly for both the Professional Dilemmas and Clinical Problem Solving sections of the exam, as both are important for achieving a high score.

Is the MSRA difficult?

The MSRA can be a difficult exam for many applicants, as it covers a wide range of medical knowledge and requires strong problem-solving and critical thinking skills. Additionally, the situational judgment test (SJT) component can be particularly challenging, as it requires applicants to respond to ethical and professional scenarios in a limited amount of time.

To give you an idea of what to expect, here are a few example questions from the MSRA:

Professional Dilemmas (SJT):

- You are working as a junior doctor on a busy medical ward. You overhear a senior nurse talking negatively about a patient's family. What do you do?

- You are on call as a junior doctor in the emergency department. You receive a call about a patient with a severe allergic reaction. What is the most appropriate immediate action to take?

Clinical Problem-Solving Test (CST):

- A patient presents with a 6-week history of a painful, non-healing ulcer on their foot. Which of the following tests is most likely to confirm the diagnosis?

- A patient presents with acute chest pain and shortness of breath. An electrocardiogram (ECG) shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

However, with the right preparation and practice, it is possible to perform well on the exam.
Pastest offers a wide range of resources to help you prepare, including online courses and practice tests. It is important to review the relevant medical knowledge, practice time management, and familiarize yourself with the types of questions that will be asked in the exam. Additionally, seeking guidance from current medical professionals and attending preparatory courses can help you to gain a better understanding of the exam and its expectations.

How to apply for the MSRA exam

If you are interested in taking the MSRA, the first step is to determine which recruiting body is responsible for the selection process for your chosen specialty. The application process can vary slightly depending on the specialty, but generally, you will need to complete an online application and provide evidence of your qualifications and experience.

Here are the general steps for applying to take the MSRA:

1. Identify the recruiting body: Each specialty has its own recruiting body responsible for the selection process. The recruiting body for the specialty you are interested in will be able to provide you with detailed information on the application process.
2. Register with the recruiting body: You will need to register with the recruiting body and create an account. This will give you access to the application form and other relevant information.
3. Complete the application form: The application form will require you to provide personal details, education and training history, and any relevant work experience. You will also need to provide evidence of your qualifications, such as copies of your medical degree or professional qualifications.
4. Pay the application fee: There is a fee to take the MSRA, which varies depending on the specialty. You will need to pay the fee when you submit your application.
5. Book your exam: Once your application has been accepted, you will be able to book your exam. You will need to select a test date and location that is convenient for you.

It is important to carefully review the application requirements and deadlines for the specialty you are interested in, as they can vary. Additionally, it is recommended that you begin preparing for the exam well in advance of the test date, in order to give yourself the best chance of success.

Where is the MSRA delivered?

The MSRA is delivered in Pearson VUE test centres across several consecutive days within the MSRA window. The exam is offered throughout the UK and internationally; you can find your closest test centre here. It’s worth noting that there may not be availability at your nearest or preferred Pearson VUE test centre, due to the demand within the short assessment window, so you may be required to travel further to sit your exam.

Please note: currently, all MSRA invitations will be for MSRAs delivered within a Pearson VUE test centre; however, once you receive your invitation you can apply for a remote test ‘by exception’ if you meet the criteria set to do so. Requests for remote examinations are assessed and approved on a case by case basis.

How many times can you do the MSRA?

You are allowed to take the MSRA a maximum of three times, although this varies depending on the specialty. If you do not achieve a satisfactory score after three attempts, you may not be eligible to apply for the specialty in question.

How much does MSRA exam cost?

The assessment itself is free of charge, but please note that any travel and accommodation expenses incurred will be your own responsibility and will not be reimbursed. We strongly recommend that you book your assessment as early as possible to secure a spot at the test center nearest to you and avoid any potential inconvenience or delays.

How long is MSRA exam valid for?

The MSRA score is valid for one year, after which you will need to retake the exam if you wish to apply for a specialty that requires it.

What's a good MSRA score?

For both the PD and CPS sections the candidate will be given a standardised score that comes under a specific band (1-4). For example, those who score <180 in each exam are limited to Band 1, which represents a ‘very poor level of performance’. Scoring over 291 in the exam puts the candidate in Band 4, illustrating a ‘very good level of performance’ in the exam. Additionally, 181-230 is Band 2, representing a ‘below average performance’ and 231-290 puts the candidate in Band 3 or a ‘good level of performance’ in the exam.

What specialties need MSRA?

The MSRA is now used as part of the selection process for many medical specialties, including core medical training, GP training, surgery, psychiatry, emergency medicine, and more. You should check the relevant recruiting body for your chosen specialty to confirm whether the MSRA is required.

How do I get invited to MSRA?

If you are eligible for the MSRA, you will be invited to take the exam by the relevant recruiting body for your chosen specialty. You can check the eligibility criteria on the Pastest website or by contacting the recruiting body directly.

When should I take MSRA exam?

The timing of the MSRA exam can vary depending on the specialty and the recruiting body. It is important to check the relevant website for the latest information on exam dates and application deadlines.

In general, it is recommended that candidates take the MSRA exam as early as possible to maximize their chances of success and to ensure that they have ample time to apply for the specialty program they are interested in. Many specialties have strict application deadlines, and taking the MSRA exam early can help ensure that candidates have enough time to complete the application process.

Candidates should also consider their personal circumstances when deciding when to take the MSRA exam. For example, if a candidate is completing a foundation training program, they may want to consider taking the MSRA exam in the final year of their training to ensure that they have the necessary knowledge and experience to perform well on the exam.

It is also important to note that some specialties may require candidates to have completed certain training or have specific work experience before taking the MSRA exam. Candidates should check the eligibility criteria and requirements for their chosen specialty program to determine when the best time is to take the MSRA exam.

How can Pastest help you pass the MSRA?

Pastest offers an online revision resource that cover all aspects of the test. Here, we'll explore how Pastest can help MSRA candidates achieve success on the exam:

Comprehensive Content

The resources cover all areas of the exam, including Professional Dilemmas and Clinical Problem Solving, and feature a range of question types, including Single Best Answer and Extended Matching Questions. The content is updated regularly to ensure that it is relevant and up-to-date with the latest exam format and requirements.

Practice Questions

One of the key features of Pastest's MSRA online revision resources is the extensive range of 1,950 practice questions that are available. The practice questions are designed to help candidates develop their understanding of the exam format and the types of questions that they may encounter on the day. The questions are accompanied by expanded explanations, which help candidates understand why particular answers are correct and others are incorrect. This is an effective way to help candidates develop their critical thinking skills and improve their ability to apply their medical knowledge to real-world scenarios.

Mock Exams

To help candidates assess their readiness for the MSRA exam, Pastest also offers a range of mock exams. These are designed to simulate the real exam experience, allowing candidates to practice their time management skills and get a feel for the format and content of the exam. The mock exams are accompanied by detailed feedback and analysis, which can help candidates identify areas where they need to improve and develop strategies for addressing these areas.

Personalised Learning

Pastest's MSRA online revision resources are designed to be flexible and adaptable to individual learning needs. The resources include a range of personalised learning tools, including customised question sets, progress trackers and performance analysis. The resources can also be accessed from anywhere, at any time through the dedicated Pastest app, making it easy for candidates to fit their study around their busy work and personal lives.

Expert Support

Finally, Pastest's MSRA online revision resources are supported by a team of expert medical professionals who are available to provide guidance and support to candidates. The team includes experienced doctors, educators and examiners who have a deep understanding of the exam format and requirements. This means that candidates can access high-quality support and guidance throughout their preparation for the exam.