I scored in the top 1% in the Professional Dilemmas section of the MSRA and was offered my first-choice training programme. Looking back, that's hard to believe because when I first started revising, I felt completely overwhelmed.
I hadn't sat an exam since medical school, I'd never done an SJT before, and suddenly I was expected to revise hundreds of clinical topics alongside preparing for a completely new style of exam.
The biggest thing that helped me was accepting that I wasn't going to feel fully prepared from day one. Instead, I gave myself 11 weeks and focused on building my revision gradually.
Starting my MSRA revision
After being away from formal exams for a while, my first goal was simply to get back into the habit of studying.
Rather than trying to cover everything immediately, I focused on understanding the exam format and working through practice questions. As I identified weaker areas, I gradually increased the intensity of my revision and used my results to guide where I spent my time.
That approach felt much more manageable than trying to revise everything at once. And if I'm honest, it didn't really feel like everything clicked until the final few days before the exam. That's when all the weeks of practising questions, reviewing mistakes and becoming familiar with the exam format finally came together.
Professional Dilemmas was my biggest challenge
The part of the MSRA I found most difficult was definitely Professional Dilemmas.
I'd never sat an SJT before, so at first I found it difficult to understand what the questions were really asking. It wasn't simply about knowing the clinical knowledge – it was understanding why one response was more appropriate than another, especially when several options initially seemed reasonable.
For me, practising questions was the biggest turning point.
I used the Pastest MSRA question bank alongside the practice papers. I also worked through the Professional Dilemmas past papers, which contain full sets of SJT (Situational Judgement Test)-style questions designed to reflect the format and decision-making required in this section of the exam.
What I found most useful wasn't simply seeing whether I'd answered correctly, but understanding the reasoning behind each answer. Instead of memorising responses, I began to recognise the principles behind the questions, which made approaching unfamiliar scenarios much more intuitive.
That made a huge difference to my confidence.
Using mock exams to prepare for the real thing
Mock exams were another key part of my preparation.
The MSRA is a time-pressured exam, so knowing the material is only part of the challenge. The mocks helped me practise working at pace while also highlighting the areas where I needed to focus my remaining revision.
I found using question banks, practice papers and timed mock exams together far more effective than relying on any single resource.
What I'd do differently
If I had to prepare for the MSRA again, I'd start earlier than I think I needed to. Giving myself more time would have allowed me to build confidence more gradually and spend longer consolidating the topics I found most difficult.
I'd also remind myself that revision doesn't always feel productive straight away. There were times when I questioned whether I was making progress, but looking back, every practice session was helping to build the knowledge and confidence I needed for exam day.
If I could give one piece of advice, it would be this:
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Start earlier than you think you need to. Give yourself time to build your knowledge and become familiar with the exam format.
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Increase your revision gradually. Building momentum over time felt much more sustainable than trying to do everything at once.
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Learn from every mistake. Don't just check whether an answer is right or wrong – understand why.
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Focus on your weaker areas. Use question banks, practice papers and mock exams to identify where your revision will have the biggest impact.
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Practise under timed conditions. Getting comfortable with the pace of the exam was just as important as learning the content.
How Pastest fitted into my revision
Pastest became a key part of my revision because it supported every stage of my MSRA preparation.
The MSRA question bank helped me understand the judgement behind Professional Dilemmas questions rather than simply memorising answers. The clinical question bank, practice papers and mock exams helped me identify weaker areas, build confidence and prepare for the pace of the real exam.
Pastest includes two full past papers dedicated to the Professional Dilemmas section of the MSRA, which is made up of SJT-style questions. They gave me the opportunity to practise the style, format and pacing of this part of the exam under realistic conditions, helping me become much more comfortable with the judgement-based scenarios before exam day.
I also made sure I used Pastest alongside the official MSRA practice materials, rather than treating any one resource as a replacement for the official papers.
Since I sat the exam, Pastest has updated its MSRA resource with an improved question bank, new mock exams and a free MSRA Revision Guide. It's a great place to start if you're unsure how the exam works or how to structure your revision.
You can find out more about the updated MSRA resource here.
The result
In the end, I scored in the top 1% for Professional Dilemmas and secured my first-choice training programme.
Looking back, the biggest lesson I learned is that you don't need to have everything figured out from the start. Give yourself enough time, revise consistently, learn from your mistakes and trust the process.
If you're preparing for the MSRA now, remember that it's completely normal for your confidence to grow gradually. Keep showing up, stick to your revision plan and trust that all those practice questions really do add up. Before you know it, everything starts to come together.