For some specialties, if you score highly on the MSRA, you can bypass the interview stage of recruitment, meaning there are huge advantages of preparing effectively and performing well in the MSRA. Furthermore, General Practice ST1 and Core Psychiatry CT1 assess and rank applicants based solely on their MSRA performance; therefore, if you’re applying for these, it’s more important than ever to ensure that you’re as prepared as possible for the exam. The Professional Dilemmas section is limited to 95 minutes and is a ranking test, consisting of 50 scenarios. For each situation presented, the candidate will have to rate the appropriateness of 4-5 independent actions (from 1=most to 5=least appropriate). Preparing well for the MSRA will ensure that you give yourself the best possible chance of achieving a high MSRA score and positively impacting your ST application. The following are some final tips to support you in preparing effectively for the MSRA exam:

Ifoundthistobethemostusefulresourceasitgivesyoulotsoftherandomdetailsandfootnotestuffthatcomesupinquestionbanksandtheexam.Ialsofoundithelpfulforphysiologyasthiswasnotastrongpointforme(havingdonealmostnophysiologysince1styearofmedschool),aswellasepidemiologyandstatistics.Ifoundahugedifferencewhendoingquestionsbeforeandafterreadingthisbook,andIdoubtIwouldhavepassedwithoutit.Ireadabout90%ofthebook,skippingonlyacoupleoftopicsIwasveryconfidentin. Useyourstudyleave.Attendacourseifyou'reableto-IreceievedsomeverygoodteachingandsawalotofinterestingneuroandcardiacsignsImightnothaveotherwiseseen.Downsides:cost,arrangingtimeaway.Thereisagoodbreakdownofthedifferentcoursesinthisarticle: After sitting the exam, it was apparent that Emedica is the most representative out of all the MSRA question banks that I have encountered – this is in terms of question style, exam format, and areas of knowledge tested. Although I left the exam not feeling very confident and began to lose hope of getting into my top choice this year, I had scored 623 (305 in the Professional Dilemmas section, and 318 in the Clinical Problem Solving section) – securing band 4 in both, ranking 19th out of 6533 GP candidates that passed and securing a spot in Salford/Trafford to start GPST1 in August 2022.Questions are constantly reviewed to ensure they are up-to-date and consistent with current guidelines and clinical practice For GP applicants, your offer and location of your offer will depend solely on your MSRA score, as opposed to an interview being included like in previous years. Some locations are much more popular than others, so will require a higher MSRA score to be in line with the competition. The score for each paper is normalised; this is usually around a mean score of 250, but as normalisation is dependent on each year’s average scores, there could be a variation of up to 40 marks either side of the mean score. There is no negative marking; marks can still be rewarded for answers that are not entirely correct but unanswered questions will be given no marks. You will be given a set of responses (usually between 7 – 10) and asked to select the most appropriate option for multiple, individual scenarios. Each of the responses may be used once, more than once or not at all when selecting a suitable option for each scenario.

Having gone through the process feeling under a lot of pressure for a few reasons, I think my advice to those preparing for the exam, especially those with children and slightly more difficult revision circumstances would be: I naively planned to start preparing for the MSRA exam in August when I was due to begin my first FY2 rotation, which would’ve allowed me 6 months to prepare at a good steady pace. Unfortunately, my first FY2 rotation was Cardiology – by far the busiest one that I have ever encountered. Regular nights, long and hectic on-call shifts and very eventful and understaffed wards all meant that I was regularly staying late to finish urgent jobs. Subsequently, this meant that I neglected my study towards the MSRA and before I knew it December came around and I was rotating onto General Practice with only around 6 weeks left to focus on the exam! This is why I was reluctant to even bother applying this year, but thanks to question banks such as Emedica, I’m so glad that I did. Many specialties – namely community sexual and reproductive health, general practice, neurosurgery, obstetrics and gynaecology, ophthalmology, psychiatry (core and child and adolescent), and radiology – use the MSRA in selection processes for specialty training. 1 Negative marking is not utilised. Consequently, candidates are encouraged to answer all questions. 1 Candidates who have achieved the minimum score in an earlier round in the same recruitment year may transfer their score or resit to improve their score. However, regardless of whether this score is better or worse, it will replace the former score. 2 Getting into GP training has become increasingly competitive over the last few years, especially for doctors aiming to get into popular areas. Dr Zeinab Dafalla shares here experience and tips that helped her get an MSRA score of 623. This was one of the highest scores in the country (she ranked 19th out of over 6500 doctors that passed the MSRA for GP) and helped her to secure her 1 st choice area in Salford, Manchester.C is the best option as you are speaking directly with the registrar, and not undermining them in front of the patient or team. The question states that the ward round was busy so waiting until the end may be more appropriate, especially as the operation is still in 2 days’ time. GMC Good Medical Practice states that you should make sure ‘arrangements are made, wherever possible, to meet patient’s language and communication needs’ and be satisfied that consent is taken before providing treatment. As the nurse is reluctant to speak it is important to ensure the concerns do not go unnoticed, especially since you are aware his daughter usually translates. It does not test knowledge or problem-solving. Instead, the content relates to the GMC’s Generic Professional Capabilities framework and tests attributes that are important for doctors’ training progression and job performance. The three main competencies tested are professional integrity, coping with pressure and empathy and sensitivity. 1 Knowledge of specialty training is not needed but a general understanding of primary and secondary care work is expected. Questions are set in the context of the UK Foundation Programme; candidates assume the role of F2 doctors. However, to make certain the fairness of the MSRA for all candidates including International Medical Graduates, questions do not entail any knowledge of policies or procedures that are specific to the UK. 1

Passmedicine provides an online revision for the MRCP Part 1, MRCGP Applied Knowledge Test (AKT), GP ST Stage 2 – Specialty Recruitment Assessment, Medical student finals, MRCP Part 2, Situational Judgement Test, PLAB, DRCOG. Revision questions in the modern form to help you pass. The MSRA is separated into two sections, and you can see an example of a question from each section in our question bank below. Professional Dilemmas PaperAs well as exploring the exam topics, incorporating practice questions is essential for your MSRA preparations. This allows you to become familiar with the different types of questions and scenarios you’ll encounter during the exam, and provides opportunities to practise applying your knowledge and problem solving skills, which are important elements that will be assessed within the MSRA exam. The CPS paper comprises 97 questions and assesses higher level synthesis of medical knowledge. 1 Typically, this part of the MSRA is allocated 75 minutes. Candidates may be allowed 25% or 50% additional time. The CPS paper poses scenarios that test candidates’ ability to apply their knowledge and use problem-solving skills to make clinical decisions. The settings of the scenarios provide context, but the judgement required to answer the questions is not specific to one setting. The questions are based on the Foundation Programme curriculum and cover twelve topics relevant to general medicine ( Box 1). 1 You will be given a set of responses (usually between 5 – 8 in this instance) and asked to select the most appropriate option for a single scenario. The premise of the exam is to test the individual’s ability to apply their medical knowledge, not just recall their knowledge. It is split into two parts: Professional Dilemmas and Clinical Problem Solving, both independently timed. I found the scoring scale for MSRA slightly confusing as there is no maximum score achievable. Instead, they used a system called ‘normalisation’ which takes into account the score of everyone who takes the exam and normalises them around a mean score of 250 with a standard deviation of 40. The scores are then placed into bands 1-4. Band 1 are the lowest scores and are unsuccessful in progressing further, and 4 includes the highest scorers.