A Complete System to Pass the MSRA and Get Your First Choice

The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based exam used by over 15 UK medical specialties as a key part of their specialty training recruitment process. It assesses doctors across two papers: Clinical Problem Solving (CPS) and Professional Dilemmas (SJT). Your MSRA score determines whether you are shortlisted for interview, and in some specialties – most notably GP training – directly determines which training posts and locations you are offered.

Specialties currently using the MSRA for recruitment include: General Practice, Core Psychiatry, CAMHS, Radiology, Ophthalmology, Obstetrics and Gynaecology, Neurosurgery, Community Sexual and Reproductive Healthcare (CSRH), Anaesthetics (ACCS), Core Surgical Training (CST), and others. The list continues to expand. Always check the specific national recruitment website for your specialty – the weight given to the MSRA score varies significantly between specialties.

The MSRA is held multiple times each year as part of different recruitment rounds. Typically, there is a main sitting early in the year for August start posts, with an additional sitting shortly afterwards for selected specialties such as General Practice and Psychiatry. A later round may also run for February start posts.

Exact dates vary each year and are usually confirmed closer to the time. The most up-to-date information can be found on the NHS England medical specialty training recruitment pages.

There is no fee to sit the MSRA.

The MSRA has two independently timed papers with a total duration of approximately 2 hours 50 minutes.

The Professional Dilemmas (SJT) paper is 95 minutes with 50 questions assessing professional integrity, coping with pressure and empathy/sensitivity. No clinical knowledge is tested. Question types are ranking (rank 4–5 actions) and multiple choice (choose the 3 most appropriate from 8).

The Clinical Problem Solving (CPS) paper is 75 minutes with 97 questions across 12 clinical areas, using SBA and EMQ formats. There is no negative marking in either paper – attempt every question.

Candidates receive a band between 1 and 4. Band 4 indicates a high score; Band 1 is usually unsuccessful. For GP training, scores are normalised around a mean of 250 with a standard deviation of 40.

The higher your score, the better your ranking and the greater your chance of securing your first preference training post or location. In some specialties, scoring above a certain percentile bypasses the interview stage entirely.

Aim as high as possible.

Most doctors start MSRA preparation 6–8 weeks before their exam. For GP training and Psychiatry applicants, where the MSRA score is the primary determinant of post allocation, more preparation time is advisable – 2–3 months if possible.

The CPS paper requires breadth of clinical knowledge across 12 specialties; the PD paper requires a thorough understanding of UK professional standards and GMC Good Medical Practice.

For GP training, MSRA scores can be carried forward within the same 6-month recruitment cycle (Round 1/2) for future rounds, provided you tick the carry-forward box on your application.

For most other specialties, MSRA scores are not transferable between recruitment years. Always check the specific specialty recruitment website for the latest rules.

The MSRA requires strong clinical knowledge across a broad range of specialties plus solid SJT technique. For GP training in particular – where your MSRA score directly determines training post offers – high performance matters enormously. Candidates who underperform most commonly do so on the PD paper due to insufficient understanding of UK professional standards, or on the CPS paper by leaving entire clinical domains under-revised.

Yes. You can resit the MSRA in a future recruitment round. For Round 1 (August intake), previous scores from other rounds cannot be transferred – you must sit the MSRA in the Round 1 window.

The MSRA Gold Package covers the core digital materials – video courses, audiobooks, question banks and flashcards – for self-paced preparation across both MSRA papers. The MSRA Ultimate Package adds the 2-day live virtual crammer course. For a high-stakes exam where your score directly determines specialty training offers, the added structure of the Ultimate Package is worth considering.