MSRA Preparation That Gives You the Best Chance of Your First-Choice Specialty

When preparing for MSRA,  there are two main chosen approaches – question-bank based and ‘formal revision’ based.

Relying on one alone leave can leave you a little short. No question bank can cover every aspect of the MSRA, whilst purely reading books and guidelines means you won’t gain any experience of dealing with questions you may face in the exam.

If planned well, both should be used hand-in-hand as both have advantages in terms of improving retention and performance.

A few key references to familiarise with and keep referring to throughout preparation: MSRA Blueprint, NICE guidelines, BNF and BNF for children, Oxford Handbook of clinical medicine, GMC Good Medical Practice booklet.

The MSRA Blueprint should be used as a guide to your preparation. This outlines which areas will be tested in the MSRA – not going through this will lead to surprises on the day. It covers quite a lot but if you plan things well it will ensure you cover everything.

Make a timeline. Planning is vital given the huge amount of material to cover for MSRA. Work out how long you have between now and your exam, and break down your revision accordingly. Which topics to have covered by when, how many questions to complete per week? etc. Lack of this may lead to haphazard preparation and an overwhelmed feeling. Our MSRA revision planners are designed to help you plan out your revision and can be found here: Free Planner

The most comprehensive package for MSRA is our MSRA Ultimate Package. This is a package which focuses on the two core components needed for MSRA success – knowledge and technique. The package has 6 months access to all material and contains a live, virtual crammer course, 2 online video courses, 2 audiobook courses, 2 question banks, multiple mock exams, clinical flashcards, and SJT flashcards. To find out more about the package and for doctor reviews click here.

The MSRA exam dates for round 1 applications (for starting your placements in August 2026) have been announced. There will be 2 sittings. The first will be between 6-19th January 2026, and the second sitting will be 12th-25th February 2026 for GP and Psychiatry applicants only.

Your MSRA scores can be transferred for future rounds within a 6 month period for GP training applications. It is important to tick the box confirming you wish to carry forward your MSRA score from a previous round otherwise it will be assumed you wish to resit the MSRA exam. For other specialties it is best to check with their individual specialty websites for further information.

There are several areas of UK postgraduate medical practice which require trainees to pass an MSRA exam. These are

Radiology
Psychiatry
Ophthalmology
Obstetrics and Gynaecology
Neurosurgery
Child and Adolescent Mental Health Services (CAMHS)
Community Sexual and Reproductive Healthcare (CSRH)
Anaesthetics
Core surgical training
ACCS Emergency Medicine

Please note that CST (core surgical training) will be using MSRA for the purpose of shortlisting for the first time this year for 2025 recruitment.

Many International Medical Graduate doctors complete internship in their home country before coming to the UK.

To enter speciality training in the UK, applicants must demonstrate that they have a) achieved foundation level competences and have b) completed accepted clinical experience (usually 24 months in total). By completing the CREST 2024 (Certificate of Readiness to Enter Speciality Training) form, an applicant – who has the necessary clinical experience – can demonstrate that they have achieved foundation competences and apply directly to speciality training.

For full details on the CREST form read here.

The CREST form is NOT for applicants who have:

– Completed a UK Foundation programme (within last 3.5 years) – you would need to submit a copy of your UKFPCC.
– Started but not completed a UK foundation training
– Completed a Foundation Year 2 standalone post

The Professional Dilemma Paper – or SJT – is a 95 minute exam paper consisting of 50 questions. It is usually taken first and then followed by the second part of the MSRA test – The Clinical Paper. It assesses 3 core competencies:

a) Professional Integrity
b) Coping with Pressure
c) Empathy and Sensitivity

It assesses how someone behaves when posed with a potential professional dilemma at work as well as your ability to judge the situation and decide how to approach it.

No clinical knowledge is assessed in this paper and there is no negative marking.

There are two types of questions on the MSRA SJT exam (see this video which covers how to approach the two main types of MSRA SJT Question):

1) Ranking questions – These are questions where you are presented with four or five actions relevant to the clinical scenario and are asked to rank how you would approach the situation in order or appropriateness (with ‘1’ being most appropriate and ‘5’ being the least appropriate action)

2) Multiple choice questions – These will ask you to choose the three most appropriate actions related to the situation from a list of eight – the combination of these three actions should help resolve the situation in the question.

There is plenty of MSRA SJT teaching in our MSRA Ultimate Package.

The clinical paper is usually the second part of the MSRA exam, and is taken after the Professional Dilemma paper (usually after a short break).

The MSRA clinical paper lasts for 75 minutes and consists of 97 questions.

It is designed to assess your ability to apply your knowledge for clinical problem solving, rather than being a test of pure knowledge.

Questions are designed to assess 5 core competencies.

a) investigation
b) diagnosis
c) emergency
d) prescribing
e) management

12 clinical topic areas are included, and these are all covered in our MSRA Ultimate Package

– Cardiovascular
– Dermatology/ENT/Eyes
– Endocrinology/Metabolic
– Gastroenterology/Nutrition
– Infectious/Haematology/Allergy/Genetics
– Musculoskeletal
– Paediatrics
– Pharmacology and Therapeutics
– Psychiatry/Neurology
– Renal/Urology
– Reproductive
– Respiratory

There are 2 different types of question:

1) Extended matching questions – EMQ (chose the single most appropriate answer from a choice – answers relate to several questions)

2) Single best answer – SBA (choose the single most appropriate answer from a choice – answers relate to a single question).

There is lots of MSRA Clinical teaching in our MSRA Ultimate Package.

This video covers how a dual preparation approach can help increase your clinical paper score.

You will be allocated a band number between 1 and 4. A band 1 score in either paper usually means the candidate has been unsuccessful. Band 4 represents a high score.

Each Speciality will utilise MSRA marks in a different way. Please visit the relevant Speciality recruitment website for full details.

For GP training the MSRA is marked using a method called normalisation. The MSRA scores for GP recruitment candidates are normalised around a mean score of 250 with a standard deviation of 40.

It is important to start MSRA preparation early to ensure you score highly in the exam. The MSRA will assess your competencies against the GMC Good Medical Practice guidelines for the SJT paper and will test your clinical knowledge across a number of clinical areas. You will therefore need a strong grasp of ethical concepts, clinical knowledge and good exam technique to pass this exam.

The most comprehensive package for MSRA is our MSRA Ultimate Package. This is a package which focuses on the two core components needed for MSRA success – knowledge and technique. The package has 6 months access to all material and contains a live virtual crammer course, 2 online video courses, 2 audiobook courses, 2 question banks,  multiple mock exams, clinical flashcards,  and SJT flashcards. To find out more about the package and for doctor reviews click here.

The most comprehensive package for MSRA is our MSRA Ultimate Package. This is a package which focuses on the two core components needed for MSRA success – knowledge and technique. The package has 6 months access to all material and contains a live virtual crammer course, 2 online video courses, 2 audiobook courses, 2 question banks, multiple mock exams, clinical flashcards, and SJT flashcards. To find out more about the package and for doctor reviews click here.

Our free MSRA Planner Programmes can help guide your preparation on a day-by-day basis.

We also offer plenty of free teaching and support through Social Media: daily teaching through our Flagship MSRA Telegram teaching group, GP Training Facebook Support Group, YouTube channel and Instagram page.

When searching for the best MSRA question bank for revision, the best advice is to try to find something which offers as much variety as possible.

Often people rely on one bank and get very used to a certain style of question-writing – doing the same style of question 3-4000 times is bound to trigger your brain to think in a certain way and it can be very confusing when another style is suddenly encountered in the exam. Whether you have two question banks, or whether you simply hire a few MSRA question books from the library, try at least two sources. You can try our sample MSRA mock exam questions here.

The varied nature of the MSRA can make it challenging to use just one resource to study. A combination of question-bank-based preparation and ‘formal revision’ will serve you well, offering you the advantages of both styles to improve your retention.

As the question types can change from year to year, it is important to use different MSRA exam question banks to study. This gives you a more comprehensive picture of what to expect so that you can deliver the best performance during the assessment.

The most comprehensive package for MSRA is our MSRA Ultimate Package. This is a package which focuses on the two core components needed for MSRA success – knowledge and technique. The package has 6 months access to all material and contains a live virtual crammer course, 2 online video courses, 2 audiobook courses, 2 question banks, multiple mock exams, clinical flashcards, and SJT flashcards. To find out more about the package and for doctor reviews click here.

Although you have access to material for 6 months, the majority of doctors who purchase the package are between 1 and 3 months from their exam. All material is available to use flexibly as and long as you have a plan, you can get through it all in a few weeks if needed. You will certainly cram a lot of knowledge into a short period of time – which will definitely help on the exam day itself!