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The Ultimate MSRA Preparation Guide

Find out all about the MSRA exam, including what it is and how to prepare adequately for it.


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MSRA Preparation

What is the MSRA exam?

The Multi-Specialty Recruitment Assessment (MSRA – also known as SRA) is a computer-based assessment and forms part of application for UK postgraduate training in the following specialities:

General Practice
Core Surgical Training (new for 2023)
Obstetrics and Gynaecology
Child and Adolescent Mental Health Services (CAMHS)
Community Sexual and Reproductive Healthcare (CSRH)

Each speciality utilises your MSRA result in a different way – it is worth looking at the individual specialty websites (for most this is the HEE website) for further information. Please note this is the first time that Core surgical training (CST) will be using the MSRA in its recruitment process for 2023. The MSRA can be taken at various centres across the UK.

Read more: How to get into UK GP training.

Your MSRA result for GP training can be taken forward for future rounds within a 12 month period e.g. your Round 2 score from 2021 can be carried forward for your round 1 application as it is within 12 months. You can resit MSRA within the same recruitment year if you are unsuccessful in an attempt.

For other specialties please check their websites to see if this applies for their future rounds too.

MSRA Preparation

MSRA Exam Dates

MSRA exam dates Round 2:

The MSRA exam dates for round 2 applications (for starting your placements in February 2024) will be between 25th July and 15th August 2023.

The MSRA exams will be held between 1st and 8th September 2023

MSRA exam dates Round 1:

The MSRA exam dates for new round 1 applications (for starting your placements in August 2024) will be between 26th October and 23rd October 2023.

The MSRA exams will be held between 4th and 16th January 2024.

MSRA Exam Preparation

How the MSRA exam is formatted

The assessment consists of two types of question papers:

a) Clinical questions (75-minute paper)
b) Professional dilemma questions (95-minute paper)

The Professional Dilemma Paper usually happens first and is shortly followed by the Clinical Questions paper.
A 5-minute break occurs between papers (countdown appears on screen).
There is a countdown timer for each individual paper on the screen.
Total duration of the assessment is just under 3 hours (175 minutes, including break).
The Professional dilemma paper (SJT) consists of 50 Situational Judgement Test questions in 95 minutes – this paper occurs first. See below for more details and example questions.
The Clinical problem-solving paper (CPS) consists of 97 clinical questions in 75 minutes – this paper starts 2 minutes after completion of the SJT paper. See below for more details and example questions.

MSRA Exam Preparation

The Professional Dilemma (SJT) Paper

In order to know how to prepare for the MSRA properly, you will need to know how to tackle the SJT paper. The SJT 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.

Key facts:

– The SJT is made up of 50 questions
– It lasts for a duration of 95 minutes. 
– It assesses 3 core competencies. 
– No clinical knowledge is assessed in this paper and there is NO negative marking.
– There are two types of questions that the SJT asks.

SJT: The three core competencies

The three core competencies are:
a) Professional Integrity
b) Coping with Pressure
c) Empathy and Sensitivity

All of these competencies and more are covered in our MSRA SJT Online Course.

SJT: The two types of question:

Watch: this video 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 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.

A sample SJT question 

You are a FY2 Doctor on an orthopaedic ward. Your team has just seen an elderly Spanish man on the busy ward round who understands limited English. Your registrar has gained written consent from him for a hip operation scheduled for 2 days’ time. One of the nurses quietly says to you that she suspects the patient was just nodding politely and understood very little. She says she doesn’t want to undermine the registrar. You know his daughter visits daily and always translates if she is present. Do you:

Rank the following actions in order from the most appropriate (1) to the least appropriate (5) in this situation.

A)  Call the patient’s daughter directly to alert her what has happened
B) Address your registrar in front of the patient about these concerns, presuming the patient does not understand
C) Speak to the registrar privately at the end of the ward round about the concerns
D) Ignore the nurse’s comment as the patient’s daughter could always relay any concerns when she visits later
E) Encourage the nurse to speak up and then carry on with your ward round tasks

Suggested Answer: CBAED

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.

B is not as good an option because although it does directly act on your concerns, it undermines the registrar in front of others and may impact your working relationship. Furthermore, it may distress the patient who has limited understanding of English. It ranks higher than A, E or D because at least the concerns are actively voiced directly to him.

A is a poor option as it potentially breaches patient confidentiality and may cause distress to the patient and relative. You are taking action to try and ensure patient understanding but going about it in a way that i) undermines the registrar, ii) may negatively impact your working relationship and iii) may negatively impact the patient and family’s trust in the medical care being provided. 

E is the next worst option here as although you are encouraging her to speak up, you are not taking any responsibility in following this up – and thus checking to ensure that the consent taken is valid. 

D is the worst option as it disregards a suspicion that the consent taken was invalid and fails to act on this at all. Relying on the patient’s daughter to relay any concerns that the patient may confide to her is inappropriate. This does nothing to actively voice concerns to the registrar, who is in a position to discuss the operation again and ensure consent taken is valid (in the presence of an appropriate interpreter if necessary).

Practise more SJT questions for FREE: Check out our MSRA SJT mock exams

MSRA Exam Preparation

The Clinical Paper

Another part of MSRA preparation you can’t do without is the clinical paper, which assesses your ability to apply clinical knowledge to help make clinical decisions – it is not a test of pure knowledge.

Key facts:

– The SJT is made up of 75 questions
– It lasts for a duration of 97 minutes.  
– It assesses 5 core competencies. 
– 12 clinical topic areas are included.
– There are two types of questions that the clinical paper asks.

Clinical paper: The five core competencies

The five core competencies are:

a) Investigation
b) Diagnosis
c) Emergency
d) Prescribing
e) Management

Clinical paper: The 12 clinical topic areas

The 12 clinical topic areas / MSRA specialities are:

1. Cardiovascular
2. Dermatology/ENT/Eyes
3. Endocrinology/Metabolic
4. Gastroenterology/Nutrition
5. Infectious/Haematology/Allergy/Genetics
6. Musculoskeletal
7. Paediatrics
8. Pharmacology and Therapeutics
9. Psychiatry/Neurology
10. Renal/Urology
11. Reproductive
12. Respiratory

All of these clinical topic areas and competencies are covered in our MSRA Clinical Crammer Online Course.

Clinical paper: The two 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).

A sample clinical paper question 

Ruby is 2 years old and is seen today with her father as she has had a one-week history of runny nose and has complained her throat hurts. This morning she has noted a rash on both cheeks but nowhere else on the body. Ruby is well in herself and eating, drinking, passing urine and opening her bowels as normal. She has no other medical history and is up to date with immunisations. She is not lethargic and on examination today is playing happily in the consulting room, has normal observations and an unremarkable respiratory and throat examination. There is a diffuse erythematous rash on both cheeks. What is her most likely diagnosis?

A)  Scarlet Fever
B) Herpes virus type 6
C) Measles
D) Rubella
E) Parvovirus B19

Suggested Answer and key Learning Points: E

– Slapped Cheek Syndrome (usually school age children) is caused by the organism Parvovirus B19.
– An erythematous facial rash (one or both cheeks) is a key defining feature, but usually other prodromal features are common e.g. low-grade fever, myalgia, nausea, runny nose
– The condition is usually mild and self-limiting.
– Treatment is mainly supportive e.g. rest, fluids, analgesia.
– Complications are rare in healthy people, if a patient is pregnant then further advice should be sought.

Practise more clinical paper questions for FREE: Check out our MSRA clinical mock exams. 

MSRA Preparation

What is the pass mark for MSRA?

There is no specific pass mark for the MSRA. There is no maximum score for the MSRA and your result is dependent on the results of other candidates within your cohort taking the MSRA exam.

MSRA Preparation

How is MSRA marked, and what is a good MSRA 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 training candidates are normalised around a mean score of 250 with a standard deviation of 40.

MSRA Preparation

How to Prepare for and Pass MSRA

Firstly, I would suggest becoming familiar with the controls and exam set up by looking at the demo videos at the Pearson VUE and Oriel sites. <What videos? We should include them here.

From my own experience with doctors preparing for MSRA there are two main chosen approaches – question-bank based and ‘formal revision’ based – and I am often asked which is best.

My simple answer is that relying on one method alone can leave you a little short. No question bank can cover every aspect of the MSRA, whilst purely reading books and guidelines will not give your brain adequate exposure to problem-solving. If planned well, both should be used together as both have advantages in terms of improving retention and performance.

Click here for our FREE daily preparation planner for the upcoming MSRA exam.

The best resources for MSRA

Making optimum use of time is important – using travel time to answer a few questions here or there, or listening to a chapter of our MSRA Clinical Crammer or SJT Audiobook courses for example, can add to the formal preparation time that you sit down to do.

Some prefer visual learning – for example our MSRA Clinical and SJT Online Courses allows you to follow syllabus-based teaching on screen – in more depth than the audiobooks.

Another very common question that I get asked is ‘which question bank should I use?’ I have not had experience of all banks on the market but all I would say is try and have some variety. Often doctors rely on only one question bank and get very used to a certain style of question-writing – doing the same style of question 2-3000 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 purchase two question banks, or whether you simply hire a few MSRA question books from the library, try to at least use two sources – our MSRA Online Mock Exams can offer a different style of question, as well as pressurised practice under timed-conditions – something that many candidates miss out in their preparation.

MSRA Preparation

How Arora Medical can help with your MSRA preparation.

If you are preparing for the MSRA I wish you good luck! It can be a challenging assessment but if you balance question banks with background preparation you should do very well.

Our most popular and comprehensive MSRA Ultimate Package contains an all round and complete preparation plan for boosting your MSRA score. It contains multiple resources in one discounted bundle – 2x online video courses, Live MSRA crammer course, SJT and clinical mock exams, 2x audiobooks and 3x digital flashcard sets (clinical, pharmacology and SJT). 

Click here for all of our individual MSRA revision resources (e.g. mocks, online courses etc.).

To register for our next free MSRA webinar click here: Next Free Webinar.

For our Free MSRA Countdown Programmes click here: Free MSRA Downloads.

MSRA Preparation

On a final note...

I look forward to supporting you through your successful selection process, and if applying to GP training I hope to meet you on our GP training courses!

Good luck and #CanPassWillPass.

Author Bio — Dr Aman Arora

Hello and welcome to Arora Medical Education! I am a Portfolio GP with a 24/7/365 passion for helping you fly through your medical exams and maximise your career. You can find out more about me here.

I’ve been fortunate to teach over 50,000 doctors globally through a combination of face-to-face, online, audio and social teaching, helping them pass exams such as MRCGP AKT and RCAMSRA and PLAB. You can find out more about my previous roles and qualifications here.

Feel free to contact me with any thoughts, questions or ideas to help you reach your potential. I look forward to meeting you soon!

Author Bio — Dr Pooja Arora

Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).

You can find out more about Pooja’s previous roles and qualifications here.

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