Executive summary
The Multi-Specialty Recruitment Assessment (MSRA) is a critical, computer-based exam used for entry into GP ST1 training and a growing number of other specialties in the UK. Success depends on a thorough understanding of its two distinct components: the Professional Dilemmas (PD) paper and the Clinical Problem Solving (CPS) paper. The most effective preparation strategy is to start with the official guidance and practice papers, then layer on high-quality question banks and smart AI tools to accelerate your learning and improve retention (medical.hee.nhs.uk).
This guide provides a definitive playbook for 2025, mapping out the best resources and showing how to integrate AI-powered tools. A new generation of platforms like iatroX, with its free, adaptive, and spaced repetition quizzes, can complement classic question banks, helping you to target weaknesses and consolidate knowledge more efficiently. The evidence is clear: techniques like spaced repetition significantly improve performance in medical exams.
MSRA at a glance (know the exam before you revise)
Before you begin revising, it's essential to understand the exam's structure and rules.
- What it is: A computer-based assessment delivered at Pearson VUE centres, designed to assess essential competencies for specialty training.
- Specialties using MSRA (2025): Its use is expanding. Core users include GP ST1, Core Psychiatry, Clinical Radiology, Core Surgery (new for 2025), ACCS Emergency Medicine, and O&G, among others. Always check the official page for the latest list.
- The two papers:
- Professional Dilemmas (PD): A Situational Judgement Test (SJT) with 50 scenarios, using a mix of ranking and "pick-3" multiple-choice questions.
- Clinical Problem Solving (CPS): 86 questions covering 12 clinical topics, using a mix of extended-matching questions (EMQs) and single-best-answers (SBAs).
- Key takeaway: The official candidate tips state that there is no negative marking. You must attempt every single item on both papers.
Non-negotiables: official sources to start with
Your revision must be built on the foundation of the official guidance.
- MSRA Overview: The "Taking the MSRA" page on the Health Education England website is your single source of truth for booking, outcomes, and appeals.
- Exam Content: The "What’s in the MSRA" page provides crucial detail on the PD and CPS papers, plus essential tips for candidates.
- Official Practice Paper: You must work through the official practice paper to familiarise yourself with the interface and question style.
The classic stack: high-yield MSRA question banks
These are the tried-and-tested platforms that form the core of most candidates' revision.
- PassMedicine (MSRA): Known for its large question bank covering both CPS and PD papers, offered at a very competitive price point.
- Pastest (MSRA): A long-standing leader with a sizable question bank, detailed topic analytics, and multiple subscription lengths to suit your revision timeline.
- Quesmed (MSRA): A modern platform with over 2,300 questions for the MSRA, integrated notes aligned to NICE guidance, and an excellent offline mobile app.
- BMJ OnExamination (GP ST Stage 2/MSRA): A trusted source from the BMJ, offering approximately 840 questions covering both the CPS and PD papers, with mobile app support.
AI-powered revision: faster feedback, better retention
AI tools are not a replacement for the classic stack, but they are a powerful accelerator. They help you close knowledge gaps more quickly and use learning science to retain information for longer.
iatroX (free, UK-centric)
- Quiz: The iatroX Quiz is a free, AI-powered tool with both an adaptive learning engine and a spaced repetition mode. It helps you to target your weak domains automatically, making your daily revision more efficient.
- Evidence base: The principles of spaced repetition are strongly supported by evidence in medical education, showing they improve both learning and long-term retention (PMC).
- Knowledge Centre / Ask: When you get a question wrong and need to understand the underlying guideline, the Ask iatroX feature can provide quick, cited answers that help you navigate to the definitive UK guidance to verify the information.
Study framework: CPS & PD with an “AI assist”
CPS (clinical knowledge & decisions)
- Aim for 40–60 CPS items per day in your chosen question bank.
- Debrief with citations. For every question, especially those you get wrong, quickly verify the concept against the relevant NICE or CKS summary.
- Add your errors to a spaced repetition queue. Use the iatroX Quiz or another flashcard system to ensure you review your mistakes at optimal intervals.
PD (professional judgement)
- Drill both formats. Make sure you are comfortable with both the ranking and "pick-3" question styles.
- Re-read the marking logic. Understand that there are "near-miss" scores available and that there is no negative marking.
- Practise under timed conditions. Review the rationales carefully and look for recurring professional domains being tested (integrity, coping with pressure, empathy, patient safety).
Weekly revision blueprint
| Day | Time | Activity |
|---|---|---|
| Mon–Thu | 90 mins | 60 mins: Mixed bank questions (CPS/PD).<br>15 mins: Clarify concepts with cited guidance.<br>15 mins: Spaced review (e.g., iatroX Quiz). |
| Fri | 60 mins | Full PD or CPS mini-mock under timed conditions. Debrief and add all mistakes to your spaced-repetition queue. |
| Weekend | Optional | Walk through the official MSRA Practice Paper. Focus on your technique for EMQs and PD ranking questions. |
Resource matrix
| Task | Primary Resource | Why It’s High-Yield | AI Add-on |
|---|---|---|---|
| Learn the Format | Official MSRA Pages & Practice Paper | Authoritative, up-to-date source | — |
| CPS Drill | PassMedicine/Pastest/Quesmed/BMJ OnExam | Breadth + exam-style EMQ/SBA | iatroX Quiz for spaced reviews |
| PD Technique | Official PD page + bank PD sets | Understands near-miss scoring & domains | Post-set debrief with cited summaries |
Knowledge tracing & spaced repetition—why they help
These AI-driven techniques model your understanding of a topic to decide which question to show you next and when to show it again. This process of spacing out your reviews is scientifically proven to build more durable, long-term memory, which can reduce your overall time-to-mastery for a given subject. Recent medical education studies continue to show that spaced repetition improves exam scores and knowledge retention.
FAQs
- Is there negative marking in the MSRA?
- No. You should attempt every single question on both papers.
- How many items are in each paper?
- The Professional Dilemmas paper has 50 scenarios. The Clinical Problem Solving paper has 86 items, in a mix of EMQ and SBA formats.
- Which question bank is “best”?
- A common and effective strategy is to use one large primary bank (from PassMedicine, Pastest, or Quesmed) and supplement it with a second source for variety, especially for the PD paper. Always benchmark your performance using the official Practice Paper.
- Where do AI tools fit into my revision?
- Use them after each study session. Use a citation-first Q&A tool to verify the concepts you struggled with, and then feed your mistakes into a spaced repetition engine like the iatroX Quiz to ensure you don't forget the lesson.