The MSRA is not a finals re-run. NHS England describes it as a computer-based assessment built around clinical scenarios that tests whether candidates have the competences needed for their chosen specialty. It combines Clinical Problem Solving with Professional Dilemmas, and it is used as a sift for competitive specialty training applications — GP, Psychiatry, Ophthalmology, Radiology, Neurosurgery, Paediatrics, Community Sexual and Reproductive Health, among others.
That changes what a good revision resource looks like. Finals-style Q-banks help, but they do not cover the Professional Dilemmas component, and they often do not pitch the clinical questions at the specific MSRA level — slightly above FY1, weighted toward primary care and acute presentations, time-pressured.
This guide compares the credible MSRA options.
What the MSRA tests
The structure is specific.
Clinical scenarios as the primary question format. Not free-text recall, not pattern-recognition trivia — scenarios that resemble real consultations or ED presentations.
Clinical Problem Solving paper. Tests applied clinical knowledge at CT1 to ST1 level across the major specialties.
Professional Dilemmas paper. Tests judgement in workplace scenarios — ranking actions in order of appropriateness, choosing between competing professional priorities.
Specialty recruitment relevance. The exam exists to discriminate between applicants competing for limited training places, which means the discrimination threshold is high.
Time pressure. The exam is designed to be completed quickly, with limited time per question.
Applied judgement rather than recall. The right answer is often "what would a competent doctor do?", not "what is the textbook diagnosis?".
Why finals Q-banks are not enough
The mismatch is structural.
Finals Q-banks may cover clinical knowledge but not MSRA style. The MSRA stems are different — shorter, more decision-oriented, more weighted toward primary care and acute presentations.
Professional Dilemmas requires specific preparation. There is no equivalent in finals revision, and candidates who do not practise the PD format underperform regardless of how well they know the medicine.
Clinical questions are often more primary-care and acute-oriented than finals. The MSRA reflects what a CT1 or ST1 doctor actually encounters, which weights heavily toward general practice and emergency medicine.
Candidates need prioritisation, not just diagnosis. The MSRA is faster than finals — the cognitive task is less "what is this?" and more "what do you do now?".
A finals Q-bank can be a starting point, but it should not be the only resource for MSRA preparation.
What a good MSRA resource should include
The specification follows from the exam structure.
CPS-format practice with stems pitched at the right clinical level and weighted toward the right specialties.
PD-format practice with judgement scenarios and appropriate ranking exercises.
Timed blocks that simulate the actual time pressure.
Professional judgement explanations that go beyond "the correct answer is C" — candidates need to understand why one professional action is preferred over another.
Primary-care-style clinical reasoning, because GP is the largest specialty using the MSRA.
Weakness tracking that distinguishes between clinical gaps and PD-judgement gaps.
Adaptive revision that targets weak topics automatically.
Rapid review mode for last-minute consolidation.
PassMedicine for MSRA
PassMedicine's MSRA resource includes revision mode, timed tests, performance analysis and question review functions, with explanations and revision notes under each question. The bank is established, the interface is familiar, and the model is consistent with PassMedicine's broader offering.
The strengths are bank size, brand familiarity and predictable subscription. For candidates who already use PassMedicine and want MSRA content from the same platform, it is efficient.
The limitations are that the platform is not specifically designed for the MSRA's distinct format — it adapts the broader PassMedicine model rather than building MSRA-native features.
The fit is strongest for candidates who want a familiar high-volume MSRA bank consistent with the broader PassMedicine experience.
Quesmed for MSRA
Quesmed's MSRA bank covers 2,300 questions across Clinical Problem Solving and Professional Dilemmas, with explanations and analytics. The coverage of both papers is explicit and the bank size is substantial.
The strengths are explicit dual-paper coverage, the modern interface and the integrated PD content. For candidates who want a single MSRA-focused subscription covering both papers, Quesmed is a credible option.
The limitations are weaker clinical AI integration and the study-platform positioning. The platform is optimised for the exam preparation phase rather than for ongoing clinical use.
The fit is strongest for candidates who want a dedicated MSRA resource with explicit CPS and PD coverage.
iatroX for MSRA
iatroX includes MSRA in its free UK core tier, alongside PLAB 1, UKMLA, MRCGP AKT, MRCP Part 1, MRCEM, PSA and PANE. No subscription required for MSRA content.
The architecture is adaptive: the system identifies weak clinical areas and surfaces them automatically. For MSRA candidates, this matters because the exam spans a broad clinical surface area and the cost of trying to self-prioritise is high.
Spaced repetition resurfaces material at intervals designed for retention. The clinical AI layer (Ask iatroX) answers follow-up questions with guideline-grounded reasoning — useful for MSRA candidates working through unfamiliar specialty content quickly.
The fit is strongest for working FY2 doctors revising MSRA alongside clinical work, where time and attention are the binding constraints, and for candidates who want adaptive targeting and free access to the MSRA bank.
A practical note: for the Professional Dilemmas component specifically, a dedicated PD resource alongside an adaptive CPS bank may be the right combination. The PD format is distinct enough that it benefits from focused practice, and iatroX's CPS strength complements rather than replaces PD-specific resources.
Suggested MSRA study plan with iatroX
The structure that works:
Week 1: Baseline mixed CPS block to establish weak clinical areas.
Weeks 2 to 4: Adaptive CPS targeting using the free iatroX MSRA bank. The platform surfaces weak topics — no prioritisation decisions required.
Throughout: Dedicated PD practice using a PD-specific resource. The format is distinct enough to warrant focused preparation.
Weeks 5 to 6: Timed CPS blocks to build the time-pressure familiarity. The MSRA is faster than finals, and the rhythm needs to be trained.
Final 2 weeks: Mixed timed blocks and high-yield reviews. Spaced repetition handles the long-tail topics.
Daily throughout: 10 to 15 spaced repetition questions to maintain retention across the broad MSRA surface area.
Verdict
For MSRA candidates who want a conventional bank covering both papers under one subscription, PassMedicine and Quesmed are both credible options with established MSRA-specific content.
For adaptive CPS revision connected to clinical AI and rapid weakness targeting — particularly for FY2 doctors revising while working — iatroX is the more modern route, with free access to the MSRA bank removing the cost barrier.
For most candidates, the right approach is one CPS-focused platform plus dedicated PD practice. The CPS choice between platforms depends on whether you value adaptive targeting and clinical AI (iatroX) or comprehensive PD coverage integrated under one subscription (Quesmed). The PD component benefits from dedicated focused practice regardless of CPS platform choice.
Traditional Q-banks help you practise. iatroX helps you learn, verify, retain and apply.