Dr Kola Tytler (MBBS CertHE MBA MRCGP)|21 April 2026|8 min read
The MSRA determines where you train. For GP and Core Psychiatry applicants, it is the sole factor in allocation — no interview, no portfolio review, just the MSRA score. For the fifteen-plus other specialties that use it, a strong MSRA score can bypass the interview entirely. The stakes are high, and the competition in 2026 is more intense than ever.
This guide provides a practical, week-by-week plan for MSRA revision, covering both papers, the two-sitting format introduced for 2026, scoring, resources, and common mistakes.
Understanding the Exam
The MSRA consists of two independently timed papers. The Clinical Problem Solving (CPS) paper contains approximately 65 questions testing clinical knowledge across medicine, surgery, paediatrics, obstetrics and gynaecology, psychiatry, and other specialties. The Professional Dilemmas paper — often referred to as the SJT paper — contains approximately 32 scenarios testing professional judgement, with each scenario requiring you to rank or rate the appropriateness of several actions.
The critical point that many candidates underestimate: the Professional Dilemmas paper accounts for roughly 50% of the total MSRA score. It is weighted equally to the CPS paper despite having fewer questions. This has direct implications for how you allocate revision time.
The 2026 Two-Sitting Format
For 2026 Round 1 recruitment, the MSRA is split across two windows. The January sitting is open to applicants for all specialties. The February sitting is reserved for candidates applying to Core Psychiatry and General Practice only, though if numbers exceed capacity, some GP and Psychiatry applicants will be redirected to January.
Both sittings test the same content to the same standard. Your allocated sitting will be confirmed after the Oriel application closing deadline. The practical implication: be prepared by early January regardless of which sitting you expect.
What Is a Good MSRA Score?
MSRA scores are normalised to a mean of approximately 250. Candidates are ranked into bands.
Band 1 is the highest tier, typically corresponding to scores of 530 and above. These candidates can often bypass the interview stage for many specialties. Band 2 (approximately 480–530) is competitive and usually secures interview invitations for most deaneries. Band 3 (approximately 430–480) is borderline and may not secure a place in competitive deaneries. Band 4 is below the threshold for most programmes.
For GP specifically, every point matters. The difference between a London deanery placement and a less competitive region can be a handful of marks. For Psychiatry, the entire allocation is MSRA-based — your score alone determines your training programme.
The 8-Week Study Plan
This plan assumes you are starting 8 weeks before your sitting, which is appropriate for most candidates. If you have more time, extend the early phases. If you have less, compress the knowledge-building phase but never cut the SJT preparation.
Weeks 1–2: Foundation Building
The goal is to build broad clinical knowledge across all CPS topics. Start with a high-volume question bank and work through questions in revision mode (untimed, with explanations visible). Focus on understanding the explanations rather than memorising answers.
Recommended approach: do 50–80 questions per day in revision mode. Read every explanation, even for questions you answer correctly. Flag topics where you score below 60% — these are your priority areas.
Resources for this phase: PassMedicine offers the largest MSRA CPS bank (3,000+ questions) at excellent value. iatroX offers a free MSRA Q-bank with AI-adaptive question selection that automatically targets your weak areas. Medibuddy claims the largest overall MSRA bank (4,000+ questions) with adaptive learning. Any of these works well for foundation building.
Weeks 3–4: Targeted Weakness Work
By now you should have data on your weak topics. Shift from broad coverage to targeted revision. If your cardiology scores are strong but your psychiatry scores are weak, spend 70% of your time on psychiatry.
This is where adaptive Q-banks add genuine value. iatroX's adaptive mode automatically identifies your weakest topics and resurfaces them at optimal intervals using spaced repetition. If you are using a traditional Q-bank, you will need to manually create custom tests filtered to your weak areas.
Also begin SJT preparation during this phase. Do not leave it until the final weeks. The Professional Dilemmas paper is 50% of your total score, and the skills it tests — ethical reasoning, professional judgement, prioritisation — take time to develop.
Weeks 5–6: SJT Intensive + Second-Pass CPS
Dedicate at least 50% of your daily revision time to Professional Dilemmas questions. The SJT is not a knowledge test — it is a reasoning test. You need to internalise the frameworks, not memorise answers.
Key frameworks for SJT: patient safety always comes first. GMC Good Medical Practice is the underlying framework for every question. When in doubt, choose the action that protects the patient, escalates appropriately, and maintains professional standards. Never choose an option that involves covering up, ignoring, or delaying action on a patient safety concern.
The best SJT resources are: Emedica, which is widely cited by high-scoring candidates (600+) as the single most representative SJT resource. Pass the MSRA offers a dedicated SJT Q-bank, a free 100-page SJT textbook, a YouTube channel, and a Spotify podcast for SJT preparation. Revise MSRA has 250 dedicated Professional Dilemmas questions with preparation materials.
In parallel, do a second pass through CPS questions — ideally using incorrects-only or flagged-only modes to focus on knowledge gaps.
Week 7: Mock Exam Week
Do at least two full-length mock exams under strict timed conditions. This means completing the CPS paper in the allocated time and the Professional Dilemmas paper in 95 minutes, without breaks and without looking at explanations until you finish.
Mock exams serve two purposes: they calibrate your timing (many candidates run out of time on the real exam), and they expose topics you have missed. After each mock, do a thorough review of every incorrect answer and make a final-week revision list.
Resources: Revise MSRA offers mock papers based on previous exam content. Pass the MSRA offers 20 full mock papers (10 CPS + 10 SJT). iatroX has a mock exam mode with a global countdown timer, deferred explanations, and auto-submit — simulating real exam conditions.
Week 8: Final Consolidation
Review your mock exam errors and final-week list. Do targeted SJT practice daily. Use spaced repetition to revisit topics that keep recurring in your weak areas.
Do not start any new resources in the final week. Consolidate what you know. The goal is confidence, not coverage.
Common Mistakes
Neglecting SJT preparation is the most common and most costly mistake. Candidates who score well on CPS but poorly on Professional Dilemmas often end up in Band 3 or 4, because the SJT carries equal weight.
Starting too late is the second mistake. Eight weeks is the minimum for a strong score. Six weeks is tight. Four weeks is emergency mode — and your SJT performance will suffer.
Using only one resource is the third. Each Q-bank has different question styles and coverage gaps. Using two complementary resources — one for volume (PassMedicine or Medibuddy) and one for exam representativeness (Emedica or Revise MSRA), plus a free adaptive bank like iatroX for weak-area drilling — produces the most robust preparation.
The Resource Stack at a Glance
There are now more MSRA resources than ever. Here is how each one is positioned.
PassMedicine: the volume leader. 3,000+ CPS questions, 300 Professional Dilemmas, integrated textbook. Very affordable. The default choice for most candidates.
Emedica: the exam-representativeness leader. Questions widely regarded as closest to the real exam. Best-in-class SJT content. Frequently cited by 600+ scorers.
Revise MSRA: the dedicated MSRA platform. 3,000+ questions, comprehensive revision notes, 250 PD questions, mock papers. Trusted by 15,000+ doctors annually.
Pass the MSRA: the content-rich course. 8,800+ items including Anki-style flashcards, structured notes by specialty, 20 mock papers, and the best free SJT resources (textbook + podcast + YouTube).
Medibuddy: the volume challenger. 4,000+ MSRA questions with claimed adaptive learning. Largest dedicated MSRA bank.
Pastest: the premium publisher. Decades of experience, tailored past papers, AI tutor, multimedia content.
Quesmed: the all-in-one hub. MSRA module alongside UKMLA, MRCP, and UCAT. Knowledge library and flashcards. Strong mobile app.
Meditest Revise: a newer adaptive MSRA and UKMLA bank with concise clinical-style questions.
iatroX: free MSRA Q-bank with AI-adaptive learning, spaced repetition, and integrated clinical AI for guideline lookup. Also covers AKT, MRCP, PLAB, and UKMLA at no cost. UKCA-marked, MHRA-registered.
MSRA to AKT: The GP Trainee Exam Journey
If you are applying for GP, your exam journey does not end with the MSRA. You will need to pass the MRCGP AKT during training (typically ST2 or ST3). Approximately 60–70% of the clinical knowledge required for the MSRA CPS also applies to the AKT. The AKT adds GP-specific content, a dedicated 10% statistics section, and a 10% admin/organisation section (DVLA, GMC, sick notes).
Starting your MSRA preparation with a platform that also covers the AKT means you can carry your progress forward. iatroX covers both MSRA and AKT for free. PassMedicine offers both as separate modules in the same account.
Information based on public sources as of 21 April 2026. Trademarks belong to their owners.
slug: "best-msra-question-banks-2026-compared" excerpt: "A 2026 comparison of every MSRA question bank: PassMedicine, Emedica, Revise MSRA, Pass the MSRA, Medibuddy, Pastest, Quesmed, Meditest Revise, and iatroX. Covers pricing, question counts, SJT coverage, adaptive learning, and mock exams."
Best MSRA Question Banks Compared (2026): PassMedicine vs Emedica vs Revise MSRA vs iatroX and 6 More
Dr Kola Tytler (MBBS CertHE MBA MRCGP)|21 April 2026|7 min read
The MSRA resource market has expanded significantly. What was once a two-horse race between PassMedicine and Emedica now includes seven additional platforms — each with different strengths, pricing models, and approaches to learning. This guide compares all nine, with practical guidance on which to use and when.
The Nine Platforms
1. PassMedicine — The Volume and Value Leader
PassMedicine remains the default choice for most MSRA candidates. It offers approximately 3,000 CPS questions and 300 Professional Dilemma questions, with an integrated Knowledge Tutor textbook and community comment threads that are a learning resource in themselves. Pricing is typically £20–35 for the MSRA module, making it the best value-per-question in the market.
Strengths: unbeatable volume at a low price. The comment threads contain mnemonics, debate, and clinical pearls from thousands of previous candidates. The Knowledge Tutor textbook is a genuine revision resource, not just question explanations.
Limitations: no adaptive learning. The platform does not adjust to your performance. You direct your own revision. The interface is functional but dated compared to newer competitors.
Compare PassMedicine vs iatroX | Compare PassMedicine vs Emedica
2. Emedica — The Exam-Representative Gold Standard
Emedica's reputation rests on the quality and representativeness of its questions, not their quantity. With approximately 2,380 MSRA questions, it is smaller than PassMedicine — but candidates who have sat the real MSRA consistently report that Emedica's questions feel the most like the actual exam.
Emedica's Professional Dilemmas content is frequently cited by candidates who score 600 and above as the single most valuable SJT resource. It also offers in-person and online crammer courses.
Strengths: exam representativeness. Questions are often harder than the real exam, which builds resilience. SJT content is best-in-class.
Limitations: smaller bank. Higher price point than PassMedicine. Questions can feel discouraging if you start with Emedica before building foundational knowledge.
Compare Emedica vs Revise MSRA | Compare Emedica vs Pass the MSRA
3. Revise MSRA — The Dedicated Platform
Revise MSRA is purpose-built for the MSRA. Every feature — 3,000+ questions, a comprehensive revision notes library, 250 Professional Dilemmas questions, mock papers based on previous exam content — is optimised for one exam. It is trusted by more than 15,000 doctors annually and bundles free access to Anaestheasier and a Notion-based revision dashboard.
Strengths: MSRA-specific depth. The revision notes library provides curriculum coverage beyond what question explanations alone can offer. The extras (Notion dashboard, Anaestheasier) add genuine value.
Limitations: MSRA only. If you also need AKT, MRCP, or other exam preparation, you will need separate resources.
Compare Revise MSRA vs iatroX | Compare Revise MSRA vs PassMedicine
4. Pass the MSRA — The Content-Rich Course
Pass the MSRA takes a different approach: it is a structured course rather than just a Q-bank. It offers 8,800+ items across SBA, EMQ, Anki-style flashcards (22,500), and rapid quizzes, plus 1,100+ structured revision notes organised by specialty and 20 full mock papers. Its SJT resources are the most comprehensive in the market: a dedicated SJT Q-bank, a free 100-page SJT textbook, a YouTube channel, and a Spotify podcast.
Pricing is £30 per month, £60 for three months, or £90 for six months, with a 10% discount code available.
Strengths: format diversity. The combination of notes, flashcards, quizzes, and mock exams provides multiple entry points for learning. SJT multimedia resources are unmatched.
Limitations: the headline number (8,800+) includes flashcards and rapid quizzes, not all exam-style questions. It is also MSRA-only and priced higher than PassMedicine.
Compare Pass the MSRA vs iatroX | Compare Pass the MSRA vs Emedica
5. Medibuddy — The Adaptive Volume Challenger
Medibuddy claims the largest dedicated MSRA bank at 4,000+ questions, with machine learning-driven adaptive question selection. It also publishes comprehensive MSRA exam guides that rank prominently in search, making it often the first resource candidates encounter when researching the MSRA.
Strengths: question volume (4,000+ is the largest single-exam MSRA bank). The adaptive claim, if validated, means more efficient revision. Comprehensive published guides provide good preparatory reading.
Limitations: newer platform with a shorter track record than PassMedicine or Emedica. The adaptive learning claim is difficult to independently verify.
Compare Medibuddy vs iatroX | Compare Medibuddy vs Emedica
6. Pastest — The Premium Publisher
Pastest brings decades of medical exam publishing experience to the MSRA. Its MSRA module offers a large bank covering 300+ topics, tailored past papers reflecting recent exam themes, an AI tutor for question clarification, and video and podcast content. Available with 3, 6, or 12 months access.
Strengths: institutional brand trust. Multimedia content. AI tutor is a genuine differentiator for candidates who want immediate clarification on confusing explanations.
Limitations: premium pricing. MSRA is one module within a much broader platform — the depth of MSRA-specific focus is less than dedicated platforms like Revise MSRA.
Compare Pastest vs Revise MSRA | Compare Pastest vs Medibuddy
7. Quesmed — The All-in-One Revision Hub
Quesmed's MSRA module sits within a broader platform covering UKMLA, MRCP, MSRA, and UCAT. Its strength is the integrated knowledge library (notes linked to each question), spaced repetition daily feeds, flashcards, and a polished mobile app with offline support. Pricing starts from approximately £14.99 per month.
Strengths: cross-exam efficiency. One subscription covers MSRA alongside UKMLA and MRCP. The knowledge library and app experience are among the best in the market.
Limitations: MSRA is not the headline product. The MSRA-specific question volume may be lower than dedicated platforms.
Compare Quesmed vs Revise MSRA | Compare Quesmed vs Medibuddy
8. Meditest Revise — The Adaptive Newcomer
Meditest Revise is a newer, smaller platform covering MSRA and UKMLA. It positions itself on time efficiency, claiming adaptive learning with targeted repetition and concise clinical-style questions.
Strengths: adaptive approach and concise question format. Covers both MSRA and UKMLA.
Limitations: smaller bank than all other platforms listed here. Shorter track record. Limited supplementary content (no revision notes, flashcards, or mock papers).
Compare Meditest Revise vs iatroX | Compare Meditest Revise vs PassMedicine
9. iatroX — The Free Adaptive Option
iatroX offers a free MSRA Q-bank with AI-powered adaptive learning — meaning the platform selects questions based on your demonstrated weak areas and uses spaced repetition to schedule reviews at optimal intervals. It is the only MSRA resource that is both free and adaptive.
Beyond the MSRA, the same free account covers the MRCGP AKT, MRCP, PLAB, UKMLA, MRCEM, PSA, and PANE. Specialist diploma banks (DRCOG, DFSRH, DGM, DipIMC, FFICM, DTM&H) are available for £99 per year. The platform also includes clinical AI for instant guideline retrieval, clinical calculators, and CPD reflection tools — all within a UKCA-marked, MHRA-registered medical device.
Strengths: free. AI-adaptive. Covers the entire GP trainee exam journey (MSRA → AKT → specialist diplomas). Clinical AI integration lets you explore the guideline behind a wrong answer in seconds.
Limitations: newer MSRA bank. The total question count is growing but is currently smaller than PassMedicine, Revise MSRA, or Medibuddy. No community comment threads.
How to Choose
If you can only afford one paid resource and are preparing for the MSRA alone, PassMedicine offers the best volume-to-value ratio. Supplement with the free iatroX MSRA bank for adaptive weak-area drilling.
If you want the most exam-representative experience, add Emedica for the final 4–6 weeks — especially for SJT preparation.
If you prefer structured learning rather than a raw Q-bank, Pass the MSRA's course format with flashcards, notes, and multimedia SJT resources is the best option.
If you are preparing for MSRA and AKT simultaneously, Quesmed or iatroX cover both in one platform — Quesmed as a paid all-in-one, iatroX as a free adaptive tool.
If you want the maximum possible questions, Medibuddy's 4,000+ bank offers the most volume.
The Optimal Stack for Most Candidates
The strongest approach uses three layers.
First, a knowledge-building Q-bank for broad coverage: PassMedicine (best value) or Medibuddy (most questions).
Second, a targeted resource for SJT: Emedica (best-in-class) or Pass the MSRA (most comprehensive SJT multimedia).
Third, an adaptive tool for weak-area drilling: iatroX (free, AI-adaptive, spaced repetition).
This three-layer approach covers breadth, exam simulation, and targeted weakness work — the three pillars of effective MSRA preparation.
Information based on public sources as of 21 April 2026. Trademarks belong to their owners.
slug: "msra-professional-dilemmas-sjt-revision-strategy-2026" excerpt: "A complete revision strategy for the MSRA Professional Dilemmas (SJT) paper, which accounts for 50% of the total MSRA score. Covers question formats, ethical frameworks, the best SJT resources, and daily practice strategies."
MSRA Professional Dilemmas (SJT): The Complete Revision Strategy
Dr Kola Tytler (MBBS CertHE MBA MRCGP)|21 April 2026|7 min read
The Professional Dilemmas paper is 50% of the total MSRA score. It contains approximately 32 scenarios, each presenting a clinical or professional situation where you must rank or rate the appropriateness of several actions. It is the single most under-prepared component of the MSRA, and for many candidates, it is the paper that determines their band.
This guide covers the question formats, the underlying framework, the best resources, and a practical daily strategy for SJT preparation.
Why the SJT Matters More Than You Think
Consider the maths. The MSRA has two papers, weighted roughly equally. A candidate who scores excellently on CPS but averagely on Professional Dilemmas will end up with a mid-range overall score. A candidate who scores well on both papers — even if their CPS score is slightly lower — will often rank higher overall.
The SJT is also the paper where preparation yields the most return. CPS tests clinical knowledge accumulated over years of medical school and foundation training — it is difficult to move the needle significantly in a few weeks. SJT tests reasoning skills and framework application that can be learned and practised in a structured way. Candidates who dedicate serious time to SJT preparation consistently report the largest score improvements.
Question Formats
The Professional Dilemmas paper uses two question formats.
Ranking questions present a scenario and ask you to rank 4–5 actions from most appropriate to least appropriate. You receive full marks for the correct ranking and partial marks for rankings that are close to correct. The scoring is generous for rankings that are within one or two positions of the correct answer.
Rating questions present a scenario and ask you to independently rate each of 4–5 actions on a scale from 1 (most appropriate) to 5 (least appropriate). Each action is scored independently — your rating of Action A does not affect your marks for Action B.
Understanding the difference between these formats is important because your strategy differs. For ranking questions, the relative ordering matters — focus on identifying the absolute best and absolute worst actions first, then order the middle. For rating questions, each action is judged in isolation — focus on whether each specific action is appropriate, rather than comparing them to each other.
The Underlying Framework
Every Professional Dilemmas question is ultimately testing your understanding of GMC Good Medical Practice and the principles of medical ethics. The framework can be distilled into a hierarchy of priorities.
Patient safety is always the top priority. Any action that protects a patient from harm should be ranked highly. Any action that delays addressing a safety concern should be ranked low.
Escalation is almost always appropriate. When in doubt, escalating to a senior colleague or reporting through the correct channel is a safe choice. The SJT rarely penalises appropriate escalation.
Covering up, ignoring, or delaying is almost always wrong. Turning a blind eye to a colleague's impairment, ignoring a prescribing error, or deciding to "wait and see" on a patient safety issue are consistently the least appropriate actions.
Maintaining professional boundaries matters. Actions that are well-intentioned but cross professional boundaries (treating a family member, giving personal contact details to a patient, diagnosing a colleague informally) are typically rated lower than candidates expect.
Communication is valued over unilateral action. Discussing concerns with a colleague before escalating, explaining your reasoning to the patient, and seeking consensus within the team are generally rated higher than acting alone.
The Best SJT Resources
The SJT resource landscape is uneven. Some platforms treat Professional Dilemmas as an afterthought — tacking on a handful of SJT questions to a primarily clinical Q-bank. Others have invested heavily in SJT-specific content. The differences matter.
Emedica has the strongest reputation for SJT question quality. Its Professional Dilemmas content is frequently cited by candidates who score 600 and above as the single most valuable MSRA resource. The questions are challenging, well-constructed, and closely mirror the reasoning required in the real exam. If you use only one paid resource specifically for SJT, make it Emedica.
Pass the MSRA has the most comprehensive SJT resource package. It offers a dedicated SJT Q-bank, 10 SJT mock papers (500 questions), a free 100-page SJT textbook (downloadable without subscription), a YouTube channel with SJT strategy content, and a Spotify podcast. The free SJT textbook alone is worth downloading — it covers frameworks, worked examples, and common pitfalls.
Revise MSRA offers 250 dedicated Professional Dilemmas questions with specific preparation materials. As a dedicated MSRA platform, its SJT content is well-integrated with the clinical revision experience.
PassMedicine includes 300 Professional Dilemma questions. Solid but not the headline strength — PassMedicine's primary value proposition is CPS volume and the Knowledge Tutor textbook.
iatroX includes Professional Dilemmas questions in its free MSRA bank. The adaptive mode identifies weak areas in ethical reasoning and resurfaces relevant scenarios. The clinical AI can be used to explore the GMC guidance behind a specific question — for example, asking "What does GMC Good Medical Practice say about reporting concerns about colleagues?" and receiving an instant, cited answer.
Daily Practice Strategy
Begin SJT preparation from the start of your revision period, not the end. The skills take time to develop.
In weeks 1–4, do 5–10 SJT questions per day in revision mode. Read every explanation carefully — focus on understanding the reasoning, not just the correct answer. When you disagree with the model answer, look up the relevant GMC guidance to understand the framework.
In weeks 5–6, increase to 15–20 SJT questions per day. Begin doing them under timed conditions. The real exam allocates approximately 3 minutes per Professional Dilemmas scenario — practise working at this pace.
In weeks 7–8, do full-length Professional Dilemmas mock papers under timed conditions. Review every incorrect answer and create a list of "principles I keep getting wrong" — this is your most valuable revision asset in the final week.
Common SJT Traps
The "helpful but wrong" trap is the most common. An action can sound helpful and compassionate but be professionally inappropriate. Offering to counsel a distressed patient yourself when the correct action is to refer to the appropriate team is a classic example — it prioritises your desire to help over the patient's best interest.
The "harsh but right" trap is the inverse. Reporting a colleague to a supervisor or regulatory body can feel harsh, but if patient safety is at risk, it is the correct action. The SJT consistently rewards decisive, safety-first responses.
The "discuss first" principle catches many candidates. When you suspect a colleague is underperforming, the first step is almost always to discuss your concerns with them directly (unless the situation is so urgent that immediate escalation is required). Going straight to a formal report without attempting a conversation first is usually rated as less appropriate than raising the issue directly.
Using iatroX for SJT Preparation
iatroX's MSRA bank includes Professional Dilemmas questions that benefit from the adaptive algorithm — when you consistently misapply a particular ethical principle, the platform resurfaces scenarios testing that principle until your reasoning aligns with the framework.
The Ask iatroX feature provides a unique advantage for SJT preparation. When you encounter a scenario where the model answer surprises you, you can immediately query the clinical AI for the relevant GMC or NICE guidance. For example: "What are the GMC principles on maintaining professional boundaries with patients?" — and receive a synthesised, cited answer. This closes the loop between question practice and framework understanding in a way that traditional Q-bank explanations cannot.
The Bottom Line
The Professional Dilemmas paper is 50% of the MSRA. It is the paper where structured preparation yields the most improvement. Start early, practise daily, learn the frameworks, and invest in at least one high-quality SJT resource. The marks gained from strong SJT preparation often exceed the marks gained from additional CPS revision.
Information based on public sources as of 21 April 2026. Trademarks belong to their owners.