The MSRA (Multi-Specialty Recruitment Assessment) is a machine-marked exam used for national recruitment to multiple UK medical specialties. Your score determines your ranking — and your ranking determines your choice of deanery and programme.
Which Specialties Use MSRA
GP training (the largest user), psychiatry, ophthalmology, radiology, public health, community sexual and reproductive health, and others. The list may change annually — check HEE's national recruitment website for the current cycle. If your target specialty uses MSRA, your MSRA score is the single most important factor in your application.
Format
Professional Dilemmas (PD). Situational judgement questions testing ethics, professionalism, clinical governance, and patient safety prioritisation. Questions present clinical scenarios with multiple possible actions — you rank or select the most appropriate responses. The key: rank answers by patient safety first, then professional standards, then personal preference.
Clinical Problem Solving (CPS). SBA questions testing clinical medicine — diagnosis, investigation, and management across the full clinical curriculum. This is essentially a clinical knowledge exam covering medicine, surgery, paediatrics, OBG, psychiatry, and emergency medicine.
Scoring
Raw scores from both papers contribute to a combined score. The combined score produces a national ranking within your specialty application. A "good" score is relative — it depends on the cohort size and available positions. Higher scores give more choice of deanery and programme.
How to Prepare
PD paper. Read GMC Good Medical Practice guidance. Practice SJT (Situational Judgement Test) questions — the reasoning framework is specific and learnable. Understand the hierarchy: patient safety > professional duty > personal preference. The PD paper rewards understanding of professional values, not clinical knowledge.
CPS paper. Clinical medicine revision — broader than any single specialty exam. iatroX MSRA Q-bank (free adaptive practice). Oxford Handbook of Clinical Medicine as reference. NICE CKS for management pathways.
Timeline
MSRA typically sits in January for August start. Begin preparation 2-3 months before. CPS requires broader clinical revision; PD requires specific SJT practice technique.