The MSRA is used by a long list of specialties, but they do not all use it the same way — and that changes what score you actually need. For some, the MSRA is everything; for others it is a shortlisting gate or a fraction of your final rank. This guide sets out how the main specialties use the MSRA and what that means for your target score. Weightings and cut-offs change every year and by deanery — confirm the current rules for your specialty and application round.
General Practice: the MSRA is everything
For GP, the MSRA score determines both whether you get an offer and where you are placed. In effect it has replaced the interview, so your score alone ranks you against other applicants, and the most competitive locations require above-average scores. For GP, then, the answer to "what score do I need" is simply "as high as possible" — there is no interview to make up ground. That also means GP rewards consistency across both papers: because a band of 1 in either the clinical or the professional dilemmas paper rules you out regardless of the other, and because the combined standing sets your rank, there is no single weak area you can afford to neglect.
Radiology: a shortlisting gate
Clinical Radiology uses the MSRA to decide who is invited to interview. In recent years the shortlisting cut-off has risen with demand — reportedly around 541 to 542 for 2022–23 and 555 to 556 for 2023–24 — as the interview slots, in the region of 600, are offered to the highest-scoring applicants. The process can change, though: 2025 guidance described the MSRA being used as a minimum-score gate, in the region of 201 in each section, with the final ranking driven by interview and portfolio. The practical implication is the same either way — you need a strong MSRA score to reach the interview, and interview and portfolio then do the ranking — but confirm the exact model for your year. This year-to-year variability is the single most important thing to grasp about radiology: a cut-off that secured an interview one year may not the next, and the whole basis for using the score can change, so plan to score as highly as you can rather than aiming at last year's number.
Obstetrics & Gynaecology: high scores can bypass the interview
O&G is the standout for high scorers: a sufficiently high MSRA score can secure a direct offer without interview. For everyone else, the final ranking has been weighted around one-third MSRA and two-thirds interview. So a top score can shortcut the whole process, while a middling score leaves you needing a strong interview.
Ophthalmology: a filter, then portfolio and assessment
Ophthalmology uses the MSRA to filter who progresses, with the final ranking incorporating portfolio and further assessments. A competitive MSRA score gets you through the filter; the portfolio and assessments then weigh heavily.
Core Surgical Training, anaesthetics and others: a smaller slice
For some uncoupled specialties the MSRA is one component among several. Core Surgical Training has reportedly used the MSRA at around 10% of the final offer allocation, with interview and portfolio evidence making up the rest; CT1 anaesthetics has used it at around 15% of the overall rank. Core Psychiatry and Community Sexual and Reproductive Health have used the MSRA largely to shortlist, with interview driving the final ranking. For these, a solid score to clear shortlisting matters, but the interview and portfolio carry more of the final decision.
What this means for your target
Two questions decide your target score: does your specialty rank on the MSRA, or use it to shortlist; and how competitive is it? If you are applying to GP, radiology or another route where the MSRA ranks or gates heavily, aim to maximise your score. If you are applying somewhere it is a smaller slice, you still need to clear shortlisting comfortably — but you can balance your effort towards the interview and portfolio. And if you are hedging across specialties with different models, the safe strategy is to prepare for the highest demand among them. It is also worth remembering that these weightings are reviewed and changed regularly — the proportion the MSRA contributes, and whether it ranks or only shortlists, has shifted for several specialties in recent cycles — so a model that applied two years ago may not apply to your round. Treat any percentage you read, including those here, as indicative, and check the current person specification and scoring scheme for your specialty before deciding how hard to push the exam.
How to prepare
Whatever your target, the clinical paper rewards broad, foundation-level knowledge practised under time pressure, and the most efficient way to lift your score is to target your weak areas rather than re-revise strengths. iatroX offers an adaptive engine that targets your weakest clinical topics, a Socratic tutor that rebuilds the reasoning behind each answer, spaced repetition and blueprint-mapped questions grounded in NICE and CKS. Its MSRA bank sits on one subscription at £29 a month or £99 a year, with free sample questions to try first, and because it focuses on the clinical paper, pair it with dedicated Professional Dilemmas material for the SJT.
A few common questions
What MSRA score do I need for GP? As high as possible — GP ranks on the MSRA alone, so there is no interview to recover ground, and competitive locations need above-average scores.
What MSRA score do I need for radiology? Enough to clear the shortlisting threshold, which has risen year on year; the exact cut-off and whether it ranks or only gates changes annually, so confirm for your round.
Can a high MSRA score bypass the interview? For Obstetrics & Gynaecology, a sufficiently high score can secure a direct offer; most other specialties use it to shortlist rather than to bypass interview.
Does the MSRA matter for Core Surgical Training? Yes, but as a smaller component — reportedly around 10% of the final offer — with interview and portfolio carrying more weight.