PassMedicine is a sensible, inexpensive engine for the clinical half of the MSRA — and a dashboard that can quietly mislead you about the whole. This audit is for specialty-training applicants deciding how far to trust its numbers. The principal limitation: the MSRA is two very different papers, and practice analytics built on clinical multiple-choice tell you little about the Professional Dilemmas paper that carries roughly half your score.
What PassMedicine offers for MSRA right now
As of 19 July 2026, PassMedicine sells low-cost, fixed-term MSRA access on the same model as its other UK banks — high question volume, revision and timed modes, textbook notes, and performance analytics with peer-comparison histograms. It does not advertise an AI tutor or a machine-learning adaptive engine; question selection is driven by the filters and repeat options you configure. We have deliberately not quoted a question count or price here because we could not verify MSRA-specific figures on the audit date: check both on the product page, and treat any third-party number, including in comparison articles, as stale until the vendor page confirms it.
The exam the dashboard must answer to
The MSRA is 170 minutes in two papers, per NHS England's published structure: a Professional Dilemmas paper of 95 minutes and a Clinical Problem Solving paper of 75 minutes, with an optional five-minute break between. Professional Dilemmas is situational judgement — ranking and selection formats about professionalism, communication and prioritisation, scored against consensus, with around 50 scenarios in the current specification. Clinical Problem Solving is single-best-answer and extended-matching across primary-care-weighted clinical medicine, in the region of a hundred items at a pace under a minute each. Confirm counts in the current applicant guidance for your recruitment round; the timings above are the published structure.
Two consequences follow. CPS pace is the hidden examiner — many candidates who "know the medicine" simply run out of clock. And no clinical Q-bank metric measures PD judgement, because PD is not a knowledge test.
What each metric actually measures
First-attempt accuracy on unseen items is the closest thing PassMedicine's dashboard has to a CPS predictor. Repeat accuracy measures recognition of items you have seen — it inflates steadily with use and is the single most misread number on any Q-bank dashboard. Percentile against other users tells you your position in a self-selected population that includes people six months from their exam and people six days from it; it is context, not a forecast. Coverage is effort accounting. Difficulty and time-per-item are the underused pair: for the MSRA specifically, per-domain time data is more valuable than accuracy data, because the CPS paper punishes slowness more brutally than almost any UK postgraduate exam. And nothing on the dashboard measures Professional Dilemmas at all — the metric gap that should shape your whole revision design.
Selection bias, in one paragraph
Every number the dashboard shows was generated under conditions you chose: which domains, which mode, whether repeats were included, whether you looked things up. Choose weak-area practice (diligent) and your average deflates; drift to comfortable domains (human) and it inflates; repeat your errors (good learning) and repeat accuracy rises while predicting nothing. None of these numbers is comparable with a mixed, unseen, timed block — the only practice condition that resembles the day. The general version of this argument applies to MSRA preparation with extra force because of the split-paper problem.
Audit your distribution against the exam, not the app
Fortnightly, compare three things. Your attempted-question mix against the CPS specification's domain spread — primary-care-relevant medicine dominates, and hospital-flavoured comfort zones (your last rotation, classically) reliably over-represent themselves. Your time-per-item trend against the sub-minute pace the paper demands. And your total PD practice time against the roughly half of the assessment PD represents — for most PassMedicine-centric candidates that last ratio is the embarrassing one, and fixing it matters more than another 200 clinical questions.
What a credible readiness signal requires
For CPS: unseen items, timed at exam pace, mixed across domains, no assistance, and a sample of at least 100 questions across multiple sittings before you believe any percentage. For PD: timed official practice papers and consensus-scored scenario practice — a clinical bank's analytics simply do not reach it, whatever the platform. If your readiness evidence consists of a PassMedicine overall percentage, you have evidence about half the exam, collected under conditions unlike the exam.
When to override the selector
Force what the feed will not naturally surface: timed full-pace mixed blocks (the habit candidates avoid because it feels worse than untimed accuracy); the low-volume clinical domains the CPS spec still samples; data-interpretation and calculation items if your mix lacks them; and scheduled PD sessions that no clinical filter will ever generate. The discipline is the same as for any bank — the exam does not care what you felt like practising — but the MSRA adds the sharper rule: override the entire clinical-bank paradigm twice a week in favour of the other paper.
A worked dashboard example
Six weeks out, suppose your dashboard reads: overall 71%; women's health 79% over 340 attempts; dermatology 76% over 280; musculoskeletal 61% over 90; ophthalmology/ENT thin at 40 attempts combined; average pace 68 seconds per item and 74% accuracy on timed blocks; PD practice: two untimed paper skims.
The translation: your strong domains are maintained, not grown — cap them at one small block weekly. Musculoskeletal and the thin specialties take next week's largest clinical quota (about 150 questions between them). Pace is the red flag — 68 seconds average means you are finishing on adrenaline; schedule three timed blocks specifically to bring the average under 55 seconds even at the cost of a few accuracy points. And PD moves from afterthought to fixed appointments: two timed official-material sessions this week, reviewed against the answer rationale. No pass prediction appears anywhere in that plan, because none of these numbers can honestly produce one.
A seven-day pattern for applicants
Monday: 50 PassMedicine questions in flagged weak domains, untimed, explanations read. Tuesday: a timed PD paper section, reviewed slowly — judge your ranking logic against the rationale, not just the score. Wednesday: a timed 50-question mixed block of unseen items in iatroX, whose adaptive engine deliberately probes related weaknesses across domain boundaries — your uncontaminated CPS signal for the week. Thursday: 30 quick PassMedicine questions at forced pace, plus error-list review. Friday: second PD session. Saturday: a full-length timed CPS simulation, alternating source weekly so the material stays unseen; same-day review by error type. Sunday: rest. PassMedicine's job is clinical volume; iatroX's job is unseen timed transfer practice; official material's job is PD. Nobody's dashboard is asked to measure what it cannot see.
The single number that misleads MSRA candidates most
If there is one figure to distrust on the MSRA, it is the CPS overall percentage read as a readiness score. It misleads in three compounding ways at once. It is inflated by repeats, so it drifts upward through a subscription regardless of learning. It is shaped by your domain choices, so it reflects what you practised rather than what the exam samples. And — most importantly — it is silent about the entire Professional Dilemmas paper, which carries comparable weight and which no clinical percentage can see. A candidate quoting "I'm averaging 74% on PassMedicine" is quoting a number that is simultaneously too high, unrepresentative, and about half the exam. The honest replacement is a three-part statement: unseen-timed CPS accuracy over a real sample, CPS pace against the paper's budget, and PD performance against consensus-scored material. It is less comforting and far more predictive, and building the habit of stating readiness that way is the fastest cure for the false confidence that sinks otherwise well-prepared applicants.
Continue, supplement, switch or stop
Continue with PassMedicine while unseen timed performance climbs and your domain audit stays level. Supplement the moment bank percentages rise faster than unseen performance — that divergence is recognition masquerading as progress. Switch only for a measurable, named gap; the MSRA market is crowded (we compare the main options here), and switching for novelty resets your data without improving your medicine. Stop accumulating clinical questions in the final fortnight once coverage and pacing criteria are met; the last two weeks belong to timed simulations of both papers, because the marginal mark by then lives in judgement and clock management, not in another hundred items.
Frequently asked questions
Is PassMedicine enough for MSRA on its own? No single clinical bank is, structurally: PassMedicine can carry Clinical Problem Solving volume well, but the Professional Dilemmas paper needs consensus-scored scenario practice and official material, and your readiness judgement needs unseen timed blocks from outside your practice history.
Which MSRA component does PassMedicine not reproduce well? The Professional Dilemmas paper — a clinical Q-bank's analytics have no visibility of situational-judgement performance — and, within CPS, the sub-minute pacing pressure that untimed revision practice never rehearses.
How many PassMedicine questions should I complete per day for MSRA? Around 40–60 on working days is sustainable and sufficient if their composition follows your blueprint audit; more than that typically displaces the timed blocks and PD sessions that carry more marginal marks than additional clinical volume.
When should I stop using PassMedicine and move to mixed mocks? Once every CPS domain has meaningful coverage, timed-block accuracy is stable and your pace sits comfortably under the paper's per-item budget — usually two to three weeks out — shift to full timed simulations of both papers and use the bank only for error review.
How should I combine PassMedicine with iatroX without duplicating practice? Use PassMedicine for domain-targeted clinical drilling and iatroX for unseen, timed, adaptively selected blocks that measure transfer — iatroX's MSRA practice is free, so the two-bank design costs you the price of one and keeps your readiness signal honest. A simple sequencing rule keeps them from overlapping: drill a domain in PassMedicine until its explanations stop teaching you anything new, then prove the domain is closed with an unseen iatroX block — practice first, measure second, never the same question twice.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026; MSRA structure timings are from NHS England's published pages and PassMedicine's model from its public site — verify current question counts, prices and the current applicant guidance for your recruitment round before relying on either. Disclosure: iatroX offers a free competing MSRA bank; this audit accordingly confines iatroX's role to the jobs PassMedicine does not claim. Corrections via the feedback route on iatrox.com. References: NHS England MSRA structure pages (medical.hee.nhs.uk); PassMedicine product pages; related reading: the best MSRA revision resources, what a good MSRA score looks like and why your Q-bank percentage is not your exam score.