Almost every PSA candidate knows the exam has eight sections. Far fewer know that the sections are weighted so unevenly that one of them is worth more than the other seven combined would suggest, and fewer still let that fact shape their revision or their time in the exam. The Prescribing Safety Assessment gives you 60 items and 200 marks in two hours. Eight of those items carry 80 marks. That single fact should restructure how you prepare and how you spend your time on the day.
Key takeaways
- The PSA is 60 items worth 200 marks, completed in two hours, with reference access throughout.
- The eight prescribing items are worth 10 marks each, so that one section carries 80 of the 200 marks.
- Most other item styles are worth 2 marks apiece, meaning one prescribing item equals five of them.
- Budget your time by marks, not by questions, or you will spend equal effort on unequal items.
- Track your performance by item style rather than by drug class, because the styles fail differently.
The weighting, in full
Here is the blueprint, and it is worth committing to memory because it is the most actionable fact about this exam.
| Section | Items | Marks each | Total marks |
|---|---|---|---|
| Prescribing | 8 | 10 | 80 |
| Prescription review | 8 | 4 | 32 |
| Planning management | 8 | 2 | 16 |
| Calculation skills | 8 | 2 | 16 |
| Adverse drug reactions | 8 | 2 | 16 |
| Drug monitoring | 8 | 2 | 16 |
| Providing information | 6 | 2 | 12 |
| Data interpretation | 6 | 2 | 12 |
Sixty items. Two hundred marks. And a distribution that most candidates have never actually looked at.
What that means in practice
Read the table again and the implications arrive quickly.
A single prescribing item is worth ten marks. A single calculation item is worth two. One prescribing question is therefore worth as much as five calculation questions, or five adverse drug reaction questions, or five drug monitoring questions.
The prescribing section alone accounts for 80 of the 200 marks available, which is forty per cent of the entire exam, from eight questions out of sixty. Add prescription review, at four marks an item, and just sixteen of the sixty items account for 112 marks, well over half the paper.
Now consider how most candidates actually behave. They work steadily through the paper, spending roughly similar time on each question, and if anything they hurry the prescribing items because writing out a full prescription is laborious and there is a whole paper still to go. That is precisely backwards.
Budget by marks, not by questions
With 120 minutes and 200 marks, you have about 36 seconds per mark. Convert that into a time budget per item style and the shape of a sensible exam emerges.
A ten-mark prescribing item deserves in the region of six minutes. A two-mark item deserves in the region of a minute. If a two-mark drug monitoring question has consumed four minutes and you are still hunting through a reference for the answer, you are spending prescribing-item time on a fraction of a prescribing item's value, and you should make your best judgement, move on, and protect the marks that actually matter.
This is not a licence to be careless with the small items, which add up. It is an instruction to stop treating all sixty items as equivalent, because the exam does not.
Know how the prescribing items are marked
Within that eighty-mark section, the internal structure matters too. Each prescribing item is worth ten marks, awarded as five for the drug choice and five for the dose, route and frequency.
That split is enormously useful, because it tells you that a partially correct prescription still scores. Choosing the right drug and getting the dose wrong is not a zero. Neither is choosing a defensible drug when you are uncertain and then being meticulous about how you write it up.
It also tells you where the marks bleed away. Candidates who know exactly which drug to use, and then write it up sloppily, omitting the route, muddling the frequency, or ignoring the legal requirements of a controlled drug prescription, are surrendering half the available marks on the highest-value items in the exam. Practise writing prescriptions out in full, properly, until it is mechanical.
Run eight separate revision loops
Because the item styles test genuinely different competencies, they fail differently, and a single overall percentage tells you almost nothing.
Prescribing tests whether you can select and write a complete, safe, legal prescription. Prescription review tests whether you can spot the dangerous item in a list of ten. Calculation tests arithmetic under pressure, and its failures are unit errors and decimal points rather than pharmacology. Adverse drug reactions test recognition and attribution. Drug monitoring tests what to measure and when. Data interpretation tests what to do with a result. Planning management tests drug selection without the writing. Providing information tests counselling.
Track each separately, because a candidate who is excellent at pharmacology and poor at arithmetic, and one who is the reverse, need entirely different fortnights. Ensure you have practised every style, since it is common to have done a great deal of one and almost none of another, and then target the weak styles specifically.
Where iatroX fits
iatroX's PSA bank is tagged to the blueprint's item styles, so your dashboard mirrors the structure of the exam itself rather than collapsing everything into one number, which is exactly what you need in order to run the eight loops above. The adaptive engine targets the styles and topics where you are genuinely weak, spaced repetition holds the monitoring parameters and interaction pairs that decay quickly, and explanations are grounded in current guidance including the SmPC, so the reasoning behind a dose or a contraindication sits with the question. Missed questions can be opened in the Socratic Tutor, which asks you to reason before it explains. Try it with free sample questions at iatroX. For the reference-navigation skill the exam tests as much as recall, see PSA reference navigation.
Frequently asked questions
How many marks is each PSA section worth? Prescribing is 8 items at 10 marks each, totalling 80. Prescription review is 8 items at 4 marks, totalling 32. Planning management, calculation skills, adverse drug reactions and drug monitoring are each 8 items at 2 marks, totalling 16 apiece. Providing information and data interpretation are each 6 items at 2 marks, totalling 12 apiece. That makes 60 items and 200 marks.
Which PSA section is worth the most? Prescribing, by a wide margin. Its eight items carry 80 of the 200 marks, which is forty per cent of the exam from just over a tenth of the questions.
How should I budget my time in the PSA? By marks rather than by questions. With 120 minutes for 200 marks, that is about 36 seconds a mark, so a ten-mark prescribing item warrants around six minutes and a two-mark item around a minute. Do not spend prescribing-item time on two-mark questions.
How are the prescribing items marked? Ten marks each, split as five for the drug choice and five for the dose, route and frequency. A partially correct prescription still scores, so writing up a defensible drug meticulously is far better than abandoning the item.