Dr Kola Tytler (MBBS CertHE MBA MRCGP)|21 April 2026|6 min read
The MSRA is a ranking exam, not a pass/fail exam. Your score determines which training programme and deanery you are offered. For GP and Core Psychiatry, it is the sole selection factor — no interview, no portfolio. For other specialties, a strong MSRA score can bypass the interview stage.
Understanding how the scoring works, what the band thresholds typically are, and where the most marks are gained is essential for strategic preparation.
How MSRA Scoring Works
The MSRA raw scores from the CPS and Professional Dilemmas papers are normalised to a combined score with a mean of approximately 250. The distribution produces bands.
Band 1 is the highest tier, typically corresponding to combined scores of approximately 530 and above. Candidates in Band 1 have their pick of competitive deaneries and programmes. For many specialties, Band 1 candidates can bypass the interview entirely.
Band 2 (approximately 480–530) is competitive. These candidates will typically secure interview invitations for most deaneries and programmes, though the most competitive placements (London, specific programmes) may require Band 1.
Band 3 (approximately 430–480) is borderline. Candidates may secure training places in less competitive deaneries but are unlikely to get their first-choice programmes.
Band 4 (below approximately 430) is below the threshold for most programmes.
These thresholds are approximate and vary by recruitment cycle. The exact cut-offs depend on the candidate cohort and the number of available training places.
Specialty-Specific Considerations
General Practice
GP uses the MSRA as the sole selection tool. Every mark matters. The difference between a London deanery and a less competitive region can be 10–20 points. GP applicants consistently need Band 1 or high Band 2 for competitive deaneries.
Because GP competition has intensified with rising application numbers, even scores that would have been comfortable in previous years may be insufficient for top-choice placements. The 2026 two-sitting format does not change the competitiveness — both sittings feed into the same national ranking.
Core Psychiatry
Like GP, Core Psychiatry ST1 ranks applicants solely on MSRA score. The candidate pool is smaller than GP, but the same principle applies — your MSRA score alone determines your allocation.
Radiology
Radiology is historically one of the most competitive specialties to enter. A Band 1 MSRA score is typically necessary for competitive radiology programmes. Some radiology programmes bypass the interview for Band 1 candidates.
Surgery, Ophthalmology, and Other Specialties
These specialties use the MSRA alongside other selection criteria (portfolio, interview). The MSRA provides a ranking that informs shortlisting, but the overall selection is more multifactorial. A strong MSRA score is necessary but may not be sufficient.
Where the Marks Are
The most important strategic insight: the Professional Dilemmas paper is approximately 50% of the total score. Many candidates focus disproportionately on the CPS paper (clinical knowledge) and under-prepare for the Professional Dilemmas paper (SJT). This is the single most common reason for disappointing MSRA scores.
A candidate who scores in the 75th percentile on CPS but the 50th percentile on Professional Dilemmas will end up with a lower overall score than a candidate who scores in the 65th percentile on both papers. Balanced performance across both papers is essential.
The practical implication: dedicate at least 40% of your total revision time to SJT preparation. Use dedicated SJT resources — Emedica for the most exam-representative SJT questions, Pass the MSRA for the most comprehensive SJT resource package, and iatroX for free adaptive SJT practice.
For a detailed SJT strategy, see the MSRA Professional Dilemmas revision guide.
Maximising Your Score
Start Early
Eight weeks is the minimum. Twelve weeks is comfortable. Candidates who start with more time consistently score higher.
Use Multiple Resources
Each Q-bank has different question styles and coverage blind spots. Using two complementary resources — one for volume (PassMedicine or Medibuddy) and one for exam representativeness (Emedica or Revise MSRA) — produces more robust preparation than using one alone. Add iatroX as a free adaptive supplement for weak-area drilling.
Target Your Weak Areas
The marginal gain from improving a weak topic from 40% to 60% is much larger than improving a strong topic from 75% to 80%. Adaptive tools like iatroX automate this targeting. If using a traditional Q-bank, manually filter to your weakest topics and resist the temptation to practise comfortable areas.
Do Mock Exams
Full-length mock exams under timed conditions serve two purposes: they calibrate your timing (many candidates run out of time) and they expose topics you have missed. Do at least two full mocks before the real exam.
Revise MSRA offers mock papers based on previous exam content. Pass the MSRA offers 20 full mock papers. iatroX has a mock exam mode with global countdown, deferred explanations, and auto-submit.
Prioritise SJT
This point bears repeating because it is the single most actionable piece of advice: the Professional Dilemmas paper is 50% of your total score. The SJT is the paper where structured preparation yields the most improvement. Start SJT practice from week 1, not the final week.
The Resource Stack for Maximum Score
For candidates targeting Band 1: PassMedicine (volume, breadth) + Emedica (exam representativeness, SJT) + iatroX (free adaptive weak-area drilling) + Pass the MSRA SJT textbook (free download).
For candidates targeting Band 2 on a budget: PassMedicine (best value) + iatroX (free adaptive supplement).
For candidates on zero budget: iatroX (free MSRA bank, adaptive) + Pass the MSRA free SJT textbook + NICE CKS and BNF for guideline reference.
Information based on NHS England publications and public sources as of 21 April 2026. Score thresholds are approximate and vary by recruitment cycle. Trademarks belong to their owners.