MSRA
The MSRA is the computer-delivered assessment that gates entry to UK specialty and GP training for roughly a dozen specialties. For General Practice and Core Psychiatry it is the primary, sometimes sole, tool used to rank applicants for an interview or post — so a single 170-minute sitting can decide whether you progress this recruitment cycle or wait an entire year. This page breaks down exactly what the two papers test, how scores are banded, where you sit it through Pearson VUE, and how to get it done right.
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How the MSRA is built — at a glance
50
50 situational-judgement questions in 95 minutes. Some ask you to rank 4–5 actions best-to-worst; others ask you to pick the 3 actions that together form the best response.
~86
Around 86 scored items in 75 minutes (sat among pilot questions). Single-best-answer and extended-matching items on investigation, diagnosis, prescribing, and management.
5
One optional 5-minute scheduled break sits between the two papers. Any time over 5 minutes is deducted from your Clinical Problem Solving clock automatically.
The two papers are independently timed and sat in a fixed order: Professional Dilemmas first, then Clinical Problem Solving. Each has its own on-screen countdown. Total seat time is about 170 minutes plus the short break, and you cannot return to a completed paper.
Each paper is standardised every cycle to a mean of about 250 with a standard deviation near 40, so there is no fixed pass mark and no maximum score. Results are also reported in four bands per paper; a Band 1 in either paper means you cannot progress, regardless of your other result. Specialties then rank applicants on the combined performance.
The MSRA gates entry to around a dozen UK training programmes — how it counts varies by specialty
| Specialty / programme | Entry level | How the MSRA counts |
|---|---|---|
| General Practice (GP) | ST1 | Primary ranking tool — often the sole selection score |
| Core Psychiatry | CT1 | Primary ranking tool for selection |
| Clinical Radiology | ST1 | Shortlisting to interview |
| Ophthalmology | ST1 | Shortlisting to interview |
| Obstetrics & Gynaecology | ST1 | Shortlisting to interview |
| Anaesthetics & ACCS-Anaesthetics | ST1 | Shortlisting to interview |
| ACCS-Emergency Medicine | ST1 | Shortlisting to interview |
| Core Surgical Training | CT1 | Shortlisting to interview |
| Neurosurgery | ST1 | Shortlisting to interview |
| Community Sexual & Reproductive Health | ST1 | Shortlisting to interview |
The exact list and the weight given to the MSRA are confirmed each year in the specialty person specifications. For GP and Core Psychiatry the assessment effectively decides your fate; for most other specialties it shortlists you to an interview where the MSRA score is combined with portfolio and station marks.
Two papers carry the score — bars show each paper's share of the assessment time
A situational judgement test (95 of the 170 minutes) on empathy and sensitivity, coping with pressure, and professional integrity. You are scored against a pre-determined key, so near-miss answers still earn partial marks — the skill is reading the relationships and priorities in each scenario the way the GMC expects of a foundation doctor.
A knowledge-applied paper (75 of the 170 minutes) where one mark is awarded per correct answer. Scenarios cover investigation, diagnosis, emergency care, prescribing, and non-drug management across the breadth of GP-level medicine — the question count is high and the pace is unforgiving.
The two papers measure very different things: Professional Dilemmas is a behavioural test with no factual "right answer" to revise, while Clinical Problem Solving rewards broad, fast recall across the whole GP curriculum. Candidates routinely under-prepare for one or the other and a single weak paper — a Band 1 — ends the application regardless of how strong the other is.
Two ways to sit the exam — and what to expect on assessment day
The default route. You book a seat, date, and time on the Pearson VUE website within the published assessment window and sit the exam in a quiet, monitored room. Staff verify your photo ID, store your belongings, and supervise the session. UK-based applicants are normally expected to attend a UK centre. There is no exam fee, but travel and accommodation are your own cost.
OnVUE at-home delivery is not the standard option — it is offered as a reasonable adjustment, approved case by case by the Recruitment Office for applicants with extenuating circumstances. If granted, you take the exam from a private room monitored by AI plus a live proctor, with a webcam room scan, ID check, and system test before the assessment unlocks.
A valid, unexpired government photo ID with a name that matches your booking. At a centre the staff verify it; on OnVUE the proctor captures photos before the papers unlock.
For OnVUE: a clear desk, no second monitor, no phone within reach, and a 360° webcam scan of the room. Run the OnVUE system test in advance — connection drops are the most common day-of failure.
Stay in frame on OnVUE, and use only the single scheduled 5-minute break between papers. Talking aloud, leaving the seat, or losing connection can flag or void the session.
The MSRA is sat by doctors applying to UK specialty training
Eligibility is set by the specialty — the bar is the competition
Difficulty: The MSRA is hard not because any single question is brutal, but because of breadth, pace, and stakes. Clinical Problem Solving sweeps the whole GP curriculum at speed, Professional Dilemmas has no factual answer to revise, and there is one sitting per cycle with no carry-over. A single below-threshold band — even on your weaker paper — ends the application. That all-or-nothing pressure is exactly what our help is built to remove.
The MSRA is a one-shot, high-breadth assessment sitting between you and your training number. Exam Assist pairs you with a vetted specialist who knows both papers and works on a pay-after-you-pass model — so the risk sits with us, not you. No upfront fee, guaranteed results: Exam Assist handles the sitting end to end, and you settle only after the verified result.
Tell us your target specialty, which band you need to be competitive, your assessment window, and whether you are at a centre or OnVUE. Takes a couple of minutes over WhatsApp, Telegram, or Discord.
We weigh your specialty's competition, timeline, and both papers and tell you plainly whether your target is realistic — before any money is discussed. If it isn't a fit, we say so.
Exam Assist handles the sitting end to end. You're matched with a specialist who maps the work around Professional Dilemmas and Clinical Problem Solving, the banding rules, and your Pearson VUE delivery — discreetly and confidentially.
You only pay once your result is confirmed. No verified result, nothing owed.
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Straight answers about the MSRA
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