MSRA – a guide for overseas doctors
- April 06, 2023
Many junior doctors applying for Specialty Training in the UK will need to take the MSRA or Multi-Specialty Recruitment Assessment.
The MSRA plays an important role in the shortlisting and assessment process for entry into postgraduate training in several specialties for ST1 and CT1 level jobs, by assessing essential competencies.
In this blog, we will be taking a closer look at the assessment, focusing on some key questions summarised below:
- Who needs to sit the MSRA?
- How is the assessment formatted?
- What is the structure of the MSRA?
- Where can I take the MSRA and how much does the assessment cost?
- How can I prepare for the assessment?
- #IMG Tips
Skip ahead to the relevant section if you know what you’re looking for.
MSRA Specialties
At present, the MSRA is being used within the following specialties:
- ACCS-Emergency Medicine
- Anaesthetics
- Child and Adolescent Psychiatry
- Clinical Radiology
- Community Sexual & Reproductive Healthcare
- Core Psychiatry Training
- Core Surgical Training
- General Practice
- Neurosurgery
- Nuclear Medicine
- Obstetrics and Gynaecology
- Ophthalmology
Not every specialty uses the MSRA in the same way, however on the whole, candidates’ scores from the MSRA are used as part of CT and ST recruitment to shortlist for interviews and selection centres, as well as making up part of your overall ranking (with the rest coming from interviews selection centres).
For example in 2023, GP, CAMHS, and Core Psychiatry Training will not have any interviews or selection centres and 100% of your rank will be determined by your MSRA scores. Core Surgical Training will also be using the MSRA in shortlisting for the first time this year.
MSRA Format
The MSRA is a single computer-based exam comprising two papers: Professional Dilemmas (PD) and Clinical Problem Solving (CPS). As an exam used across many specialties for entry into Specialty Training, the MSRA assesses a foundation level of competence.
There is an optional five-minute break between the two papers. If candidates choose to take a longer break, the extra time will be subtracted from the time available to complete the CPS paper.
A combination of question types is used within the assessment, primarily extended matching questions (EMQ) and single best answer (SBA) questions, however the assessment may also include multiple best answer (MBA) questions: up to 3 correct answers, picture questions: may include skin lesions, blood reports, ECGs etc., and algorithm questions – drag boxes to the right part of the algorithm or select the correct answer from a list.
Structure of the MSRA
The MSRA last 170 minutes and is divided into two sections: Professional Dilemmas (PD) and Clinical Problem Solving (CPS).
Professional Dilemmas (PD)
The Professional Dilemmas (PD) paper is a Situational Judgement Test (SJT) which measures how a candidate’s judgement regarding challenging professional dilemmas they may face.
The PD paper is not a test of knowledge of problem-solving ability or knowledge specific to specialty training within any specialty, but aims to assess professional attributes which are considered important for successful progression through training and performance in one’s clinical role.
Time: 95 minutes
Number of questions: 50
Context: the PD component is set within the context of Foundation Training with the candidate assuming the role of an F2 doctor. There is also a mixture of settings such as a hospital (across a variety of wards or placements), general practice and out-of-hours clinics.
Core competencies: professional integrity, coping with pressure, empathy and sensitivity (you can find more information on the behavioural indicators linked to these competencies here).
Clinical Problem Solving (CPS)
The Clinical Problem Solving (CPS) paper assesses a candidate’s ability to apply clinical knowledge and make clinical decisions in everyday practice.
Again, the CPS scenarios are based on Foundation level clinical practice. They test a candidate’s ability to synthesise and apply medical knowledge (not just knowledge recall).
Questions may relate to the investigation, diagnosis or management of common and important diseases as well as rare presentations.
Time: 75 minutes
Number of questions: 86
Context: the CPS covers 12 clinical topic areas relevant to general medicine. Each test paper includes a balance of scenarios which cover all 12 topics, including:
- Cardiovascular
- Dermatology / ENT / Eyes
- Endocrinology / Metabolic
- Gastroenterology / Nutrition
- Infectious disease / Haematology / Immunology / Allergies / Genetics
- Musculoskeletal
- Paediatrics
- Pharmacology and therapeutics
- Psychiatry / Neurology
- Renal / Urology
- Reproductive
- Respiratory
Core competencies: investigation, diagnosis, emergency, prescribing, management (you can find more information on these domains here).
Exam Centres for the MSRA
The MSRA is held remotely and is delivered in partnership with Work Psychology Group and Pearson VUE. Candidates will need to register for an account with Pearson VUE and once invited, they can book an assessment at a centre, date and time of your choosing (subject to availability).
The MSRA is delivered globally on several consecutive days in many Pearson VUE Computer Testing Centres. You can find your nearest Pearson VUE assessment centre by visiting the Pearson VUE website.
The exam itself is free to sit, but depending on the centre you choose, there may be additional travel and accommodation costs. It’s therefore advisable to book your seat as soon as possible for the best chance of securing a nearby centre.
Preparation for the MSRA
On the whole, your previous (and current) experience working as a junior doctor will have prepared you for most of the questions and scenarios within the MSRA, although to different extents, depending on where you have gained your experience.
However, as your MSRA scores are often added to the interview score to determine overall rank, or even to exempt you from interview, it may be advantageous to attempt to score as highly as possible.
Blueprint: First and foremost, you should use the MSRA blueprint to better understand the target domains.
Sample questions: Sample questions for both papers are available on the Health Education England Medical Education Hub. You can access these here.
Commercial resources: Exam revision courses, books and online question banks are available, although these are not officially endorsed, and you can find some of the most popular providers below:
|
4,000 Question bank and mock tests |
1,950 Question bank and mock tests |
2,200 Question bank and mock tests |
2,500 Question bank and mock tests |
|
£30 - £50 |
£35 - £55 |
£49 - £119 |
£25 - £30 |
#IMG Tips
- Start early – Once you have decided to sit the test, plan well in advance to give yourself enough time to prepare and score as highly as possible.
- Take a test tutorial – You can take a practice test to familiarise yourself with the controls and screen layouts in advance – see Pearson VUE or Oriel for details.
- Negative marking - One mark is given for each correct answer and negative marking is not used within the assessment, so try to answer all questions, even when unsure.
- Read carefully - Read the instructions and questions carefully – you may often be looking for the most suitable answer, rather than the only correct one.
Sources
https://www.bmj.com/careers/article/a-guide-to-the-multi-specialty-recruitment-assessment-msra-
https://heeoe.hee.nhs.uk/sites/default/files/msra_test_blueprint_information_nov_2019.pdf
The MSRA is a key examination for many IMGs developing their careers by entering Specialty Training. UK training programmes are very competitive and particularly for overseas doctors unfamiliar with the NHS system, taking the time for extensive preparation for the MSRA can greatly impact your chances of being successful in joining a training programme.
Read more useful articles on exams, NHS jobs and salaries in our IMG Resources library.
For regular news and updates, follow IMG Connect on social media using the links below:
Relevant Jobs
A new role as Specialty Doctor in inpatient child and adolescent mental health service at a Trust rated \"Outstanding\" by the CQC has just opened for both UK based and overseas candidates. Based in a city just north of London the trust supports doctors looking to build experience before entering ST4 or to support with CESR applications.
This is a great opportunity for overseas Specialty Doctors who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
ELIGIBILITY FOR THE ROLE:
Non-EEA:
- MRCPsych
- Experience in Child & Adolescent Psychiatry
- Specialist certification in Psychiatry (desirable)
- Experience in Child & Adolescent Psychiatry
- Experience in Child & Adolescent Psychiatry
A unique opportunity awaits Neonatal Specialist Registrars to join a prestigious UK Trust known for its national and international acclaim in specialist services. The Trust, established in 2006, is a major employer supporting the health and wellbeing of over a million residents in Nottinghamshire and providing tertiary care across the East Midlands. With a budget under £1 billion, the Trust operates 90 wards and 1,700 beds, delivering district general services to 2.5 million residents and specialist care to 4.5 million people regionally.
The Neonatal Department caters to 10,000 births annually, extending its reach to cover 23,000 deliveries in the northern EM-ODN region. Equipped with state-of-the-art facilities, the Neonatal Units offer regional neonatal surgical and tertiary medical neonatal intensive care services, admitting over 1,400 babies yearly.
The department sits within a Trust that is committed to mental health, is a Mindful Employer with opportunities for professional development, including CESR, RCPsych exams, and active involvement in research. This comprehensive package aligns with the Trust\'s ethos of continuous learning and growth, making it an ideal destination for healthcare professionals seeking a rewarding career.
Working for this Trust means being in a vibrant city, boasts excellent schools, cultural attractions, iconic sports venues, and natural beauty. Convenient transportation links and proximity to international airports enhance accessibility. The successful candidate will oversee care for high-dependency and intensive care babies, participating in daily rounds.
Applicants, including overseas Neonatology doctors pursuing CESR, can enter at the Specialty Doctor or Consultant grade. The Trust, deeply engaged in education and training, collaborates with universities in the East Midlands, playing a crucial role in shaping healthcare professionals.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Neonatology
- Board Certified Specialist in Neonatology
Non-EEA Candidates:
- MRCP
- Experience of working in Neonatology
UK based applicants
- Experience of working in Neonatology
- Within 6 - 12 months of completing CCT
Discover an exceptional opportunity for a Specialist Doctor in General Adult Psychiatry at an NHS Trust in London. This dynamic role caters to overseas specialists aspiring to join the NHS, accepting applications from EEA-specialized candidates and experienced IMGs pursuing CESR.
As part of the highly diverse General Adult Psychiatry Department, you\'ll work in various mental health services, contributing to the well-being of over 800,000 individuals. The department functions as a cohesive team of doctors built on mutual respect and trust. It offers a comprehensive range of services, including adult mental health, crisis resolution, home treatment teams, community integrated mental health teams, eating disorders, liaison psychiatry, personality disorder services, and psychological therapies.
There will be a CESR support, Section 12, and AC are provided, fostering career development. Enjoy a vibrant life in London, while advancing your career in this exceptional NHS job opportunity.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
-
Experience of working in General Adult Psychiatry (essential)
Non-EEA Candidates:
-
MRCPsych or PLAB (essential)
-
Experience of working for General Adult Psychiatry (essential)
UK based applicants
-
Experience of working in General Adult Psychiatry(essential)
An excellent job opportunity for either experienced Specialist grade (Associate Specialists) or Consultants in General Adult Psychiatry working in the community across five boroughs of Greater Manchester. The Trust\'s vision is for a happier and more hopeful life for everyone in their communities and their staff work hard to deliver the very best care for the people who use their services. They are really proud of their people, and continue to do everything they can to make sure that they are a great place to work.
The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The NHS Foundation Trust serves a population of 1.3 million and their vision is a happier and more hopeful life for everyone in their communities. The Trust has more than 3,600 dedicated and skilled staff deliver care from 88 different locations in six boroughs. The Trust\'s mental health teams provide care and treatment for people with mild to moderate conditions such as depression, anxiety or dementia, or more serious mental health illnesses such as schizophrenia and bi-polar disorder. They run \"Healthy Minds\" (psychological therapies), drug and alcohol services, psychiatric intensive care, rehabilitation services, military veterans\' services and many more.
The Trust\'s learning disability services are for people with a moderate to profound level of learning disability, such as those with downs syndrome. The Trust has an updated strategy (2022-2025) that confirms their commitment to being a specialist mental health, learning disability and autism provider, while recognising the impact of the pandemic and the changes within the health and social care system.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The service (generally for people aged 16 to 64) has been running since 2008, according to a model whereby their team of consultants are deployed as follows: three consultants work exclusively in the community and outpatient areas, one consultant works with the Early Intervention Service, two consultants cover the inpatient area and one works with our Home Treatment and A&E Liaison Team. Within this arrangement, the consultant appointed to this post will work with other sector consultants (East, West and South sector community outpatients).
WHAT IS LIFE LIKE IN THE REGION?
Situated in the east of Greater Manchester, between the City of Manchester and the Pennines National Park, the area offers a wonderful mixture of city and famously beautiful countryside. Manchester is one of the main cities of England, with all the benefits that brings including vibrant social and entertainment options in a vibrant city centre. The region enjoys excellent transport connections both international through the airport and local, via the M62, and M60 motorways and the Metrolink tram system. Approximately 22.5% of the population are from ethnic minority groups.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
If you are a new consultant you will receive mentoring and support from medical leads as well as access to a large peer group of enthusiastic and high-caliber Consultants.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- European Specialist Qualification
- Experience of working in General Adult Psychiatry
Non-EEA Candidates:
- MRCPsych
- Experience of working in General Adult Psychiatry
UK based applicants
- Experience of working in General Adult Psychiatry
- Section 12 and Approved Clinician
This is a great opportunity for any experienced General Adult Psychiatrists and including those working towards CESR or specialist registration in the UK.
The NHS Foundation Trust is currently looking for a Specialist in Inpatient Adult Psychiatry. This is an outstanding opportunity for experienced Consultants Psychiatrists, Associate Specialist (Specialist Grade) and Specialty Doctors who is looking to work toward Specialist Registration through the CESR pathway.
The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs ideally with MRCPsych and overseas consultant or specialist experience looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The NHS Trust provides mental health services to all age ranges and supports people with a range of mental health problems whether they are mild, moderate or severe. The NHS Trust employs over 9,000 people who deliver support for the patient services. In addition to providing a wide range of patient services, we also contribute to training the next generation of nurses, doctors and therapists and conduct research that will help to advance clinical practice and treatments in the future.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The Department is a 14 bedded ward which admits adults of working age. The district covers a largely rural area of 285 square miles with a population of approximately 114,000. There are 275 admissions per 100,000 adult population in Somerset. Over the last three years there was an average of 223 admissions per year with bed occupancy being lower than the national average. The majority of the patients admitted were given a diagnosis of a psychotic illness, followed by a mood disorder and then personality disorders.
The post holder will be part of the team which consists of a ward manager 0.5WTE, a deputy ward manager 1WTE, a trainee doctor 1.WTE, a medical secretary 0.4WTE, a ward administrator 1.0WTE, a ward psychologist 0.5WTE, three occupational therapists, 11 staff nurses, 17 health care assistants, and 6 service assistants.
The post holder will also be responsible for conducting Mental Health Act assessments for adults of working age admitted to the ward. Other Mental Health Act assessments for adults of working age in Mendip will fall to the community adult consultant psychiatrists. The post holder may be invited to contribute.
WHAT IS LIFE LIKE IN THE REGION?
Based in the South West, the trust is located between various areas of outstanding natural beauty and the idyllic rolling hills of Exmoor, featuring national hotspots for cycling, surfing, and climbing. There’s plenty to keep you occupied alongside the abundance of music festivals and local traditions.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
There is real opportunity to progress through CESR at pace at this trust, with a strong desire for newly-qualified consultants to develop their specialty areas of interest and undertake in various cancer trials and research projects where possible. Research is encouraged here, particularly when this is appropriate to professional development and to the service development of the department.
If you are a new consultant you will receive mentoring and support from medical leads as well as access to a large peer group of enthusiastic and high-caliber Consultants.
ARE YOU ELIGIBLE FOR THIS ROLE?
UK based candidates:
- Specialty Doctor Experience
- Specialisation in Psychiatry
- MRCPsych
- Consultant or specialist experience