MSRA – a guide for overseas doctors
- February 14, 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
An opportunity for a SAS grade Anaesthetists to work for an established NHS Trust that prides itself on delivering high quality care and services. .
This is a great opportunity for overseas Anaesthesia specialists who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced anaesthetists IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The Trust is one of the largest teaching hospital trusts in England, serving a regional, national and international population. In April 2018 the trust now has a turnover of £1.6bn, over 2,700 beds and employs more than 20,000 members of staff. It also provides the city wide vascular service including a vascular emergency service and endovascular service. A dedicated elective paediatric surgical unit for patients over the age of 1 has been set up and offers trauma, ophthalmic, ENT and general surgery.
The trust consist of 4 hospitals covering all sub-specialisms along with excellent support in their CESR pathways to develop their professional careers.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The anaesthetic department also provides a consultant led acute pain service, a pre- operative assessment service as well as support for anaesthetics in remote areas such as endoscopy and radiology. The pioneering techniques in surgery and pain control that have been developed whilst treating military patients are used for civilian surgery in the UK and elsewhere, and are progressed through the Surgical Reconstruction and Microbiology Research Centre (SRMRC).
With almost 200 Consultants based over the four main hospital sites, the trust currently provide anaesthetic and ICU cover in excess of 400 sessions/week across both the Trust and those hospitals with which we have service level agreements.
WHAT IS LIFE LIKE IN THIS AREA?
Fancied by most IMG\'s, the area has an internal airport connected to all major cities in the UK along with excellent road and train routes around the country. With low cost of living compared to all the other cities, the area has vibrant independent restaurants, shops and bars throughout the centre and popular districts.
New bars and shops open frequently as the city continues to build its youthful and unique identity. There is so much diversity and history within the area that the shops, food and venues reflect this. Old icons such as the Custard Factory host alternative shops and bars, just a short walk from the city center.
There\'s excellent schooling covering off both private and public schooling around the area with people from different cultures and backgrounds in the area.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The Trust have wellbeing groups that organise regular ‘coffee & gas’ meetings, support the trainee buddy system and raises awareness of mental health issues and support systems. They also produce a monthly newsletter featuring department news and colleague profiles and is soon to launch in-house mentoring. The Trust is committed to the development and maintenance of the highest clinical standards through individual appraisal. This will include the audit of personal and clinical practice, as well as involvement in departmental and specialty reviews. It will also involve attention to continuing professional development, in order to meet the requirements for continuing medical education as expected by the relevant Royal College.
The successful applicant would be expected to have an active interest in the areas of both teaching and research. Our junior anaesthetic training has recently been adapted to reflect the new RCOA Anaesthesia curriculum. Due to the number of specialties covered at the Trust, they are able to deliver the vast majority of the curriculum across our four sites except advanced paediatric case.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Anaesthetics
- Relevant European Qualification (recognised by GMC)
- FRCA Primary, EDAIC, or equivalent
- Experience of working in Anaesthetics
- Experience of working in Anaesthetics
- Within 6 - 12 months of completing CCT
An outstanding opportunity for a psychiatrist to join Forensic Psychiatry Department as Specialty Doctor that has received outstanding ratings from the CQC on three occasions. You will offer psychiatric input and conduct assessments, both psychiatric and physical, for patients on two wards. One ward is a self-contained low secure rehabilitation unit situated away from the main hospital premises, while the other is a medium secure rehabilitation ward. This role offers exposure to a broad spectrum of clinical presentations, including personality, affective, anxiety, psychotic, neurodevelopmental, and substance-related disorders. Moreover, it provides a platform for developing knowledge and understanding of forensic mental health sections. This position also offers CESR support for those seeking progression within the UK NHS Jobs system.
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.
What is the NHS Trust like?
The Mental Health NHS Trust is a leading provider of mental health service serving a population of 1.2 million. With five main inpatient sites and 25 community locations, they offer comprehensive support for both mental and physical health needs, catering to young people and adults alike. From managing phobias and anxiety to addressing conditions like bipolar disorder and schizophrenia, their services are diverse and inclusive. They integrate community health services with mental health care, enabling simultaneous treatment of conditions such as diabetes and mental health issues, promoting holistic patient care.
Forensic Psychiatry Team & Department
The Forensic Service enjoys a stellar reputation, earning an \'Outstanding\' rating from the Care Quality Commission. The Forensic Service delivers care in low and medium secure environments, featuring specialized facilities such as the National Stalking Clinic and the Fixated Threat Assessment Centre (FTAC). These services focus on evaluating and managing risks for prominent individuals.
The inpatient service consists of one acute assessment and treatment medium secure male 4 4 ward, four treatment and intervention medium secure male wards, one female medium secure ward, one medium secure and one low secure male learning disability ward, one low secure male FICU ward and 4 low secure male wards. There are currently 25 Consultant Forensic Psychiatrists in post, working with 5 senior psychiatric trainees who rotate with posts at other forensic psychiatric services in the region. There are 5 junior psychiatric trainees, coming from the UCH training schemes. The service currently employs 10 specialty doctors, working in the prisons and in the rehabilitation parts of the service.
Life in the area
The area offers a blend of urban and suburban living, providing both rural escapes and city conveniences. Residents can explore scenic parks or enjoy activities at different parks. The area boasts a range of quality schools and easy access to universities like Middlesex University. Transport links are excellent, with frequent trains to central London and nearby cities, as well as efficient connections to major airports. Housing options vary from historic cottages to modern apartments, catering to diverse preferences and lifestyles.
Career Development and Opportunities Available
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Forensic Psychiatry (Desirable)
Non-EEA Candidates:
- MRCPsych
- Experience of working in Forensic Psychiatry (Desirable)
UK based applicants
- Experience of working in Forensic Psychiatry (Desirable)
An excellent opportunity for an experienced Consultant Old Age Psychiatrist to join an established NHS community clinic in London. The post if suitable for overseas psychiatrists, including candidates who are pursuing CESR. Specialists in Psychiatry, holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The post offered is that of Specialist Psychiatrist in Older Adult Psychiatry, working in both the community mental health team and the memory clinic. In addition to this post, three additional CMHTs make up the older adult community service for the borough. The personnel of the CMHT include: medical staff, Community Psychiatric Nurses, Occupational Therapist, and Psychiatric Social Workers. There is a Psychological Therapy Department which provides therapy for older adults and which works across CMHTs in the Borough as does the Occupational Therapy Service.
The post holder will have responsibility for the diagnostic assessment and treatment of older adult psychiatric patients from the designated catchment area referred to and accepted by the service. Outpatient clinics and domiciliary visits in the community will constitute the majority of the direct clinical care provided by the post holder.
WHAT IS LIFE LIKE IN NORTH LONDON FOR PSYCHIATRISTS?
This great world city is far more than just the capital of the United Kingdom of Great Britain and Northern Ireland. London is bustling, vibrant, multicultural and cosmopolitan. London is both old and new, a place where traditional pubs rub shoulders with the newest cocktail bars. Its most ancient castle is right next door to its newest skyscrapers. London\'s energy, as 8.6 million people go about their everyday lives, is tangible in every journey on the Underground, every stroll through a market and every walk along the banks of the River Thames. From the royal parks to the theatre stage, London really does have it all.
Working as a psychiatrist in London brings a range of exciting prospects. You will have the opportunity to work in some of the best mental health trusts in the UK, who will offer you the opportunity to constantly grow your medical and scientific knowledge and skills. In London you will have the opportunity to work in a wide range of settings, and as you progress through your career, you will have more opportunity to shape the way you work; you can develop research, work part time or full time and can combine your career with a wide range of other interests.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THE TRUST?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
-
6 years experience of working in Older Adult Psychiatry
-
Board Certified Specialist in Psychiatry (desirable)
Non-EEA Candidates:
-
MRCPsych (desirable)
-
6 years experience of working in Older Adult Psychiatry
UK based applicants
-
6 years experience of working in Older Adult Psychiatry
-
S12 (desirable)
An NHS job opportunity is available for an ambitious and passionate General Adult Psychiatrist to join a trust rated \"Outstanding overall\" CQC. This position presents an ideal prospect for psychiatrists from overseas who aspire to establish themselves within the UK\'s NHS system and progress toward a consultant-level career. It is well-suited for candidates seeking support to achieve Certificate of Eligibility for Specialist Registration (CESR). Doctors must have 6 years work experience after finishing core psychiatry training or equivalent international qualification to be considered for this opportunity.
What is the department & team like?
The department boasts a comprehensive General Adult Psychiatry department, equipped to deliver exemplary mental health care. Staffing includes a proficient team of consultants and dedicated junior doctors committed to providing superior patient care and support. The department\'s activity is marked by a wide spectrum of cases, ranging from common mental health disorders to more complex presentations. Patients receive tailored treatment plans incorporating evidence-based therapies, medication management, and holistic approaches to ensure comprehensive care.
Facilities within the department are modern and conducive to patient well-being, fostering an environment conducive to recovery and healing. Patients benefit from comfortable inpatient units, outpatient clinics, therapy rooms, and recreational spaces. On average, the department manages a significant caseload of general adult psychiatry cases annually, indicative of its pivotal role in addressing mental health needs within the community. The team\'s dedication to excellence and patient-centered care underscores the department\'s status as a leading provider of psychiatric services in the region.
What is the area like?
Location in a beautiful part of the south of England with easy links to London and Cambridge. Housing options range from historic cottages in quaint villages to modern developments, catering to diverse lifestyles. The location truly provides a balanced living experience, combining natural beauty, cultural richness, and modern comforts.
ELIGIBILITY FOR THE ROLE:
Non-EEA:
- MRCPsych (Desirable)
- 6 years specialist experience in General Adult Psychiatry
- Specialist certification in psychiatry (desirable)
- 6 years specialist experience in General Adult Psychiatry
- 6 years Specialty Doctor experience in General Adult Psychiatry
Join an Older Adult Community Mental Health team led by experienced consultants and supported by a dynamic team of Specialty Doctors. This NHS Trust, rated \"Good\" overall by the CQC, prioritizes staff support and offers a flexible training program for career advancement and work-life balance. Ideal for overseas Consultants and specialists seeking to establish themselves in the NHS and also Junior Doctors or Specialty Doctors already in the UK. MRCPsych is essential for mosts doctors trained outside of Europe. European doctors would need specialisation in psychiatry with ideally expertise in old age.
The post holder is expected to provide direct psychiatric services through the comprehensive evaluation, diagnosis, treatment planning, and treatment of patients assigned to him/her. The post holder is expected to be involved in discussions about assessments, treatment and risk management of patients in accordance with medical standards. The final decision rests with the consultant.
Life in the West Midlands
The West Midlands offers a blend of rural charm and urban amenities, catering to diverse preferences of residents. Its picturesque countryside provides opportunities for outdoor activities such as hiking, cycling, and exploring historic landmarks like Worcester Cathedral. The area boasts reputable schools and universities, ensuring quality education for families. Transportation links are convenient, with access to major cities like Birmingham and Bristol, as well as airports for domestic and international travel. Housing options range from quaint cottages in rural villages to modern developments in bustling towns, accommodating various lifestyles and preferences.
Career Development & Opportunities Available
The NHS Trust provides an environment that actively supports career development and offers various opportunities for professional growth. Staff members have access to ongoing training and development programs to enhance their skills and stay abreast of the latest advancements in healthcare. The Trust encourages and facilitates career progression, with opportunities for staff to take on additional responsibilities and roles within their specialties. Continuous professional development is promoted, ensuring that individuals can advance their careers and contribute effectively to patient care.
For those seeking further qualifications or specialization, the Trust may provide support for relevant educational pursuits, contributing to the professional development of its staff. CESR is a key feature of this role, with a current cohort of candidates working through CESR you will benefit from excellent support.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Specialist Qualification in Old Age Psychiatry
Non-EEA Candidates:
-
MRCPsych (Desirable)
-
Experience of working in Old Age Psychiatry (essential)
UK based applicants
- Experience of working in Old Age Psychiatry (essential)
- MRCPsych (desirable)
- Section 12 (desirable)