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 |
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£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
Here’s the anonymized version of the job advert:
A UK-based mental health provider is seeking a Senior Specialist in Psychiatry with an interest in memory assessment services for older people. The psychiatry department includes a skilled team of consultants and clinical nurse specialists, offering a supportive environment for career growth. This opportunity is open to both international applications and UK-based doctors, with preference for those holding European Specialist training or MRCPsych qualifications.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
- MRCPsych or equivalent qualification is required, along with a minimum of six years in relevant psychiatry roles.
- An interest in dementia and memory-related care is essential.
- The salary will be competitive, dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide senior medical leadership within the Memory Assessment Service (MAS), overseeing complex cases.
- Collaborate with a multidisciplinary team to assess, diagnose, and treat dementia and related memory disorders.
- Supervise and mentor clinical staff and contribute to their professional development.
- Participate in service improvement and innovation initiatives.
LIFE IN THE REGION
The region offers a mix of urban living in vibrant towns and peaceful countryside settings, providing options to suit a range of lifestyles. It is well-connected by major transport links and boasts excellent schools, recreational opportunities, and cultural attractions for individuals and families. The area also has a rich history and cultural significance, adding to its charm as a great place to live and work.
A private diagnostic imaging clinic in a major Canadian city is looking for a Radiologist with an interest in specialized imaging services. The radiology team comprises a motivated group of professionals, including radiologists, Ultrasound Technologists, and Medical Radiation Technologists. This radiology job is open to both international applications and Canada-based doctors, though those with CCT from the UK, Ireland, or qualifications recognised by the Royal College of Physicians and Surgeons of Canada (FRCPC) are most encouraged to apply.
JOB REQUIREMENTS AND DETAILS
A fellowship level qualification in Diagnostic Radiology from the Australasia region, South Africa, Switzerland, Singapore, Hong Kong, Ireland, UK, and the USA is required for this role, and anyone with an interest in specialized imaging services such as Breast Imaging, MSK Ultrasound, or Image-Guided Pain Management should apply. Earning potential of between $600,000 and $800,000 is available, dependent on experience.
CORE DUTIES OF THIS ROLE
- Ensure accurate and timely production of diagnostic imaging reports.
- Supervise and guide diagnostic imaging personnel during scheduled hours.
- Maintain effective communication with patients and other physicians to ensure proper care.
- Monitor and report equipment malfunctions and inventory shortages.
LIFE IN THIS REGION
This major Canadian city offers a blend of urban and suburban living options, with lively downtown areas and peaceful neighborhoods for families. The region provides excellent schools, reliable transport links, and an array of leisure activities for adults and families alike. Known for its cultural diversity and natural beauty, this area is a significant hub for commerce and education in Canada.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists.
- Application support with expert knowledge of specialisms & recruitment practice.
- At least two video-calling interview preparation sessions.
- Contract and offer negotiations for salary, relocation packages, tenure, and more.
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role, including:
- Document gathering and checking sponsorship and visa application support, if applicable.
- Support sourcing short- and long-term accommodation.
- Travel arrangements and family support for finding schools and any other aspects of pastoral care.
A leading private healthcare provider in the North West of England is seeking an experienced Consultant Anaesthetist to join their team at their state-of-the-art hospital in Merseyside. Serving over 15,000 patients annually across multiple locations, this provider is known for delivering thousands of successful cosmetic procedures each year. The Merseyside facility boasts a patient satisfaction rate exceeding 98% and has received high marks in its CQC inspection. With a multidisciplinary team of over 100 medical professionals, it offers some of the shortest waiting times for consultations and surgery in the region, making it an excellent choice for a step into the UK private sector.
Key Responsibilities:
- Deliver high-quality anaesthetic care for cosmetic surgical procedures, ensuring patient safety and comfort.
- Collaborate with multidisciplinary teams to create tailored anaesthetic plans.
- Conduct pre-operative assessments and oversee post-operative care.
- Uphold the highest standards of patient care and contribute to clinical improvements.
Eligibility Requirements:
- Full GMC registration with inclusion on the Specialist Register in Anaesthesia.
- Extensive anaesthetic experience, ideally in cosmetic or plastic surgery.
- A patient-focused approach and a commitment to clinical excellence.
- Strong communication and teamwork skills.
What’s on offer:
- Competitive salary and benefits package.
- The opportunity to work in state-of-the-art facilities with a leading private healthcare provider.
- Support for professional development and career progression.
How will IMG Connect support you?
Partnering with IMG Connect you’ll receive expert guidance throughout your recruitment and relocation journey. Our tailored support includes:
- Bespoke CV preparation with a specialist.
- Application support and NHS recruitment insights.
- At least two interview preparation sessions via video call.
- Contract and offer negotiation, including salary and relocation packages.
Once your role is secured, our relocation executives will assist with:
- Document gathering and verification.
- Sourcing short or long-term accommodation if required.
- Travel arrangements, ensuring a smooth transition to your new position.
A Birmingham-based hospital is looking for a Consultant in Maternal and Fetal Medicine with an interest in prenatal surgery. The department comprises a team of specialist consultants supported by a multidisciplinary team of doctors. This role is open to both international applications and UK-based doctors, though those with relevant specialist qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Candidates must possess full GMC registration and at least six months of eligibility for entry to the Specialist Register. A relevant specialist qualification is required, and completion of Labour Ward ATSM is essential. Experience or an interest in prenatal surgery is highly desirable. The salary will be competitive and dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Deliver high-quality care in maternal and fetal medicine, managing complex pregnancies and contributing to fetal interventions.
- Participate in specialist clinics and multidisciplinary reviews.
- Contribute to education and training of junior medical staff and trainees.
- Collaborate in emergency and high-risk case management as part of the on-call rota.
The hospital is located in a vibrant region offering both urban living and tranquil suburban options. The area features excellent schools, reliable transport links, and numerous cultural and leisure activities for individuals and families. Its historical significance and role in British innovation make it a fascinating place to live and work.
An NHS hospital in East England is looking for a Consultant in Obstetrics and Gynaecology with an interest in Fetal Medicine. The Obstetrics and Gynaecology department comprises a team of 12 full-time and 2 part-time consultants, supported by a large team of middle-grade doctors. This Obstetrics and Gynaecology job is open to both international applications and UK-based doctors, though those with European Specialist or MRCOG are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration and experience equivalent to UK CCT are not necessarily required for this role, and anyone with an interest in Fetal Medicine and High-Risk Obstetrics should apply. The salary will be between £105,504 and £139,882 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Provide consultant-led service with the highest standards of care in obstetrics and gynaecology.
- Develop care pathways and clinical guidelines in collaboration with the multi-professional team.
- Participate in the management of high-risk pregnancies and fetal medicine procedures.
- Supervise and mentor junior medical colleagues and participate in teaching and clinical governance activities.
LIFE IN EAST ENGLAND
The hospital is based in a region offering vibrant urban living options in large towns and quiet rural retreats in scenic countryside and coastal areas. The area provides excellent schools, both state and private, with strong transport links to major cities. There are a variety of leisure activities available, including outdoor pursuits, cultural attractions, and shopping. Historically, the region has deep roots in British history, with significant landmarks and connections to famous figures in the arts and history.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect, you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists
- Application support with expert knowledge of NHS specialisms & recruitment practice
- At least two video calling interview preparation sessions
- Contract and offer negotiations for salary, relocation packages, tenure, and more
Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role, including:
- Document gathering and checking COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
- Travel Arrangements
- Family support for finding schools and any other aspects of pastoral care