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How I Prepared for the MSRA Exam

By Dr Aniqah Bhatti

ST1 Radiology Resident


Hi, my name is Aniqah. I have recently starting my specialty training post as an ST1 in Clinical Radiology after completing my foundation training at QMC.


If you are planning on applying for specialty training, it's highly likely that you will need to sit the Multispecialty Recruitment Assessment (MSRA). The MSRA forms a core part of most applications.


I sat the exam in January 2025 and received offers for my top choices from multiple specialities. In this post, I will share information about the exam, how I prepared and my tips for the MSRA.


Background information

Applications for specialty training generally open in October and close in November. The application needs to be submitted on Oriel by the deadline. If you require any reasonable adjustments (e.g. extra time) you need to indicate this on the application form and submit evidence from your healthcare provider.


The 2026 Round 1 application cycle has confirmed there will be two MSRA sittings, one in January 2026 and the second in February 2026. The allocated sitting will depend on which speciality you have applied for.


The majority of candidates sit the exam in a Pearson Vue Examination centre and some candidates who meet certain criteria are allowed to sit the examination at home.


I recommend you review the official information on the NHS England Website.


You will receive an email invite to register with Pearson Vue and then exam slots are released on a certain day. If you require reasonable adjustments, you will be pre allocated to your desired location on a specific date. The rest of the candidates need to choose a day and location to book the exam; the slots go very quickly so I recommend refreshing the website and booking as soon as possible. There is an option to adjust the booking and you can move your exam to a different centre/date if needed.


Depending on which speciality you apply for, your MSRA score will contribute in different ways. This table published by MindtheBleep shows how each speciality looks at your MSRA score. As you will see, for some specialities the MSRA score contributes to interview invitations and for some specialties contributes to the final score which determines your overall ranking. For GP and Psychiatry applications, it is the only component of the specialty application before job allocations. For O&G, the 75 candidates that score highly on the MSRA bypass interview. Overall, it’s a part of the application that you can excel in if you prepare properly.


Exam Structure


The MSRA has two components:

  1. Professional Dilemma section (consisting of 50 questions lasting 95 minutes),

  2. Clinical Problem-Solving exam (97 questions in 75 minutes).

There is an optional 5-minute break between each component.


At the start of the exam there is a 10-minute introduction to familiarise yourself with the exam format and computer system.


Professional Dilemma Section

  • Ranking questions – read a stem and rank 5 questions from most to least appropriate. The key is to consider each statement separately when ranking them.

  • Multiple choice questions – read a stem and select 3 options from 8 options that would together form the correct answer.


Clinical Problem-Solving Section

  • Extended matching questions – question and then select a single answer from 7 – 10 answers

  • Single best answer question – select single most appropriate answer out of 5- 8 responses for 1 clinical presentation.


More information including official example questions and a link to a practice paper can be found here.


How I prepared

I sat the MSRA in January. I had initially planned to start preparing in August at the start of FY2 during my T&O rotation and spend roughly four months preparing for the exam.


In reality, I bought Passmedicine and started completing questions from mid-September. I tried to do a couple of questions after work and throughout the day when I was on a break or during the trauma meeting. I am the type of person who usually crams and relies on time pressure to focus. I left the bulk of my prep for the month before the exam and tried to do 50 questions daily, then 500-600 questions daily the week before the exam.


My advice would be start as early as you can (start of FY2), space your revision out alongside your clinical placements so that you don’t get too tired! I found going to the mess or cafe after a clinical day a good way to get some revision if I knew I’d be too tired to revise when I got home or using my break during a long day shift to get a short 30 min burst of questions in. Also having a study buddy/accountability partner is helpful; I used to check in with a fellow FY2 and we would motivate each other to get X number of questions done in a day.


I started by completing the Passmedicine Question Bank and then reading the clinical summary if I got the answer wrong. After my first pass through the questions, I identified my weaker areas and skim read the Passmedicine textbook on those topics. I then repeated all the incorrect questions. After this, I reset the question bank and repeated all the questions again.


After this I bought MCQBank and only had time to complete the question bank once.


I personally found Passmedicine useful for revising clinical content and MCQbank was more representative of the real exam (contained questions that were similar to those in the actual exam).


I also completed the mock exam on the MSRA website but found the questions to be easier than the real exam.


I found the actual exam content to be fair and difficulty was similar level as medical school finals with a few added random questions. Some of the question stems were short and 2 answers could have been an appropriate answer but there was often a key word missing that helped eliminate a condition or the question asked to pick the most likely condition.


Professional Dilemma Section

I’d recommend reading the GMC good medical practise and applying that thought process when choosing answers to the professional dilemmas section.


I completed the Passmedicine SJT questions once and due to time constraints completed some of the MCQbank question bank. In addition to this I did the mock exam on the MSRA website and read the explanations. I also went through the 2 UKFPO SJT mocks that I used when preparing for the UKFPO SJT test.


I wouldn’t say any question bank was the same as the actual SJT component of the exam but I managed to score well by applying the 4 ethical principles and applying the GMC good medical practise. The question banks were good to develop my thought process and cover key ethical areas. I would recommend doing the Passmedicine, MCQbank, MSRA mock and SJT mocks as many times as you can until you score highly.


If anyone has any questions about the MSRA exam or about specialty applications feel free to reach out.


References and useful websites:

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