Updated: Apr 22
By Aalia Pagarkar
Hello everyone! My name is Aalia, I am an FY4 doctor working as a Medical Education Fellow this year. I decided to apply for General Practice and part of this application process requires us to complete an exam called the Multispecialty Recruitment Assessment (or MSRA for short). I thought I would write a bit about my experience of preparing for and sitting the exam, and summarise a few tips and learning points that I discovered as I went through the process.
If you haven't tuned into the first part of this blog before, please do so before continuing!
Preparing for the Professional Dilemma paper
I found this paper quite tough and vague and left the exam not really knowing how I had done. There were a plethora of questions with response sets that I was not sure how to rank, and some questions where I couldn’t tell what was the best or worst option! To prepare for the Professional Dilemma paper, I used both PassMedicine and Pastest question banks. I am not sure how useful these were, however all of these questions helped me get into the mindset of how the paper expects me to answer the question, as opposed to what may actually happen in practice. I would recommend using more than one question bank to get a variety of question styles to prepare you. I started preparing for the MSRA Professional Dillemas paper about 2 months prior to the exam. The questions can be extremely wordy, so I would get into the habit of reading these and trying to pick out the salient points. I did not realise how gruelling reading long questions would be
for my eyes, so I would recommend doing a decent amount of questions under a time limit so that you get used to exam conditions. If I were to repeat the exam, I would probably have spent more time reviewing GMC’s Good Medical Practice guides on their website – especially the ones surrounding Consent, Social Media, Good Medical Practice, Care at the end of life, Candour and Raising concerns, and Confidentiality. I know these can seem tiresome to read, but guides are relatively short and sweet – you don’t ave to commit these to memory but it provides a good baseline on how the GMC expects you to act in certain situations which may help in answering the Professional Dilemmas questions. Preparing for the Clinical Problem Solving paper
I wish I had been a lot more organised in revising for this paper! I started revising about 2 months prior to my exam which was not a huge amount of time to wrap my head around everything and make the notes that I wanted to make – I would have probably started at least 3 months before to give you enough time to prepare.
Having said that, everyone is different, and you should focus on what works best for you. Some people revise better far in advance, and prefer to chip away at revision slowly and steadily in the lead up the exam – if you are this kind of person you may wish to give yourself more time to fit your revision style. I am the kind of person who requires the stress and adrenaline of an upcoming exam to make me focus properly – I also had several deadlines for work in the few months leading to the exam which meant it was more difficult for me to dedicate lots and lots of time to revising – this is why I ended up only starting proper revision 2 months before my exam.
In terms of preparation, I bought three question banks – PassMedicine, Pastest, and Medibuddy as these seemed to be the cheapest of all of the options available. I liked PassMedicine the most because it provided really good thorough explanations and has a textbook that you can open up to look up different conditions that you have been tested on. It also has a knowledge tutor function which is essentially like an online flashcard type function which allows you to rapidly test random facts and presentations which may be useful on the go. I thought that Pastest was really good in terms of the breadth of topics covered and there were quite a few questions in the Pastest question bank that I then got tested on in my MSRA CPS paper. I did not have sufficient time to fully explore Medibuddy as a revision resource, but I found this resource to be the least useful because their questions were way too specific and niche for what the MSRA expects.
There are other question banks out there including eMedica and MCQ Bank which came highly recommended to me and I was told that the question style was very similar to the MSRA paper itself – I did not buy these as there were more expensive than the others, and the website was quite clunky, but I had heard good things about them! Other things you can do to prepare
The MSRA will send you a practice paper to complete after you apply for the exam. I did this practice paper a week before the exam under timed conditions. I found the Clinical Problem Solving Paper quite easy, and it was much easier compared to the actual MSRA exam, but nevertheless good practice. The Professional Dilemmas practice paper was tough and I would say at the same level as the MSRA exam. The questions in both papers were also worded in a similar way to the actual exam, so this was useful.
I listened to the Zero to Finals Medicine Podcast and looked through their YouTube videos too, and I found these to be really useful to just have a 5-10 minute recap on a condition that I may have forgotten about. I listened to these on my drive to work every day. Although they are meant for final year medical students, I found them to be equally useful for MSRA. They were short, sweet and well explained and seemed pitched at the right level for MSRA revision.
I think if I had more time, I would have made short revision cards and looked more thoroughly at the NICE CKS guidelines. The MSRA questions aren’t extremely specific such that they will ask a question pertaining to a very specific piece of guideline, but they will expect you to know things like red flag symptoms and when to refer to secondary care – which I think is fair enough!
There will also be several courses online offering to prepare you for the MSRA – often these are intensive three day courses. I did not go on any of these, as they costa lot of money and I was not sure what I could get out of them that I could not by doing the question banks. The MSRA is not an exam that you can revise for in 3 days through an intensive course! – Any courses that you do attend, I would suggest doing a thorough background review on them, and would discuss with the people who have actually done them before paying lots of money for them. I would also not just rely on what the reviews say on their website. If you feel like you would benefit from a course, then I would look on the Foundation Year 3 Facebook group as a lot of people advertise FREE MSRA courses on there / courses that do not take as much money and are usually run by people who have recently done the MSRA themselves. My exam
In my Clinical Problem solving exam, I had such a variety of questions – the exam really does test all of those subject areas to an equal degree and tests all of investigations, management and diagnosis in an equal balance too. I would say please don’t ignore subjects but try to get a grip on the common presentations, investigations and management. The paper itself does not have long stems – they tend to be as a whole, quite short, so going with your gut instinct is the best option, as sometimes they don’t give you all the information you would need to make a definitive diagnosis.
The Professional Dilemmas question was very obscure – and many of the questions I ranked did not have the most obvious order. It is difficult to keep reading the large amounts of text in the paper for a long time – so I would recommend getting used to this, and doing as many questions as possible so you get into the mind frame of how you should answer the questions.
I think the main thing I wold change about my revision to score even higher would be to start a bit earlier so that I would have time to make revision cards, and keep going through questions so you develop the pattern recognition required for the exam.
I ended up getting a Band 4 in both my Clinical Problem Solving paper and Professional Dilemmas paper, and was able to get my top choice hospital: Guy’s and St Thomas’, London. Top tips
Have a revision plan that is suitable for you – there is no right way to revise for this paper but I would recommend doing as many questions as possible from different resources so that you get the breadth of question experience required to tackle the exam.
What is right for someone else might not be right for you – everyone has a different way of revising. Please don’t focus on whether your revision plan aligns with someone else’s – this may only spook you! I would say focus on what works for you.
Try revising with a buddy – I did weekly revision sessions with friends and I found this to be so enjoyable and rewarding! You can learn from each other, and it can break up the usual lonely monotonous revision.
Every little helps – Dedicate a few hours to exam preparation where possible, and even if you don’t have a few hours to spare, use the spare few minutes in the day to go through some questions when you can – every little helps, more so than you think! Resources
I found the following resources super helpful and used these consistently throughout my revision:
PassMedicine – including the textbook and knowledge tutor functions
PasTest – excellent range of questions in their question bank
Zero to Finals Podcast and Youtube – they also have a website: https://zerotofinals.com/
BMJ OnExamination – Ask your hospital library if they can give you a code to get this resource free – they often have a subscription.
Finally, I would just like to say good luck with your revision! If you had any further questions I am more than happy to discuss these! Aalia