The Multi-Specialty Recruitment Assessment (MSRA) is an exam used for recruitment in the majority of CT1/STI entry training programmes in the U.K.
Recruitment into training programmes starting in 2027
The Multi-Specialty Recruitment Assessment (MSRA) is an exam used for recruitment in the majority of CT1/STI entry training programmes in the U.K.
There are two recruitment rounds for specialty training programmes that use the MSRA: Round 1 and Round 3.
Round 1 is for training programmes that are due to start in August of the following year. This includes all 12 of the training programmes that use the MSRA and is considered to be the main recruitment cycle with the most places available.
Round 3 is for training programmes that are due to start in February of the following year. Currently this only includes GP Training, Core Psychiatry and Core & ACCS Anaesthetics. This is considered to be a mop-up round, filling spaces that were not filled in the 1st recruitment round, or where candidates have since left their post. The number of spaces available for this round can vary a lot year to year.
Round 2 does NOT use the MSRA and consists of training programmes recruiting at a ST3+ level.
After sitting the MSRA you will receive a standardised score for both the Professional Dilemmas (PD) paper and Clinical Problem Solving (CPS) paper and a single combined score which is simply the PD and CPS scores added together.
This score will be the same for every specialty training programme that you apply for as scores are standardised across all MSRA-takers, not on a specialty-by-specialty basis.
Yes, you can transfer your MSRA score from Round 1 to Round 3.
Importantly you cannot transfer your score from Round 3 to Round 1. This is as Round 1 is considered the start of a recruitment year and Round 3 is considered the end of a recruitment year.
Estimated, based on patterns observed in previous years
The next recruitment cycle using the MSRA will be Round 3. This will be recruiting for training programmes starting in February 2027.
There has been some speculation about whether there will be a Round 3 recruitment cycle this year. At least for ACCS/Core Anaesthetics CT1 it has been confirmed that there will be.
This will be for recruitment into training posts starting in February 2027.
Following this a new recruitment year will begin, starting with Round 1, for programmes starting in August 2027.
IMPORTANT - Dates for both of these rounds have not yet been formally released. We have estimated the dates below from patterns observed in previous recruitment years. This will be updated once dates are officially released.
Round 3 Programmes Starting Feb 2027 | Round 1 Programmes Starting Aug 2027 | ||
| Applications Open | 28th July 2026 | 22nd October 2026 | |
| Applications Close | 13th August 2026 | 19th November 2026 | |
Book MSRA via Pearson Vue 1st Sitting | 21st August 2026 | 14th December 2026 | |
Book 2nd Sitting | No 2nd Sitting | 28th December 2026 | |
MSRA Window 1st Sitting | 3-10th September 2026 | 5-15th January 2027 | |
2nd Sitting GP and Core Psychiatry Training ONLY | No 2nd Sitting | 9-22nd February 2027 | |
| Results Released | By 20th October 2026 | By 16th March 2027 |
The dates above are our estimates. Leave your email and we'll let you know the moment the official Round 3 and Round 1 dates are confirmed.
One email when dates are confirmed. No spam, unsubscribe any time.
The MSRA is made up of two papers: Professional Dilemmas (PD) and Clinical Problem Solving (CPS).
The MSRA is 2 hours and 50 minutes long (170 minutes).
The Professional Dilemmas paper is 1 hour and 35 minutes (95 minutes).
The Clinical Problem Solving paper is 1 hour and 15 minutes (75 minutes).
There is an optional 5 minute break between the two papers which is not included in the total running time of 170 minutes.
It is a computer based exam sat either at a Pearson VUE center or at home via Pearson OnVUE. To sit the exam at home you must have extenuating circumstances that have been approved by the National Recruitment Office. You can see a demo of what the computerised test will look like here.
Don't be cheating now or Sue will catch you out
You will need to bring a government issued ID. To see what forms of ID are allowed then please see Pearson VUEs ID policy here (opens pdf).
Your name on the ID must match the name on your Oriel application. If there is a discrepancy then you should contact the National Recruitment Office beforehand.
You are expected to arrive 15 minutes before the exam is due to start, this is to allow time for ID checks. Sometimes the test center can be very busy, with queues, so it is normally advisable to arrive even earlier. Late entrants are not allowed in.
Professional Dilemmas (PDs) are the rebranded MSRA name for Situational Judgement Test (SJT) questions.
The paper consists of 50 questions, some of which are pilot questions and do not contribute to your score. Pilot questions are not labelled, so you will not know if the question you are answering is a pilot question or one that will actually contribute to your score.
In a PD question you will be given a scenario that contains a dilemma. You are then marked on how well you can resolve the dilemma. For example, your consultant shows up to operate drunk but tells you he's still okay to operate as the booze actually helps with his hand shakes, do you trust his judgement (bad), raise your concern (good) or grab a bottle to help with your own hand shakes (unemployable).
You are a Foundation (F2) doctor working in respiratory medicine. Alan is a fellow F2 doctor working on the same ward as you. You see him when you are not at work. Alan tells you that he will refuse to have a seasonal influenza vaccination.
Rank in order the following actions.
There are two types of PD questions: ranking and multiple-choice.
In a ranking question you will be given 4-5 options, each of which are meant to resolve the dilemma being presented.
Options are independent of one another and should be ranked as such.
What this means is that when you are given 4 options (A-D) and you rank them A > B > C > D you are saying that A is more appropriate an action to take and better resolves the scenario than B. NOT that you would do A followed by B.
In multiple choice questions you will be given 7-8 options, each of which will contribute to resolution of the dilemma to different degrees.
Unlike ranking questions, options are NOT independent of each other and you are choosing the group of 3 options which when taken together best resolve the dilemma.
What this means is that when you are answering a question you may think that A and B are the best options. But A and B may have a lot of overlap which makes choosing them together redundant. With this in mind A, C and D maybe the best group for this question, even if B, when seen in isolation, is a better option than C and D in isolation.
Each PD question is constructed to assess one of three domains: Empathy & Sensitivity, Coping with Pressure and Professional Integrity.
Questions may sometimes contain distracting elements to make candidates think the question is testing a different domain than the one the exam writers are truly testing for.
It can be helpful to think about what domain the examiners are testing for, with practice you may start recognising common patterns for distractors.
The CPS paper consists of 86 clinical questions. Just like the PD paper some of these questions are pilot questions and do not contribute to your score. Pilot questions are not labelled.
There are 12 clinical areas that questions cover, which essentially cover the entirety of modern medicine.
Scenarios are designed to be relevant to the level of a Foundation Year 2 doctor.
There are two types of CPS questions: Extended Matching Questions (EMQ) and Single Best Answer (SBA).
In Extended Matching Questions (EMQs) you will be presented with multiple clinical scenarios each with a similar theme, such as the acute red eye or headaches. Each group of EMQs, with the same theme, will share the same set of 7 to 10 plausible options. You will be asked to select the most appropriate answer.
In Single Best Answer (SBA) questions you will be given a single clinical scenario with 5-8 plausible answers. You must select the best answer for the clinical scenario.
The MSRA is currently being used in recruitment for 12 different training programmes.
Each training programme independently decides whether they want to use the MSRA and how they want to use it themselves. This has led to significant divergence in how different programmes use and weight the MSRA.
See details of how each programme uses the MSRA in the table below.
Click on any blue training programme for it's complete guide
Scroll right
| How the MSRA is used | Final Selection Score Weighting | ||||
| Programme | Direct Selection | Interview Shortlisting | MSRA | Portfolio | Interview |
| Anaesthetics CT1/ACCS | 15% | 85% | |||
| Broad Based Training CT1 (Scotland only) | 75% | 25% | |||
| Clinical Radiology ST1 | 40% | 60% | |||
| Core Psychiatry Training | |||||
| Core Surgical Training | 10% | 45% | 45% | ||
| CSRH ST1 | 100% | ||||
| Emergency Medicine ACCS | 40% | 60% | |||
| General Practice ST1 | |||||
| Neurosurgery ST1/2 | MSRA is 40% of shortlisting score Portfolio is 60% of shortlisting score | 12% | 18% | 70% | |
| Nuclear Medicine ST3 | 40% | 60% | |||
| Obstetrics & Gynaecology ST1 | Top 75 candidates on MSRA will get direct offer | 33.3% | 66.6% | ||
| Ophthalmology ST1 | 50% | 50% | |||
| Trauma & Orthopaedics ST1 (Scotland only) | Being trialled, score not currently used | ||||
The Clinical Problem Solving (CPS) and Professional Dilemmas (SJT) papers are distinctly different, testing completely different attributes. We believe the strongest approach is to prepare for each separately.
The CPS paper tests 12 different clinical topical areas.
It can be helpful to break up your revision by clinical topical area. We recommend spending extra time on more niche topics such as 'Eyes' and 'Genetics' as these are areas where people frequently drop marks. Gaining extra marks here can elevate your overall score (and your rank).
NICE CKS is the recommended resource for familiarising yourself with assessment, red flags and different lines of management for most conditions that are likely to come up in the CPS.
Once you are familiar with common topics, such as the 'acute red eye', we recommend working through a question bank. This can really help consolidate knowledge, and help you identify gaps where you may need to do further reading.
Passmedicine is one of the more popular question banks for this.
Practise under time pressure too. With 86 questions in 75 minutes you've got under a minute each. It can be useful to get used to this pace so it doesn't take you by surprise in the real exam.
The Professional Dilemmas paper, commonly referred to as the Situational Judgement Test (SJT), is notoriously tricky to revise for. This is because it's testing your judgement, something fairly subjective and open to debate.
Start by familiarising yourself with the MSRA Blueprint, which maps out the precise domains, and characteristics within each domain, that you're being assessed on.
From there, work through our free MSRA Question Bank, which contains 289 official NHS England SJT practice questions. For years these have been scattered across the internet, or shared in private chats: we've collected every last one of them and digitised them for automatic marking and cohort statistics.
We have also digitised every question, so you get automatic marking, performance tracking over time and, most importantly, a way to see how you rank against other 2027 applicants. It's free to access here. We will be using your responses to these questions to produce the first fully validated MSRA SJT question bank.
Finally, consider finding a 'practice buddy': someone to work through SJT questions with. You can answer questions separately, then discuss your answers. This can help you see questions from angles you'd missed, and help make sense of the judgement you are being assessed for.
