Multi-specialty recruitment assessment (MSRA)
The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based exam that has been integral to the ST1 radiology application process since 2016. It is split into two parts - Professional Dilemmas (PD) and Clinical Problem Solving (CPS) papers.
All applicants must take the test in late January/early February, and rankings based on MSRA scores determine interview invitations. Notably, achieving a sufficiently high MSRA score is crucial for securing an interview slot.
The MSRA score contributes significantly to determining final selection, accounting for 20%, alongside the portfolio (30%) and interview performance (50%). This demonstrates the importance of this exam.
format of the msra
Part 1: Professional Dilemmas (PD) Paper
Aim:
The PD paper within the MSRA consists of a Situational Judgement Test (SJT) comprising of 50 questions in 95 minutes. This assessment method gauges a candidate's beliefs about appropriate behaviour in challenging professional situations.
Unlike a test of knowledge or problem-solving ability, the PD paper focuses on evaluating professional attributes deemed vital for successful training progression and job performance. There is no negative marking.
Context:
The PD test, assessing aptitude for specialty training entry, places candidates in the role of an F2 doctor. Despite this role assumption, subject matter experts meticulously review each scenario to eliminate region-specific or UK-centric knowledge, preventing disadvantage to certain candidates like International Medical Graduates.
To enhance test relevance for all specialty applicants and ensure face validity, the PD paper blueprint mandates scenarios from diverse contexts and rotations a Foundation Doctor might realistically encounter. These include hospital settings, general practice, out-of-hours clinics, and even non-medical contexts when relevant.
Three core competencies are covered:
Professional Integrity
Coping with Pressure
Empathy and Sensitivity
These core criteria are covered in the Person Specification (2024 Recruitment).
Part 2: Clinical Problem Solving (CPS) Paper
Aim:
The CPS paper evaluates your capacity to apply clinical knowledge and make decisions in practical scenarios. These scenarios are rooted in Foundation-level clinical practice, assessing your ability to synthesise and apply medical knowledge, not just recall it. There are 86 items split into extended matching questions and single best answers.
Context:
CPS questions are grounded in 12 clinical topics pertinent to general medicine, ensuring a comprehensive coverage in each test paper. These topics encompass Cardiovascular, Dermatology/ENT/Eyes, Endocrinology/Metabolic, Gastroenterology/Nutrition, Infectious disease/Haematology/Immunology/Allergies/Genetics, Musculoskeletal, Paediatrics, Pharmacology and Therapeutics, Psychiatry/Neurology, Renal/Urology, Reproductive, and Respiratory.
All scenarios are aligned with the Foundation (FY2) training program.
The test assesses proficiency in 5 core domains:
Investigation: Conducting specific tests to reach a conclusive diagnosis or eliminate potential causes of illness/injury.
Diagnosis: Identifying a condition, disease, or injury by evaluating patient symptoms and signs.
Emergency: Recognising and responding to potential serious illnesses based on suggested factors, requiring immediate attention.
Prescribing: Providing guidance, authorisation, or review of medication usage as part of a patient's clinical management plan.
Management (non-prescribing): Offering advice, authorisation, or review of non-medicinal/drug-related treatment methods as part of a patient's clinical management plan.
Tips and tricks
The MSRA can be a crucial component for success in the radiology application as, in situations where top candidates perform equally well in the interview, the MSRA score becomes the distinguishing factor for preferred placements.
Effective preparation is key, with many candidates starting revision at least 2 months before the exam. Allocate ample time for practice questions and increasing your knowledge base.
Do not neglect your “weaker” areas, especially if you have experience in certain placements.
Carefully read instructions and questions, providing your best answers with the given information. Recognize that in the SJT, there may not always be an absolute right or wrong answer, as rankings are assessed against a predetermined key using a near-miss approach.
Resources
Online Resources:
SJT Practice Paper: Click here to access a practice paper produced by the UK Foundation Programme to familiarise yourself with the exam and style of question.
MSRA Practice Exam Paper (SJT + CPS): Click here to access a practice paper of both components of the MSRA exam.
GMC Good Medical Practice: Click here to access the GMC guidance on Good Medical Practice. Candidates in the past have found this to be the key to understanding the dilemmas encountered in the SJT component of the exam.
Pearson VUE: Click here to access the platform used for the exam. This is a good resource to familiarise yourself with the interface you will perform the exam on.
MSRA Exam Structure: Click here to access the exam structure which is also used for other specialties, including General Practice.