🩺 MSRA (Multi-Specialty Recruitment Assessment) Explained

🧩 What is MSRA?

The Multi‑Specialty Recruitment Assessment (MSRA) is a computer-based exam used in the UK to shortlist candidates for postgraduate medical specialty training (such as GP, Psychiatry, Radiology, O&G, etc.) 

🧠 What Does It Test?

It’s split into two key components:

• Professional Dilemmas (PD) – a Situational Judgment Test (SJT) that measures your professional integrity, coping under pressure, empathy, and sensitivity through workplace-based scenarios 

• Clinical Problem Solving (CPS) – clinical scenarios designed to evaluate your decision-making in areas like investigation, diagnosis, emergency care, prescribing, and non-drug management

⏱ Exam Format & Timing

The total duration is 170 minutes (2 hours 50 minutes), with a short optional break in between:

Section	Questions	Time
Professional Dilemmas (PD)	50	95 min
Break (optional)	–	~5 min
Clinical Problem Solving (CPS)	86–97†	75 min

†Note: CPS has 86 scored items among ~97 questions including pilots 

• Only 86 of those questions are officially marked (scored) and count toward your final CPS result.

• The remaining ~11 questions are called “pilot questions”. They are unscored and are being tested for future exams to evaluate their difficulty, clarity, and performance.

• You won’t know which questions are pilot—they are mixed in with the scored ones.

📋 Types of Questions

Professional Dilemmas (PD)

• Ranking questions: Rank 4–5 options in order of appropriateness (about half of PD questions)

• Multiple‑choice: Choose three out of eight actions that together address the scenario (about half)

Clinical Problem Solving (CPS)

• Extended Matching Questions (EMQ): Select the best option from 7–10 options across multiple scenarios (about half) 

• Single Best Answer (SBA): Pick the one best out of 5–8 choices for a single scenario (the other half).

⏳ Timing Tips

• PD paper: 95 minutes for 50 questions → ~1.9 minutes/question.

• CPS paper: 75 minutes for ~86–97 items → ~0.9–0.87 minutes/item.

• No negative marking – attempt every question

MSRA Scoring & Results Interpretation

Unlike typical exams with fixed maximum marks, the MSRA (Multi-Specialty Recruitment Assessment) uses a scaled scoring system. Your performance is not judged by raw marks alone but by how well you do compared to other candidates in your exam cycle.

🧮 How Scoring Works:

• Each section—Professional Dilemmas (PD) and Clinical Problem Solving (CPS)—is scored out of a normalised scale, with:

  • Mean = 250

  • Standard Deviation = 40

This means most candidates will score between 210 and 290, and exceptional performance is reflected in scores above this range.

Your score is normalised relative to how all candidates perform in that particular sitting.

📊 What Does “Normalised Score” Mean?

• Both Professional Dilemmas (PD) and Clinical Problem Solving (CPS) sections are scored and then recalibrated to fit a standard scale, with a mean of 250 and a standard deviation of 40 

• Since scores are based on relative performance, there is no absolute “top” score—your score depends on how well you do compared to everyone else .

🎯 Score Bands

Scores are categorized into bands (1–4).

Clinical problem solving test scores meaning:

Standardised score range	Approx percentage scoring in this range	Score Band	Score Meaning
Below 170	3%	1	Very poor level of performance
171-185	3%	1	Very poor level of performance
186-210	9%	2	Below average performance
211-230	13%	2	Below average performance
231-250	19%	3	Good level of performance
251-270	23%	3	Good level of performance
271-290	20%	3	Good level of performance
291-310	9%	4	Very good level of performance
Above 310	1%	4	Very good level of performance

Professional dilemmas test scores meaning:

Standardised score range	Approx percentage scoring in this range	Score Band	Score Meaning
Below 170	5%	1	Very poor level of performance
171-185	5%	1	Very poor level of performance
186-210	18%	2	Below average performance
211-230	21%	2	Below average performance
231-250	19%	3	Good level of performance
251-270	16%	3	Good level of performance
271-290	11%	3	Good level of performance
291-310	4%	4	Very good level of performance
Above 310	1%	4	Very good level of performance

A Band 1 in either section means you won't proceed with recruitment

✅ Bottom Line

• There’s no maximum possible MSRA score—you're scored based on cohort comparison.

• Aiming for a score well above average (Band 3–4) is key to boosting your selection chances.

• Individual specialties set different cut-off thresholds based on their competition and recruitment needs.

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✅ Bottom Line

• There’s no maximum possible MSRA score—you're scored based on cohort comparison.

• Aiming for a score well above average (Band 3–4) is key to boosting your selection chances.

• Individual specialties set different cut-off thresholds based on their competition and recruitment needs.

✅ Summary

The MSRA is a fair, competencies-based assessment combining professional judgment and clinical decision-making. Familiarity with PD and CPS formats, plus practicing under timed conditions using official practice papers, can significantly boost your performance.

• There’s no fixed maximum score.

• Scores are adjusted based on exam difficulty and cohort performance.

• Some specialties use MSRA as a shortlisting tool; others offer direct appointments based on MSRA score alone.

📚 References

• medical.hee.nhs.uk+15medical.hee.nhs.uk+15pulsejobs.com+15

• https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/multi-specialty-recruitment-assessment-msra/taking-the-msra/what-happens-on-the-day-and-what-to-bring

• https://heeoe.hee.nhs.uk/sites/default/files/msra_test_blueprint_information_nov_2019.pdf

• https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/general-practice-gp/how-to-apply-for-gp-specialty-training/gp-specialty-training-recruitment/gp-msra