MSRA format, timing and scoring
The MSRA is a computer-based assessment of 170 minutes with two papers: Professional Dilemmas (95 minutes) and Clinical Problem Solving (75 minutes). Neither paper is negatively marked.
The two papers
| Paper | Time | Length | What it is |
|---|---|---|---|
| Professional Dilemmas (PD) | 95 minutes | 50 questions | A situational judgement test: how you believe you should behave when faced with a challenging professional dilemma |
| Clinical Problem Solving (CPS) | 75 minutes | 86 items | Your ability to apply clinical knowledge and make clinical decisions in everyday practice |
The times above are the standard times on the official structure page. That page also sets out the times for candidates awarded extra time as a disability accommodation under the Equality Act 2010.
How the sitting runs
- The MSRA is computer-based and is delivered as a single assessment.
- The two papers are timed independently, and an onscreen countdown timer shows the time left in each.
- Professional Dilemmas comes before Clinical Problem Solving. When you finish it, there is an optional 5-minute scheduled break.
- If you take longer than 5 minutes, the extra time is taken off your Clinical Problem Solving paper.
- A glossary of frequently used terms and a list of abbreviations are available for reference during the assessment.
- A generic demo is available in advance so you can get used to the controls and screen layout.
Professional Dilemmas
The official Professional Dilemmas page describes the paper as a situational judgement test. The official page says it is not a knowledge test: it aims to assess professional attributes. It is set in the context of the Foundation Programme, with you taking the role of an F2 doctor, and it covers three core competencies: professional integrity, coping with pressure, and empathy and sensitivity.
It has two parts. In Part 1 you rank a series of options in response to a situation. In Part 2 you select the three most appropriate actions, taken together, from a list of plausible actions. Both are marked against a pre-determined key: the closer your response is to the key, the more marks you get, and you do not need the exact order to score well on a ranking item.
MSRA Navigator does not cover this paper yet.
Clinical Problem Solving
The official Clinical Problem Solving page says the scenarios are based on Foundation-level clinical practice and test your ability to synthesise and apply medical knowledge, not just recall it. Items sit in 12 clinical topic areas and cover 5 core domains.
Around half of the items are extended matching questions, where several scenarios share one list of options, and the other half are single best answer questions. One mark is awarded for each correct response.
The topic areas, domains and question types are set out in What the Clinical Problem Solving paper tests.
How it is scored
There is no negative marking in either paper. The official tips page puts it plainly: answer all the questions, because a wrong answer can score more marks than a missed question.
MSRA scores are normalised, so there is no maximum achievable score. For GP applicants the GP MSRA page says the scores in each paper are normalised around a mean of 250 with a standard deviation of 40, and each paper is also banded 1 to 4. How scores and bands work is covered in How MSRA scores and bands work.
Dates and rules can change, and this page is not legal or careers advice. Confirm them on the official page before you rely on them: Structure of the Multi-Specialty Recruitment Assessment (NHS England).