The Bottom Line
- MSRA is a computer-based assessment used across multiple specialties; for some, it can be the primary ranking metric.
- Two papers: Professional Dilemmas (SJT-style) + Clinical Problem Solving (broad medicine).
- PD rewards “safe, escalatory, policy-aligned” judgement; CPS rewards speed + pattern-recognition under constraints.
- If you’re applying to a specialty that uses MSRA for shortlisting, the MSRA is effectively your “entry ticket” to interview.
What specialties use it?
The MSRA is used by multiple national recruitment processes (and the list evolves). In recent recruitment guidance and specialty documents, it is referenced across areas including General Practice, Psychiatry, Radiology, Anaesthetics, ACCS-EM, Obstetrics & Gynaecology, Ophthalmology and more. Always confirm your target specialty’s current rules on the official recruitment pages.
The MSRA is delivered at Pearson VUE test centres. It is designed to assess competencies in person specifications using clinical scenarios, and it is intentionally broad: it tests how you think, not whether you can memorise one niche guideline.
The PD paper trap
Most candidates underperform because they treat PD like “common sense.” High scorers treat it like a rules-based system: immediate patient safety first, escalate appropriately, document, follow policy, be honest, seek senior support early, and avoid lone-wolf heroics.
If you remember only one thing
MSRA is not an exam you “wing.” It is an exam you systematise: timed practice, post-session error logs, and a PD framework that is consistent and defensible.