Is MSRA mandatory for all specialities? Which ones are optional?

In this blog, we’ll know which specialities require it, the specialities which don’t require it, and how best to prepare for it.

What’s MSRA?

The Multi-Specialty Recruitment Assessment (MSRA) is a part of the recruitment process for medical specialities in the UK. It’s a computer-based exam and it comprises a Professional Dilemmas (PD) paper and a Clinical Problem Solving (CPS) paper.

The General Medical Council (GMC) conducts the MSRA exam to assess the problem-solving skills and clinical decision-making abilities of applicants. It ensures that only the best candidates are selected for speciality training. 

The MSRA is divided into two sections:

• Professional Dilemmas (SJT): This exam will evaluate your capability to work under challenging work scenarios, ethical dilemmas, and patient care
• Clinical Problem-Solving (CPS): This tests your clinical knowledge and application of that knowledge under clinical scenarios. The emphasis is mainly on primary care and community medicine.

If you’re eyeing the PG medical training for any speciality mentioned below, it’s mandatory for you to appear in MSRA:

• General Practice ST1
• ACCS Emergency Medicine CT1/ST1
• Anaesthetics CT1
• Broad-Based Training (Scotland) ST1
• Clinical Radiology ST1
• Community Sexual and Reproductive Health ST1
• Core Psychiatry Training  CT1
• Core Surgical Training CT1 
• Nuclear Medicine ST3
• Neurosurgery ST1/ST2/ST3
• Obstetrics and Gynaecology ST1
• Ophthalmology ST1 

The MSRA results are used differently within each speciality’s selection process. For example:

• GP (100%): No selection centre
• Psychiatry (100%): No interviews
• Radiology (33%): MSRA score can bypass interviews
• O&G (25%): MSRA score can bypass interviews
• Neurosurgery (40%)
• Anesthetics (15%)
• Ophthalmology (13%)
• Nuclear Medicine: Used at ST3
• Core Surgery (10%)

It’s evident that in GP and psychiatry, your rank completely depends on your MSRA scores. There's no other selection method like an interview or portfolio.

On the other hand, other specialities combine your MSRA score with interviews. For e.g., if you're applying for CT1 anaesthetics, only 15% of your MSRA score will be considered for your overall rank.

Your MSRA score is equally important as any exams sat in medical school. It’s advised that you check recruitment websites for further guidance

Which Specialties Don’t Require the MSRA?

Besides the variation in assessment, certain specialities don’t require the MSRA. Those are very few:

• Paediatrics: The MSRA is no longer required for the recruitments in Paediatrics. This speciality relies more on interviews and academic records.
• Cardiology, Respiratory Medicine, and Gastroenterology: These specialities focus on other assessments instead of MSRA.
• Public Health: Here the emphasis is on skills in public health and policy-making. It requires unique assessments than the MSRA.
• Pathology: Histopathology and haematology use alternative selection methods.

Conclusion

Since requirements change annually, you should keep checking the recruitment guidelines for each speciality. PD and CPS exams test your professional ethics, so study the GMC’s professional guidelines on values and ethics. It will help you refine your ethical decision-making.

If you’ve read this far, do try Medlogbook to log your medical experiences. I’ve created this to organise your competencies which could help with moving abroad. You can be better prepared for submitting work evidence, a requirement in most countries for practising.