MSRA Practice Test
Updated October 2026Facts verified Oct 28, 2026 against NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P
MSRA: upcoming dates and official changes
- Nov 19, 2026: GP specialty training applications on Oriel (needed to be invited to the MSRA) close on 19 November 2026 at 4pm.[6]
- Jan 5, 2027 – Jan 20, 2027: The first MSRA sitting for 2027 recruitment runs 5–20 January 2027.[6]
- Feb 10, 2027 – Feb 18, 2027: The second MSRA sitting for 2027 recruitment runs 10–18 February 2027.[6]
- Mar 17, 2027: MSRA results are expected from 17 March 2027 on the GP recruitment timeline.[6]
- The MSRA Clinical Problem Solving paper has 86 items.[1]
- The MSRA Professional Dilemmas paper has 50 questions.[2]
- The MSRA lasts 170 minutes in total across two papers: Professional Dilemmas (95 minutes) and Clinical Problem Solving (75 minutes).[3]
- For GP specialty training, MSRA paper scores are banded 1 to 4 and applicants with band 1 in either paper are deemed unsuccessful.[4]
- Unsuccessful GP applicants may be able to resit the MSRA depending on application numbers, and can transfer their MSRA score by answering 'Yes' when reapplying.[4]
- The MSRA is a computer-based assessment delivered in partnership with Work Psychology Group and Pearson Professional Examinations.[5]
- Eligible applicants to MSRA-using specialties are invited to take the MSRA.[4]
- MSRA results are expected from 17 March 2027 on the GP recruitment timeline.[6]
- GP specialty training applications on Oriel (needed to be invited to the MSRA) close on 19 November 2026 at 4pm.[6]
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
MSRA Exam at a Glance
What changed for MSRA in 2026
- Oct 24, 2026: Delivery changed to Computer-based, delivered with Pearson Professional Examinations (previously Computer-based at Pearson Professional Examinations test centres worldwide; OnVUE remote only for extenuating circumstances).[5]
- Oct 24, 2026: Eligibility changed to Invitation to eligible applicants (previously By invitation after applying on Oriel to an MSRA-using specialty).[4]
- Oct 24, 2026: Time limit changed to 170 minutes (PD 95 + CPS 75) (previously 170 minutes (PD 95 min + CPS 75 min)).[3]
- Oct 24, 2026: Registration deadline changed to 19 November 2026, 4pm (previously 19 November 2026, 4pm (Oriel applications close)).[6]
- Oct 24, 2026: Retake policy changed to Resit possible depending on application numbers; opt in to score transfer when reapplying (previously Resit possible depending on application numbers; opt in/out of score transfer at reapplication).[4]
- Oct 24, 2026: Score release changed to From 17 March 2027 (previously From 17 March 2027 (GP timeline)).[6]
What the MSRA is and how it works
According to NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P, “There are 86 items in the CPS paper.”[1]
NHS England (Workforce, Training and Education) Medical Training Recruitment uses the MSRA to assess applicants for specialty training, including General Practice. You cannot book it yourself. After you apply, you will be invited to take the MSRA if you are eligible.
The MSRA is computer-based and is delivered with Pearson Professional Examinations. It lasts 170 minutes and has 2 parts:
- Professional Dilemmas (PD): 95 minutes, 50 questions. These are situational judgement questions about realistic workplace problems. In 2020 the paper was shortened from 58 to 50 questions.
- Clinical Problem Solving (CPS): 75 minutes, 86 items. These ask you to apply clinical knowledge to diagnosis and management.
For General Practice ST1 there is no fixed pass mark. However, a band of 1 in either paper means your application is unsuccessful. Other specialties use MSRA scores in different ways, so check the recruitment page for each specialty you apply to. Scores are released from 17 March 2027.
If you reapply, you may be able to resit, but this depends on the number of applications received in that round. When you reapply you can also opt in to transfer your score. Rules can change between rounds, so check the official MSRA pages on medical.hee.nhs.uk before you rely on any detail here.
MSRA content outline and where to practise each area
The content areas below are copied from the official MSRA content outline published by NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P. The right-hand column shows which of our practice sets covers it.
| Official content area | Practice on this site |
|---|---|
| Cardiovascular[1] | MSRA Clinical Problem Solving Practise moving from chest pain, breathlessness and ECG findings to the most likely diagnosis and the next management step. |
| Dermatology / ENT / Eyes[1] | MSRA Basic MSRA Practice Learn to tell apart common rashes, ear and throat problems and red-eye presentations, and to recognise which ones need urgent referral. |
| Endocrinology / Metabolic[1] | MSRA Data Interpretation Interpret thyroid, glucose, calcium and electrolyte results and link each abnormal pattern to its cause and first-line treatment. |
| Gastroenterology / Nutrition[1] | MSRA Essential MSRA MCQ Work through abdominal pain, altered bowel habit and abnormal liver tests, and learn the red-flag features that change management. |
| Infectious disease / Haematology / Immunology / Allergies / Genetics[1] | MSRA Clinical Reasoning Practise reading blood films and counts, choosing antibiotics in context and spotting the presentations of anaphylaxis and inherited conditions. |
| Musculoskeletal[1] | MSRA Basic MSRA Practice Separate inflammatory from mechanical joint and back pain, and know which features suggest a serious underlying cause. |
| Paediatrics[1] | MSRA Comprehensive MSRA Practise recognising the unwell child, common childhood infections and rashes, and developmental or safeguarding concerns. |
| Pharmacology and therapeutics[1] | MSRA Pharmacology and Prescribing Drill drug interactions, contraindications, side effects and monitoring requirements for commonly prescribed medicines. |
| Psychiatry / Neurology[1] | MSRA Clinical Reasoning Practise assessing risk in mental health presentations and localising neurological signs such as headache, weakness and seizures. |
| Renal / Urology[1] | MSRA Data Interpretation Interpret kidney function results and urine findings, and know when to stop or adjust medicines in acute kidney injury. |
| Reproductive[1] | MSRA Essential MSRA Cover contraception, pregnancy-related presentations, menstrual problems and the safe prescribing rules that apply in pregnancy. |
| Respiratory[1] | MSRA Clinical Problem Solving Practise linking chest X-ray, spirometry and blood results to conditions such as asthma, COPD, pneumonia and interstitial disease. |
MSRA Practice Test Questions
Prepare for the MSRA - Exam exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
MSRA Basic MSRA Practice
MSRA Exam Questions covering Basic MSRA Practice. Master MSRA Test concepts for certification prep.
MSRA Comprehensive MSRA
Free MSRA Practice Test featuring Comprehensive MSRA. Improve your MSRA Exam score with mock test prep.
MSRA Essential MSRA MCQ
MSRA Mock Exam on Essential MSRA MCQ. MSRA Study Guide questions to pass on your first try.
MSRA Clinical Problem Solving
MSRA Test Prep for Clinical Problem Solving. Practice MSRA Quiz questions and boost your score.
MSRA Clinical Reasoning
MSRA Mock Test covering MSRA Clinical Reasoning. Online MSRA Test practice with instant feedback.
MSRA Data Interpretation
Free MSRA Quiz on MSRA Data Interpretation. MSRA Exam prep questions with detailed explanations.
MSRA Ethics and Law
MSRA Practice Questions for MSRA Ethics and Law. Build confidence for your MSRA certification exam.
MSRA Exam Strategy
MSRA Test Online for MSRA Exam Strategy. Free practice with instant results and feedback.
MSRA Pharmacology and Prescribing
MSRA Study Material on MSRA Pharmacology and Prescribing. Prepare effectively with real exam-style questions.
Worked examples: how to reason through MSRA questions
These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.
Example 1
Question: How is the MSRA structured and what does it assess?
- Two papers: Clinical Problem Solving (1hr 15min) and Professional Dilemmas (1hr 30min), both computer-based
- A single 3-hour written exam
- An oral examination with clinical stations
- A practical skills assessment
Answer: A. Two papers: Clinical Problem Solving (1hr 15min) and Professional Dilemmas (1hr 30min), both computer-based
Explanation:
A is correct. The MSRA is a computer-based assessment with 2 separate papers. Clinical Problem Solving tests how you apply clinical knowledge. Professional Dilemmas uses situational judgement questions, where you rank or choose responses to workplace scenarios. Option A's CPS time of 1hr 15min matches the official structure. Its PD time does not: the official structure page gives a longer PD time, so use that figure when you plan your timing.
B is wrong because the MSRA is not a single written paper. C is wrong because it has no oral exam or clinical stations. D is wrong because it does not test practical skills.
Rule to remember: the MSRA has a clinical knowledge paper and a professional judgement paper, both taken on a computer. Prepare for each paper separately.
Example 2
Question: A CXR shows bilateral hilar lymphadenopathy, diffuse interstitial shadowing, and no pleural effusion. ACE level is elevated. What is the most likely diagnosis?
- Lymphoma
- Sarcoidosis
- Pulmonary fibrosis
- Tuberculosis
Answer: B. Sarcoidosis
Explanation:
B, sarcoidosis, is correct. Bilateral hilar lymphadenopathy, interstitial shadowing and a raised ACE level together are the classic pattern of pulmonary sarcoidosis. A biopsy showing non-caseating granulomas confirms the diagnosis.
Lymphoma can enlarge hilar nodes, but the nodes are often asymmetric, it usually comes with systemic B symptoms and it does not typically raise ACE. Pulmonary fibrosis causes interstitial change but not hilar lymphadenopathy, and ACE is not a marker for it. Tuberculosis more often causes one-sided hilar nodes, upper-zone shadowing or cavitation, and ACE is not used to diagnose it.
Rule to remember: bilateral hilar lymphadenopathy plus a raised ACE points to sarcoidosis. A raised ACE supports the diagnosis but does not prove it.
Example 3
Question: A junior doctor is asked to obtain consent from a patient for a complex bowel resection they have never performed. What is the ethically correct action?
- Obtain consent as instructed and document it
- Refuse and ensure the consenting clinician has the knowledge and skill to perform the procedure
- Obtain consent but note they are not the operating surgeon
- Ask the patient to sign a generic consent form
Answer: B. Refuse and ensure the consenting clinician has the knowledge and skill to perform the procedure
Explanation:
B is correct. GMC guidance says consent should be sought by someone who knows enough about the procedure to explain its benefits, risks and alternatives and to answer the patient's questions. A doctor who has never performed or been trained to consent for a complex bowel resection cannot do this. The right step is to decline politely, explain why, and make sure a suitable clinician takes consent.
A is wrong because documenting consent the patient did not fully understand does not make it valid. C is wrong because saying you are not the operating surgeon does not fix your gap in knowledge. D is wrong because a generic form is not informed consent. Consent is a discussion, not just a signature.
Rule to remember: work within your competence, and only take consent for procedures you understand well enough to explain.
How to use these practice tests
Start with the official material. Read the MSRA structure page and the official descriptions of the CPS and PD papers on medical.hee.nhs.uk so you know the question styles before you practise.
Take a baseline. Do the full MSRA practice test once, without preparing. Sort your mistakes into clinical (CPS) and judgement (PD) errors.
Build CPS knowledge by topic. Use the topic table above to find your weak areas. Then work through the Clinical Problem Solving, Data Interpretation and Pharmacology and Prescribing sets. Read every explanation, including on questions you got right, and keep a running list of the rules you missed.
Practise PD reasoning. Use the Professional Dilemmas, Situational Judgement and Ethics and Law sets. Before you check each answer, write down why the best response is best: patient safety, honesty, working within your competence and escalating at the right point.
Finish under real timing. The real exam gives you 95 minutes for PD and 75 minutes for CPS, so practise each paper in a single timed sitting. Use the Exam Strategy set to work on pacing, and check your invitation for your test date.
MSRA Exam Flashcards
⏱️ How long is the MSRA exam?
The MSRA lasts 170 minutes in total: 95 minutes for the Professional Dilemmas paper and 75 minutes for the Clinical Problem Solving paper. An optional 5-minute break is allowed between the two papers.
START MSRA PRACTICE TEST🧭 How many questions are in the MSRA Professional Dilemmas paper?
The PD paper has 50 scenarios (cut from 58 in 2020). About half ask you to rank 4-5 actions and half ask you to pick the 3 best of 8 actions. There is no negative marking.
START MSRA ETHICS PRACTICE TEST🩺 How many questions are in the MSRA Clinical Problem Solving paper?
The CPS paper has 86 items. Roughly half are Extended Matching Questions and half are Single Best Answer questions with 5 to 8 options.
START MSRA CPS PRACTICE TEST📅 When is the MSRA for 2027 recruitment?
For Round 1 2027 (applications open 22 October 2026) the MSRA runs in two windows. January 2027 is open to all specialties; February 2027 is reserved for Core Psychiatry and GP applicants.
START MSRA PRACTICE TEST🤝 What does the MSRA Professional Dilemmas paper test?
It is a situational judgement test set in the role of an F2 doctor. It scores 3 competencies: professional integrity, coping with pressure, and empathy and sensitivity.
START MSRA ETHICS PRACTICE TEST📚 What topics are on the MSRA CPS paper?
CPS questions cover 12 clinical topic areas, from cardiovascular to respiratory, at Foundation level. They test 5 domains: investigation, diagnosis, emergency, prescribing and non-prescribing management.
START MSRA CPS PRACTICE TEST🏥 Which specialties use the MSRA?
They include General Practice ST1, Core Psychiatry CT1, Core Surgical Training CT1, ACCS Emergency Medicine, Clinical Radiology ST1, Obstetrics and Gynaecology ST1, Anaesthetics CT1 and Ophthalmology ST1.
START MSRA PRACTICE TEST📊 What is the maximum MSRA score?
There is no maximum score. MSRA scores are normalised against the average performance of each cohort, so a "max" figure is not meaningful. Each specialty sets its own use of the score.
START MSRA DATA PRACTICE TEST⚖️ Can you appeal your MSRA result?
No. The MSRA outcome is final and cannot be reviewed, re-marked or disputed. Results appear in your Oriel account on the date in the recruitment timeline.
START MSRA PRACTICE TEST🏠 Can you take the MSRA at home?
Usually not; the MSRA is taken at Pearson test centres. Remote OnVUE testing is only offered as a reasonable adjustment for extenuating circumstances, approved case by case.
START MSRA PRACTICE TESTMSRA FAQ
Sources & last verified
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — number of questions, other (official source). “There are 86 items in the CPS paper.” Verified Oct 28, 2026.
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — number of questions (official source). “As of 2020, the PD paper has been shortened slightly from 58 to 50 questions.” Verified Oct 24, 2026.
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — time limit (official source). “The MSRA is 170 minutes in length and there are 2 component parts” Verified Oct 24, 2026.
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — passing score, retake policy, eligibility (official source). “Applicants who achieve a band of 1 in either paper will be deemed unsuccessful.” Verified Oct 24, 2026.
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — delivery (official source). “The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based assessment.” Verified Oct 24, 2026.
- NHS England (Workforce, Training and Education) – Medical Training Recruitment, with Work Psychology Group and Pearson P — score release, registration deadline, testing window (official source). “**Date:** from 17 March 2027.” Verified Oct 24, 2026.
How we verify: editorial & fact-checking policy. Report an error: contact us.
How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- medical.hee.nhs.uk — Registration deadline, score release, test dates, eligibility, passing score, retake policy, exam format, time limit, test delivery · verified Oct 2026