NHS England invites eligible applicants for specialty training, including General Practice, to sit the Multi-Specialty Recruitment Assessment (MSRA). It is a computer-based test. This page has free practice sets for both papers, Clinical Problem Solving and Professional Dilemmas. It also has worked answers to sample questions, a map of the official topics, the key dates for the current recruitment round and answers to common questions.
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
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:
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.
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. |
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.
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.
Question: How is the MSRA structured and what does it assess?
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.
Question: A CXR shows bilateral hilar lymphadenopathy, diffuse interstitial shadowing, and no pleural effusion. ACE level is elevated. What is the most likely diagnosis?
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.
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?
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.
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.
In the current round, the first sitting runs from 5 to 20 January 2027 and is open to all specialties. A second sitting, from 10 to 18 February 2027, is only for Core Psychiatry and General Practice. Your invitation will tell you how to book a slot within your window. Check the official recruitment timeline in case the dates change.
The MSRA lasts 170 minutes and has 2 papers. The Professional Dilemmas paper is 95 minutes and has 50 questions. The Clinical Problem Solving paper is 75 minutes and has 86 items. Both papers are computer-based and delivered with Pearson Professional Examinations, so practise each one under its own time limit.
There is no fixed pass mark for General Practice ST1. However, a band of 1 in either paper means your application is unsuccessful, so you need a reasonable score in both papers, not just a strong total. Other specialties use MSRA scores in different ways. Check the recruitment page for each specialty you apply to.
In the current round, scores are released from 17 March 2027, according to the General Practice recruitment timeline. Scores may be released in stages, so check the official timeline and your application account rather than relying on any single date reported elsewhere.
Possibly. 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 existing score. Check the official MSRA pages on medical.hee.nhs.uk for the rules that apply to your round before you decide.
You do not register for the MSRA on its own. You apply for specialty training, and if you are eligible you will be invited to take the MSRA. For General Practice, the date listed in the current recruitment timeline is 19 November 2026 at 4pm. Confirm the deadline for your specialty on the official site.
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