MSRA Practice Test

The MSRA is the computer-based assessment taken by applicants to medical specialty training, delivered by Pearson Professional Examinations. This page sets out the format, timing, booking and scoring rules as published by NHS England, and gives you free practice sets on clinical problem solving, professional standards, scoring and preparation to use before your appointment.

MSRA Exam at a Glance

What changed for MSRA in 2026

• Oct 24, 2026: Delivery changed to Computer-based, delivered by Pearson Professional Examinations (previously Computer-based at Pearson VUE test centres; OnVUE remote only as an approved adjustment).^[6]
• Oct 24, 2026: Eligibility changed to Book after receiving an invitation; UK-based applicants test at a UK centre (previously By invitation after applying to a specialty that uses the MSRA).^[7]
• Oct 24, 2026: Testing window (January 2027 sitting (all specialties)) changed to January 2027 (invitations 5–20 January 2027) (previously 5–20 January 2027).^[9]

What the MSRA is and how it works

According to NHS England Medical Training Recruitment, “There are 86 items in the CPS paper.”^[1]

The Multi-Specialty Recruitment Assessment is a computer-based test used in recruitment to medical specialty training. It is run by NHS England Medical Training Recruitment and delivered by Pearson Professional Examinations. It has a Clinical Problem Solving paper of 86 items and a Professional Dilemmas paper of 50 scenarios. The whole assessment lasts 170 minutes, made up of 95 minutes for Professional Dilemmas and 75 minutes for Clinical Problem Solving.

You book after you receive an invitation, choosing a centre, date and time. UK-based applicants test at a UK centre. Sittings are set by the recruitment calendar: a January 2027 sitting is open to all specialties, with invitations sent 5–20 January 2027, and a February 2027 sitting is reserved for Core Psychiatry and General Practice applicants only. Exact February dates have not yet been published.

Appointments must be rescheduled or cancelled at least 24 hours ahead. A missed test needs re-authorisation from the MSRA team. Scores appear in your Oriel account shortly after the testing window closes.

Pass marks depend on the programme. For General Practice, Core Psychiatry and BBT in Scotland, the published mark is 186 on both papers. Other specialties may use scores differently, so check your own specialty's page. The registration deadline on the ophthalmology timeline is 19 November 2026, 4pm UK time; confirm the date for your specialty on the official site.

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: When reviewing an incorrect practice answer for the MSRA, what is the MOST productive follow-up action?

1. Move on quickly to maximise question volume
2. Read only the answer explanation provided
3. Identify the knowledge gap, read the relevant guideline or topic, then revisit similar questions
4. Discuss the question on social media forums

Answer: C. Identify the knowledge gap, read the relevant guideline or topic, then revisit similar questions

Explanation:

The correct option is to identify the knowledge gap, read the relevant guideline or topic, then revisit similar questions. This turns a single mistake into a repaired weakness and checks that the repair worked. Moving on quickly to maximise volume leaves the gap in place, so the same error returns. Reading only the provided explanation is passive and often gives you a fact you will not recall under time pressure. Discussing the question on social media forums can spread wrong or outdated advice and does not tie your learning to a trusted source. Rule to remember: every wrong answer should lead to a named gap, a check against a reliable source, and a retest.

Example 2

Question: How is the Multi-Specialty Recruitment Assessment Test typically divided?

1. Single comprehensive section
2. Multiple sections including written and practical components
3. Only practical scenarios
4. Only written assessments

Answer: B. Multiple sections including written and practical components

Explanation:

Of the options given, multiple sections including written and practical components fits best, because the MSRA is not a single block of the same item type. The published structure has a Clinical Problem Solving paper and a Professional Dilemmas paper, and they test different skills. Be aware that the wording is loose: both papers are taken on a computer, and there is no hands-on practical station. A single comprehensive section is wrong because the papers are separate. Only practical scenarios and only written assessments are wrong because each describes just part of the format. Rule to remember: prepare separately for clinical knowledge questions and for judgement-based scenarios, and read the official structure page for exact detail.

Example 3

Question: A 45-year-old woman presents with sudden onset severe headache she describes as 'the worst headache of her life.' A CT head is normal. What is the most appropriate next investigation?

1. MRI brain with gadolinium
2. Lumbar puncture for xanthochromia
3. CT angiography of the brain
4. Blood cultures and CRP

Answer: B. Lumbar puncture for xanthochromia

Explanation:

Lumbar puncture for xanthochromia is correct. A sudden severe headache described as the worst of her life raises suspicion of subarachnoid haemorrhage. A normal CT head does not rule it out, so the next step is to look for xanthochromia in the cerebrospinal fluid. MRI with gadolinium is not the standard way to exclude it and does not answer the question being asked. CT angiography looks for an aneurysm, which is a later step once bleeding is confirmed or while suspicion remains high. Blood cultures and CRP point to infection and do not address this presentation. Rule to remember: a normal CT does not close the question when the story is classic.

How to use these practice tests

Start with the official MSRA pages on the structure of the assessment, the Clinical Problem Solving paper and the Professional Dilemmas paper, so you know what each paper asks of you. Then try the Evaluation Structure and Format set to check that you understand the layout and timing.

Spend most of your practice time on the Clinical Problem Solving set, and on the Professional Standards and Ethics and Communication and Documentation sets for judgement-style scenarios. Our questions are written by us and are not real exam questions, so use them to find weak areas, not to predict your score.

After each session, write down every miss, name the gap, read the matching guideline, and retest the topic a few days later. Practise under timed conditions as your sitting approaches, keeping the overall time limit in mind. Use the Preparation Resources and Strategies and Scoring and Results sets to review how results are reported. In the last days, check your booking, your centre and your identification requirements on the official booking page.

Sources & last verified

1. NHS England Medical Training Recruitment — number of questions (official source). “There are 86 items in the CPS paper.” Verified Oct 24, 2026.
2. NHS England Medical Training Recruitment — number of questions (official source). “There are 50 scenarios in the PD paper.” Verified Oct 24, 2026.
3. NHS England Medical Training Recruitment — time limit (official source). “The MSRA is 170 minutes in length” Verified Oct 24, 2026.
4. scotmt.scot.nhs.uk — passing score (official source). “The pass mark for both papers of the MSRA is 186.” Verified Oct 24, 2026.
5. NHS England Medical Training Recruitment — retake policy (official source). “You must reschedule assessment appointments at least 24 hours before the appointment.” Verified Oct 24, 2026.
6. NHS England Medical Training Recruitment — delivery, testing window (official source). “The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based assessment.” Verified Oct 24, 2026.
7. NHS England Medical Training Recruitment — eligibility (official source). “you can book an assessment at a centre, date and time of your choosing.” Verified Oct 24, 2026.
8. NHS England Medical Training Recruitment — score release (official source). “in your Oriel account against your application.” Verified Oct 24, 2026.
9. NHS England Medical Training Recruitment — registration deadline, testing window (official source). “Date: Thursday 19 November 2026” Verified Oct 24, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.