MSRA Exam 2027: Format, Dates, Scores & Prep

Resitting and Transferring Your Score

Whether you can carry a score forward depends on the specialty, and for 2027 most of them say no. Anaesthetics, Clinical Radiology and ACCS Emergency Medicine state that scores from 2026 rounds are not transferable and every eligible applicant sits again in January. GP and Core Psychiatry allow a previous score to be transferred between rounds within a 12-month cycle, provided the selection process is unchanged in the later round, but you must choose at the point of application whether to transfer or resit, you cannot change your mind afterwards, and a resit replaces the earlier score even if it is lower. Core Psychiatry adds that no score can be transferred into Round 1: for an August start you sit in the Round 1 window.

How to Prepare for the MSRA

NHS England says none of its question writers take part in or endorse any course or book, and that sharing details of live questions is treated as unprofessional behaviour. The official preparation materials are free, and you should start with them:

The practice paper, with a PD section, a CPS section, answer keys and rationales. Sit it to time.
The glossary and abbreviations lists published alongside it, which are the same ones you can open during the exam.
The Pearson demo, so the screen layout, flagging and navigation hold no surprises on the day.
The PD competences list on the NHS England page, so you know what "most appropriate" is measuring.

From there, the two papers need different preparation.

Preparing for the PD paper

Situational judgement rewards calibration, not cramming. Practise ranking under time, then read the rationale for every scenario you got wrong and ask which competence the key is rewarding. Most lost marks come from choosing the heroic option (sorting it out yourself) over the professional one (escalating, communicating, keeping the patient safe), or from treating the ranking options as a sequence when they are independent actions.

Preparing for the CPS paper

Eighty-six items in 75 minutes means roughly 50 seconds each. Question banks earn their keep here because the paper is about pattern recognition across all twelve topic areas at F2 level, not depth in any one. Work through a bank by topic, keep a list of the diagnoses and first-line drugs you keep missing, and finish with full timed papers so your pace is set before January.

Question banks and courses listed on MedCourse

These are the MSRA resources our providers list; MedCourse earns a commission on some of them, and we have not sat them ourselves. Compare them against the free official paper first.

Question banks: Pastest MSRA, Quesmed MSRA, Medibuddy MSRA and Emedica MSRA.
Courses: The London MSRA Course, Emedica's crammer bundle and high-yield booster.

See all MSRA courses and question banks

How long to give it depends on what the score does for you. If the MSRA is your whole selection (GP, Core Psychiatry), treat it like a membership exam and plan eight to twelve weeks. If it is a gate you need to clear with a margin (radiology, ophthalmology), four to six weeks of timed practice is a reasonable floor. Those are our suggestions, not official guidance; nothing from NHS England specifies a preparation time.

Frequently Asked Questions

Is there a fee for the MSRA?

NHS England's pages give no fee for sitting the MSRA. You pay your own travel and any other costs, and the MSRA team states that expenses are not reimbursed.

How long is the MSRA?

170 minutes of testing: a 95-minute Professional Dilemmas paper and a 75-minute Clinical Problem Solving paper, with an optional five-minute break between them. Approved adjustments add 25% or 50% to each paper.

Is there a pass mark?

Not a single one. Scores are standardised around the cohort, so there is no maximum and no fixed pass mark. Some specialties set floors: 201 on each paper for Clinical Radiology ST1 and 186 for Core Psychiatry, and GP treats a band 1 in either paper as unsuccessful.

Do I need the MSRA for IMT?

No. Internal Medicine Training shortlists on a self-assessment score. See our IMT recruitment guide.

Can I sit the MSRA from home?

Only as an approved reasonable adjustment for extenuating circumstances, through Pearson's OnVUE system. Everyone else sits at a test centre.

Can I use last year's score?

For anaesthetics, radiology and ACCS Emergency Medicine, no: 2026 scores are not transferable. GP and Core Psychiatry allow a transfer between rounds within 12 months, chosen at the point of application, but not into Round 1 for Core Psychiatry.

What happens if I miss my appointment?

Contact the MSRA team through the support desk immediately. You cannot rebook online yourself, slots will be scarce, and a missed appointment on the final day of the window cannot be accommodated.

Can I appeal my MSRA result?

No. The outcome is final and there is no review, re-mark or appeals process. A complaint is possible only about a failure in the process itself, through the national complaints procedure.

Dates from NHS England's GP recruitment timeline (reviewed 28 August 2025) and the Clinical Radiology and Anaesthetics 2027 pages, checked 14 October 2026. Results dates differ by specialty and some are still "to be confirmed": the CST and anaesthetics pages do not yet give one. Check your specialty's timeline before you rely on a date.

What Is the MSRA?

The MSRA is a computer-based assessment sat at a Pearson Professional Examinations (Pearson VUE) test centre. It is written by Work Psychology Group with clinicians from every specialty that uses it, and it is designed to test the competences in the person specification through clinical scenarios, not to test knowledge for its own sake. All of the scenarios are set at Foundation (F2) level, whatever specialty you are applying to.

It runs for 170 minutes and has two independently timed papers, with an optional five-minute break between them:

Paper	Time	Questions	What it tests
Professional Dilemmas (PD)	95 minutes	50 scenarios	Situational judgement: professional integrity, coping with pressure, empathy and sensitivity
Clinical Problem Solving (CPS)	75 minutes	86 items	Applying clinical knowledge: investigation, diagnosis, emergency, prescribing, management

With an approved adjustment under the Equality Act you can be given 25% extra time (PD 122 minutes, CPS 93 minutes) or 50% (146 and 109 minutes). You request this on the application form, with evidence, and requests after the application deadline are not considered.

The break rule

The five-minute break between papers is optional, but it is timed, and NHS England's own pages disagree about what happens if you overrun it. The structure page says the excess is taken off your CPS paper; the test-day page says the test is revoked. For OnVUE both say the test is revoked, with no re-sit. Do not find out which applies to you: take a comfort break before you start, not in the gap.

Which Specialties Use the MSRA in 2027?

NHS England lists these specialties and programmes as recruiting with the MSRA for August 2027:

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

Northern Ireland also uses it for Core Surgical Training, Clinical Radiology, Core Psychiatry and Emergency Medicine ST1, and Scotland for Broad Based Training, Core Psychiatry (Scotland) and Trauma and Orthopaedics ST1.

Internal Medicine Training does not use the MSRA. IMT shortlists on your self-assessment score, and the 2027 priority rules described below apply to its interview invitations and offers too. You can work out your self-assessment score with the calculator in our IMT application scoring guide. If you apply to both IMT and a specialty on the list above, you sit the MSRA for the other application only. You sit it once per round, and one score is used for every specialty you applied to.

How Much Does the MSRA Count for Your Specialty?

This is the question the official hub does not answer in one place, and it changes how you should prepare. In some specialties the MSRA is everything. In others it is a gate you must clear and then it disappears from your rank. Here is the 2027 position, specialty by specialty, from each recruitment office's own pages.

Specialty	What the MSRA does in 2027
General Practice ST1	The whole selection. There is no interview; you are ranked across the UK on your MSRA score alone (the "Single Transferable Score") and offers are made in rank order, with the 2027 priority group considered first (see the note below the table). A band 1 in either paper means you are unsuccessful.
Core Psychiatry CT1	The whole selection. You need at least 186 in each paper (the figure NHS England publishes) to be appointable, then you are ranked on your MSRA score, with offers following the 2027 priority rules below. Ties are broken on the PD paper first, then CPS.
ACCS Emergency Medicine ST1	Shortlisting if applicants exceed the interview capacity of about 882, then 40% of your final score, with the interview worth 60%.
Obstetrics and Gynaecology ST1	33.3% of your final score. The lowest scorers are shortlisted out. Score very highly on both papers and you bypass the interview and go straight to an offer on your MSRA alone.
Anaesthetics CT1	Shortlisting for interview where applicants exceed capacity, then 15% of your total selection score, 7.5% from each paper. New for 2027: you must also reach a minimum MSRA score to be invited to interview at all. The cut-off had not been published when we checked on 16 October 2026.
Core Surgical Training CT1	Shortlisting (roughly the top 1,200 are invited to interview), then 10% of your final score. The portfolio station and the management and clinical station are 45% each.
Clinical Radiology ST1	A gate and a shortlisting tool only. You must score at least 201 on each paper; above that, the MSRA is used to cut applicants to interview capacity. Your final rank is 30% portfolio and 70% interview, with no MSRA in it.
Ophthalmology ST1	Shortlisting only. If your evidence-folder self-score is 19 or more, you are ranked on your MSRA score and the top 350 have their folders verified. The MSRA does not count towards the final offer score, which is folder 50 plus interview 50.
Nuclear Medicine ST3	Shortlisting only. Your MSRA score is the shortlisting score and you must reach 201 on each paper; no previous sittings are accepted. The final rank is 40% portfolio and 60% interview, with no MSRA in it.
Neurosurgery, CSRH	Used in selection; these are recruited by regional offices and the weighting is on their own recruitment pages, linked from the Medical Hub.

Each row is taken from that specialty's 2027 recruitment page on NHS England's Medical Hub, checked 14 October 2026. Recruitment offices change weightings between rounds, so confirm yours before interview season.

Two things follow from the table. If you are applying to GP or Core Psychiatry, the MSRA deserves the preparation other people give an interview, because it is the interview. If you are applying to radiology, ophthalmology or nuclear medicine, the MSRA is a competitive shortlisting test rather than part of your final score: the published floors (201 a paper, or Ophthalmology's top 350 by MSRA) are the minimum, and only the highest scorers above them are interviewed, so a high score still matters even though it disappears from your rank once you are through.

New for 2027: the priority group comes first at offers

The Medical Training (Prioritisation) Act 2026 applies to every specialty in this table. Your MSRA and interview performance still set your rank. But when interview invitations and training offers are made, applicants in the priority group are considered in rank order before anyone outside it, and non-priority applicants are offered posts only if places remain. You are in the priority group if you hold a UK or Irish primary medical qualification (or one from Iceland, Liechtenstein, Norway or Switzerland), or you are a British or Irish citizen, have indefinite leave to remain or EU Settlement Scheme leave, or you have completed or are on the UK Foundation Programme. Your status is shown in Oriel the day after applications close, and you have until Tuesday 24th November 2026 at 5pm to ask for it to be reviewed. Full rules are on NHS England's prioritisation page.

The Professional Dilemmas Paper

The PD paper is a situational judgement test. It is not a test of knowledge. Every scenario puts you in the shoes of an F2 doctor and asks how you should behave. The settings range across hospital wards, general practice and out-of-hours work, and NHS England checks each scenario so it does not rely on local or very UK-specific procedure, which matters if you trained abroad.

Fifty scenarios in 95 minutes, in two formats:

Ranking. Four or five independent actions, which you rank from most to least appropriate. The actions are not steps in sequence; judge each on its own.
Best three. Eight plausible actions, from which you choose the three that together resolve the situation.

The three competences being scored are professional integrity, coping with pressure, and empathy and sensitivity. NHS England publishes the behaviours behind each of these; it is worth reading that list once, because the "best" option is always the one that shows them.

How the PD paper is marked

Your ranking is compared with an answer key agreed by a panel, and you score more the closer you are to it. You do not have to match the key exactly to score well on a scenario. There is no negative marking in either paper, so never leave a question blank: a wrong guess scores nothing, but a near-miss on a ranking can still score points.

The Clinical Problem Solving Paper

The CPS paper measures how you apply clinical knowledge to decisions a Foundation doctor makes every day. Eighty-six items in 75 minutes, which is under a minute each, so pace matters more than depth.

Every paper balances twelve topic areas: cardiovascular; dermatology, ENT and eyes; endocrinology and metabolic; gastroenterology and nutrition; infectious disease, haematology, immunology, allergies and genetics; musculoskeletal; paediatrics; pharmacology and therapeutics; psychiatry and neurology; renal and urology; reproductive; and respiratory. Across those topics the questions test five things: choosing investigations, making the diagnosis, recognising an emergency, prescribing, and non-drug management.

Extended matching questions give you a list of seven to ten options and several short cases; each option can be used once, more than once or not at all.
Single best answer questions give one case and five to eight options.

One mark per correct item, no negative marking. A glossary of terms and a list of abbreviations is available on screen throughout the paper.

MSRA Scoring: What Is a Good Score?

Your raw marks in each paper are converted to a standardised score, so there is no maximum and no pass mark as such. NHS England normalises scores around the cohort, and the GP recruitment office describes the scale: each paper is scored around a mean of 250 with a standard deviation of 40, and each score is banded 1 to 4. Band 1 means the minimum standard has not been met.

The most useful numbers NHS England has published are the 2026 Round 1 score distributions for GP applicants. They show you what a given score meant against everyone else who sat it.

Standardised score	CPS paper: share of applicants	PD paper: share of applicants	Band
Below 186	4%	7%	1 – very poor
186–230	16%	36%	2 – below average
231–290	56%	53%	3 – good
291 and above	24%	4%	4 – very good

NHS England, GP ST1 2026 Round 1 scoring tables (page reviewed 25 September 2023, data for the 2026 round). Percentages are approximate and are for GP applicants; other specialties receive the same standardised scores but their cohorts differ.

Read against that, a score around 250 is average, 270 or more on the PD paper already puts you in roughly the top sixth of applicants, and 291 or more on the CPS paper puts you in the top quarter. The published cut-offs that exist are low by comparison: Radiology's 201 on each paper and Core Psychiatry's 186 are floors, not targets. Where the MSRA is the whole selection, as in GP and Core Psychiatry, your rank is what matters and every point moves it.

Results go into your Oriel account on the date your specialty publishes; anaesthetics applicants, for example, see the raw score under the "Shortlist" tab of the applicant dashboard and the paper breakdown under "Station Scores". The outcome is final. There is no review, re-mark or appeal.

Booking the MSRA

You do not book the MSRA when you apply. After applications close you receive an Oriel message asking you to register for a Pearson Professional Examinations account using your Oriel credentials. If you applied to several MSRA specialties you may get the same message more than once; register once. Accounts created before the 2021 round are no longer valid.

Three things that catch people out

Registering is not an invitation. After you register, your account will say you have no pre-approved assessments. The invitation to book comes later, once eligibility has been checked. If you are invited and do not book in time, your application does not progress.
Centres fill up. Capacity at each centre is finite. If your nearest centre has no slots you are expected to travel to the nearest one that does. Book as soon as the invitation arrives.
Your name must match your ID. Any difference between your Oriel name and your government-issued photo ID must be corrected in your Oriel profile before the day.

If you are outside the UK during the window you can sit at a Pearson centre abroad, subject to seats. If you are in the UK, including the Channel Islands and the Isle of Man, you are expected to use a UK centre. Remote sitting through OnVUE is offered only as a reasonable adjustment for extenuating circumstances, approved case by case, and the rules are strict: a clean desk, a room scan, no unscheduled break, and your own equipment and connection at your own risk.

You can reschedule or cancel through your Pearson account up to 24 hours before your slot. If you miss your appointment, contact the MSRA team through their support desk straight away; you cannot rebook yourself, and a missed appointment on the last day of the window cannot be accommodated. There is no fee listed for sitting the MSRA, but your travel and other expenses are yours: the MSRA team does not reimburse them.

The MSRA Exam Explained (2027)

Key Documents

MSRA Dates 2027