MSRA

Overview

The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based test used in the UK's national recruitment process for doctors applying to certain core and specialty training programmes. It is run by Health Education England's recruitment office together with Pearson VUE and is delivered at Pearson VUE test centres. The MSRA has two papers: Professional Dilemmas, which looks at professional judgement and behaviour, and Clinical Problem Solving, which looks at applied clinical knowledge. It does not decide a training place on its own — the MSRA score feeds into each specialty's own selection process alongside a self-assessment/portfolio score, an interview, or both, depending on the specialty.

Who can apply

A doctor must first apply, through Oriel, to one of the specific training programmes that uses the MSRA for that recruitment round. For the 2026 round this includes programmes such as Acute Care Common Stem (Emergency Medicine), Anaesthetics CT1, Core Surgical Training CT1, Core Psychiatry CT1, Clinical Radiology ST1, General Practice ST1, Obstetrics and Gynaecology ST1, Ophthalmology ST1, Neurosurgery, Nuclear Medicine ST3 and Community Sexual and Reproductive Health ST1. The exact list of participating specialties, and the minimum eligibility for each (such as full GMC registration, completed Foundation competence, and limits on prior experience in that specialty), is set and published separately every year, so applicants should always check the current list on Oriel and the relevant specialty page before applying. Only applicants who meet a programme's eligibility criteria are invited to book an MSRA sitting.

Exam pattern

MSRA runs for 170 minutes in total, split into two papers taken back to back with a short optional break in between.

Professional Dilemmas

The paper describes situations a trainee doctor might face with patients, colleagues or the wider team, and is designed around professional attributes such as integrity, coping under pressure, and empathy and sensitivity, rather than clinical knowledge.

Clinical Problem Solving

The paper is set at the level of a doctor who has completed the Foundation Programme, and covers diagnosis, investigation, prescribing, emergency management and ongoing care decisions.

MSRA is delivered on-screen at Pearson VUE test centres, with sittings offered on several consecutive days at each recruitment cycle; candidates choose a centre, date and time when booking. Remote delivery at home, through Pearson's OnVUE proctoring, is offered only as a reasonable adjustment for candidates with extenuating circumstances, approved case by case by the recruitment office.

Marking and results

Each paper is scored and the two scores are combined into a single MSRA result. How that MSRA result is then used varies by specialty: some programmes rank applicants on the MSRA score alone, while others combine it with a self-assessment or portfolio score, an interview score, or both, using weightings that each specialty sets and publishes for that recruitment round. Applicants should read the scoring guidance published for their specific specialty and year on Oriel or the relevant Health Education England specialty page, rather than assume one specialty's method applies to another.

Important dates

For the 2026 recruitment round, Health Education England scheduled two MSRA sittings: one in January 2026, open to applicants across all participating specialties, and a second in February 2026, reserved for applicants to Core Psychiatry and/or General Practice only. Exact sitting dates, the Oriel application window for each specialty, and booking deadlines are published separately each year on Oriel and the relevant Health Education England specialty pages.

Fees

Sitting the MSRA itself is free of charge to the candidate. Candidates are responsible for their own travel and, where needed, accommodation to reach their chosen Pearson VUE test centre.

How to apply

A candidate applies for a specific training programme through Oriel during that programme's national recruitment window. Applicants who meet the eligibility criteria for that programme are then invited to book an MSRA sitting through their Pearson VUE account, choosing an available test centre, date and time. A candidate who needs a reasonable adjustment, including remote OnVUE delivery, requests this through the recruitment office before booking.

Preparation tips

For Professional Dilemmas, work through the General Medical Council's "Good Medical Practice" guidance and practise ranking and multiple-response questions under timed conditions, since the paper rewards consistent judgement rather than a single "correct" answer. For Clinical Problem Solving, revise core clinical presentations, investigations and management at Foundation Programme level and practise single-best-answer and extended-matching questions at speed, since both papers are tightly timed. Health Education England publishes an official MSRA practice paper, which is a useful way to check the question styles before sitting the real assessment.