MSRA exam guide: papers, formats and topics
Use this guide to understand what you are preparing for, then choose the notes and practice that match each part of the assessment.
Exam guidance checked against the linked NHS sources on 20 October 2026. Check the official guidance and your booking information for changes.
Two separately timed papers
The Multi-Specialty Recruitment Assessment has two components. Professional Dilemmas comes first, followed by Clinical Problem Solving. Standard testing time totals 170 minutes, with an optional five-minute break between papers.
| Paper | Questions | Standard time |
|---|---|---|
| Professional Dilemmas (PD) | 50 scenarios | 95 minutes |
| Clinical Problem Solving (CPS) | 86 items | 75 minutes |
Approved adjustments can change your time allowance. Follow your own booking instructions. See the official assessment structure.
Clinical Problem Solving: apply your knowledge
CPS uses Foundation-level scenarios to assess clinical decisions. Its five competency areas are investigation, diagnosis, emergency care, prescribing and non-prescribing management. Around half the items are single best answers (SBAs), and half are extended matching questions (EMQs).
- SBA: choose one answer to a scenario from five to eight options.
- EMQ: several scenarios share a list of seven to ten options; an option may be used once, repeatedly or not at all.
The official CPS blueprint organises the paper into 12 clinical topic areas. Our clinical topic directory lists those areas and links them to relevant existing PassFinals notes.
Professional Dilemmas: situational judgement
PD is a situational judgement test set in the role of an F2 doctor. Its three competency areas are professional integrity, coping with pressure, and empathy and sensitivity. You will encounter two response formats:
- Ranking: order four or five independent actions by appropriateness. This is not a sequence of steps to perform.
- Multiple response: select the three most appropriate actions from eight options, considering how they work together.
Read the official PD guidance and its examples to understand the instructions and scoring.
How PassFinals fits your preparation
PassFinals offers five-option clinical SBAs and separate ranking and choose-three SJT practice. It does not currently provide clinical EMQ practice or a complete MSRA mock simulation. Use the official practice paper and answer rationales to become familiar with the assessment's formats.
Our textbook uses the GMC MLA content map as its organising framework. The MLA coverage map shows that mapping and its gaps; it is not a checklist proving complete MSRA coverage. The MSRA has its own published blueprint.
High-yield notes are free to read. The full practice bank and saved question progress require a paid membership; a free account alone does not unlock them.