MSRA Preparation
When people tell you that you can’t prepare for the MSRA, don’t believe them - you absolutely can and should prepare. It’s such an important exam, and the deciding factor in if you get invited to interview. Remember, the MSRA is worth the same as your entire portfolio, so it should be given an equal amount of time and respect. Start early and gradually build your revision up as the exam approaches. Good luck If you haven’t already, have a read through our overview of the exam to put everything in this article into context.
Official MSRA Guidance
To start with, there are a few documents published by the GP recruitment office (they run the exam as it was originally only used for GPs). These are well worth a read, and you should look through them before starting your revision. The guidance covers what you can expect in the exam, including the format of the questions, how it’s scored and also how the questions are written and reviewed.
Online Question Banks
The recruitment board do not officially support any revision materials, but that doesn't stop there being some great resources out there. Question banks will make up the bulk of your revision. The Clinical Problem Solving (CPS) paper is much like medical school final written exams and therefore relies on you remembering and regurgitating a large number of facts. The most efficient way of doing this is through practice questions and ensuring you learn from the questions you get wrong. There are several question banks available (I am not affiliated with any of these!)
Subscribing to 2 question banks and completing all the questions in each at least once should be sufficient to get the full breadth of question styles and content. Each of the question banks above are primarily for use in preparation for the Clinical Problem Solving (CPS) paper; most make some attempt to address the Professional Dilemmas (PD) paper, but this often seems like an afterthought. Check out some of the resources from the UKFPO and GMC below to prepare for the PD paper separately.
Flashcards
Question banks are great, but relying on only reading information from questions you get wrong is inefficient and ineffective. Flashcards are a great way of personalising the question banks to certain aspects that you find difficult. Also, they rely on ‘active recall’, meaning you actually have to generate the answer yourself rather than choosing from a list of options; this process can really help to enhance knowledge retention and regurgitation, especially in a time-pressured exam. Paper flashcards are time-consuming to write and are ‘dumb’. Using software like Anki or Quizlet not only means you can quickly write rich flashcards with images, but you can also take advantage of ‘spaced repetition'. This is where you rank your flashcards according to how difficult you find them, and the software will apply an algorithm that shows you the most difficult ones more frequently. Make it a habit of writing a flashcard every time you get a question wrong on a question bank, and then review these flashcards daily. Over a few weeks, you will have ‘actively recalled’ thousands of facts, and your question bank performance will improve accordingly.
UKFPO Past Papers
Although designed for use in the SJT sat at the end of medical school, the UK Foundation Programme (UKFPO) past papers are great for practicing for the PD section in the MSRA. There are 2 past papers available, and by doing each and studying the answers (which also come with explanations of WHY they’ve put things in a certain order), you can get an understanding of what the examiners do and don’t like you to do. For example, whilst they do like you to stay late to cover for a colleague who’s going to be 30 minutes late because of traffic, they don’t like you to take be constantly taking on a colleague’s workload without escalating it. Helpfully, they also have the 2 different question types included: ranking and multiple choice.
GMC Guidance
The GMC have guidance on almost all ethical issues that will arise in the PD section of the paper. Apart from the standard ‘Good Medical Practice’ which you should be familiar with, they have guidance on confidentiality, consent, working with children, prescribing, raising concerns etc. There are 32 documents in total to work through, which seems like a lot, but most have summaries of the key points at the start and overlap. You’ll notice as you read through them that many of the scenarios you encounter in practice questions will be based on and reference these guidelines directly. So read them. You could even make flashcards on them if you so desire…
Pearson Vue Demo Programme
You should try and do anything you can to make the test feel more familiar. On the Pearson Vue website, there is a demo/tutorial for you to work through. This guides you through the different functions available on the testing software you’ll be using when you sit the exam. There are some useful features to get familiar with, such as flagging questions for reviw and navigating through the review screens. There might even be some keyboard shortcuts for navigating through the programme which will speed you up!
Exam Technique
There are some techniques to fall back on when answering questions difficult in the MSRA, especially in the PD paper.
- You’ll usually find in the list of actions that there is clearly one that is the most appropriate, and one that is clearly the least appropriate. Rank these as options 1 and 5 straight away. Even if there isn’t a clear best and worst, your first action should still be to decide which options should go at 1 and 5. You then only have to work out the middle 3 responses; even if you then get these wrong, they’ll be ‘closer’ to the correct order and you’ll guarantee more marks due to the ‘near-miss’ nature of the marking in this section. There will undoubtedly be some really difficult and testing questions in this section, and focusing your mind on ordering 3 actions is much less overwhelming than 5.
- A common pitfall for candidates is thinking about the ranking questions as chronological; i.e. if the correct order of responses was ABCDE, candidates interpret this as doing action A, then action B, then action C etc. This is wrong. Each action is mutually exclusive from the others and is done in isolation. If you think option A is the best response, put this first - you should then mentally remove option A from the list of responses and choose your next action based on its merit. On the contrary, the ‘choose the 3 best responses’ questions require a different perspective: these 3 actions should be taken ‘together’ to address the situation, and in isolation, they might not seem very appropriate. You can therefore think of your responses to these scenarios as action 1 AND action 2 AND action 3.
- The CPS paper is time-pressured. You have just 75 minutes to answer 97 questions, which is about 46 seconds per question. If you’re struggling with a particular question, flag it for review and come back to it later. Don’t dwell on it, you don’t have time. You might find when you return to it after a few minutes, your mind is clearer after smashing a few easy questions and calming your nerves. Also bear in mind that there are 11 pilot questions in this section; if you find a question is poorly written or doesn’t make sense, tell yourself it must be one of the pilot questions which won’t count, answer it, and move on.
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