Common questions
about the MSRA.

The Multi-Specialty Recruitment Assessment (MSRA) is a computer-based test used in the selection process for a number of NHS medical specialty training programmes. It assesses the essential competences set out in the national person specification through clinical scenarios.

The MSRA is 170 minutes in total and consists of two independently timed papers:

The MSRA has two components:

The CPS paper measures your ability to apply clinical knowledge and make clinical decisions in everyday practice. Importantly, it tests your ability to synthesise and apply medical knowledge — not just your ability to recall facts. All scenarios are based on Foundation (FY2) level clinical practice.

Each CPS test paper includes a balanced mix of scenarios across all 12 clinical topic areas:

The CPS paper covers 5 core domains:

There are 86 items in the CPS paper. Around half are Extended Matching Questions (EMQs) and the other half are Single Best Answers (SBAs).

No. One mark is awarded for each correct answer. There is no negative marking, so all questions should be attempted.

CPS items are written by a well-established team of trained clinician item writers who develop new content annually. New items go through a rigorous multi-stage review process:

You need a Pearson VUE account to book the MSRA. After applying through Oriel (oriel.nhs.uk), eligible applicants receive an invitation to book via their Pearson VUE account. Book as early as possible — popular test centre slots fill up quickly.

For Round 1 (2026 recruitment), two sittings are planned due to an anticipated rise in applicant numbers:

Yes. Rescheduling and cancellations are managed through your Pearson VUE account. Check the NHS England MSRA pages for the specific deadlines that apply to your sitting, as late cancellations or missed tests may affect your application.

You must bring: One original, valid, government-issued photo ID whose name matches your Pearson VUE account exactly. Expired IDs are accepted only with valid renewal documentation.

On arrival you sign in and present your photo ID. Personal belongings are stored securely. You are escorted to a computer desk equipped with over-ear headphones (which can help block background noise). You will be given a whiteboard and pen for working — no paper is provided.

Remote testing via Pearson VUE's OnVUE platform is available in limited circumstances. Eligibility criteria apply and must be arranged through your Pearson VUE account. For OnVUE tests, any unauthorised break automatically ends your assessment with no re-sit option.

Scores for each paper are normalised around a mean of 250 with a standard deviation of 40. Because of this normalisation, there is no fixed maximum score — your result is relative to the performance of your cohort.

There is no single universal pass mark. Scoring thresholds and band definitions vary by specialty. For Core Psychiatry, a minimum raw score of 186 in each paper is required to be considered appointable. For GP, band 1 in either paper means automatic non-progression. Always check your target specialty's recruitment page for the current threshold.

No. Your MSRA outcome is final and cannot be reviewed, re-marked, or disputed. There is no appeals process.

This depends on the specialty:

Yes. NHS England publishes an official MSRA practice paper with an answer key and rationales, available on the NHS Medical Hub publications page. This is the best starting point for understanding the question format and standard expected.

The PD paper is an aptitude test, not a knowledge test. Preparation should focus on the three core competency areas: Commitment to professionalism, Coping with pressure, and Effective teamwork.

The CPS paper tests applied clinical knowledge, not rote recall. Focus on understanding and synthesising clinical presentations across all 12 topic areas rather than memorising facts in isolation.

Yes. Additional time is available in line with the Equality Act 2010 disability accommodation requirements. Standard adjustments are:

For applicant and resident doctor queries: