MSRA · specialty recruitment guide
The MSRA: how it works and how much it counts in each specialty
The Multi-Specialty Recruitment Assessment is one computer-based exam that several specialties use in different ways. For GP and Core Psychiatry it is the whole selection. For Radiology and Ophthalmology it only decides who gets through to the next stage. This guide shows which is which.
- Official recruitment pages, quoted
- Free points calculators for each specialty
The MSRA at a glance
- Two papers in one sitting: Professional Dilemmas (95 minutes) and Clinical Problem Solving (75 minutes). 170 minutes in total, with an optional 5-minute break.
- You apply to your specialties first, then you are invited to sit it. One sitting covers every MSRA specialty you apply to.
- You sit it at a Pearson test centre. Remote testing is a reasonable adjustment only.
- Scores are normalised, so there is no maximum, and there are no re-marks or appeals.
Source: NHS England Medical Hub MSRA pages, read 31 October 2026.
How much the MSRA counts in each specialty
The same MSRA score can decide your offer in one specialty and be only a shortlisting filter in another. These are the 2027 Round 1 rules, from each specialty’s own recruitment pages.
| Specialty | How the MSRA is used | Share of final score | Minimum or cut-off |
|---|---|---|---|
| GP ST1 | Decides offers. There is no interview or selection centre. | 100% | A band of 1 in either paper ends the application. |
| Core Psychiatry CT1 | Decides offers. There is no interview. | 100% | At least 186 in each paper to be appointable. |
| Obstetrics & Gynaecology ST1 | Ranking alongside an online interview. The top-ranked applicants skip the interview. | 33% | MSRA gives 50 of the 150 marks. The top 75 on total MSRA score bypass the interview. |
| ACCS Emergency Medicine ST1 | Shortlisting if applicants exceed interview places, then ranking. | 40% | None published. The interview makes up the other 60%. |
| Anaesthetics CT1 (and ACCS Anaesthetics) | Shortlisting if applicants exceed places, then ranking. | 15% | None published. |
| Core Surgical Training CT1 | Shortlisting, then ranking with two interview stations. | 10% | None published. The portfolio station is worth 45% and the management and clinical station 45%. |
| Neurosurgery ST1 | Shortlisting, combined with your validated self-assessment. | 40% of the shortlisting score | None published. |
| Clinical Radiology ST1 | Shortlisting and a minimum score. Not part of the final score. | 0% | 201 in each paper. |
| Nuclear Medicine ST3 | Shortlisting and a minimum score. Not part of the final score. | 0% | 201 in each paper. |
| Ophthalmology ST1 | Shortlisting only. Not part of the final score. | 0% | The top 350 by MSRA have their evidence folders scored, and you also need a self-score of 19 or more. |
Sources: NHS England Medical Hub recruitment pages for each specialty, read 31 October 2026. The Neurosurgery figure is from the 2027 applicant handbook. Community Sexual and Reproductive Health ST1 is also on the official MSRA list; check its recruitment guidance for how it is used. Scotland runs some posts with its own weightings, so check the NHS Scotland guide for your specialty.
The pattern is clear. In GP and Core Psychiatry, the MSRA is everything. In Radiology, Nuclear Medicine and Ophthalmology, it gets you through the door, and then your portfolio and interview decide where you rank.
Specialties that don’t use the MSRA
Many big entry points don’t use the MSRA at all. They shortlist on a self-assessment or portfolio score instead, so what you have done (teaching, presentations, audit, qualifications) counts directly.
- IMT CT1 shortlists on its self-assessment. Score yours with the IMT application scoring calculator.
- Paediatrics ST1 uses the RCPCH shortlisting framework. See Paediatrics shortlisting points.
- Histopathology ST1 uses a self-assessment. See Histopathology ST1 self-assessment.
- Public Health ST1 runs its own assessment process. See Public Health ST1 application scoring.
- Higher entry points such as Anaesthetics ST4, Higher Psychiatry ST4 and O&G ST3 use self-assessment. Only the CT1 and ST1 entries in those specialties use the MSRA.
What’s in the two papers
Professional Dilemmas (95 minutes) has 50 scenarios, set from the point of view of an F2 doctor. About half ask you to rank options in order, and about half ask you to choose three responses from at least eight. It tests three competencies: professional integrity, coping with pressure, and empathy and sensitivity. There is no negative marking.
Clinical Problem Solving (75 minutes) has 86 items at Foundation level, split roughly evenly between extended matching questions and single best answer questions, across 12 clinical topic areas.
The two papers run back to back in one 170-minute sitting, with an optional 5-minute break between them.
How MSRA scores work
- Scores are normalised. Your raw marks are converted to a scale, so there is no maximum. For GP, each paper is normalised to an average of 250 with a standard deviation of 40, then put into bands 1 to 4.
- Each specialty scales and weights them its own way. That is why the same performance can be a pass in one specialty and fall short of another’s cut-off.
- No re-marks or appeals. The score you are given is final.
- Reusing a score is the exception. GP lets successful applicants transfer a score within a 12-month recruitment cycle. Core Psychiatry allows transfers between rounds, but not into Round 1. ACCS Emergency Medicine and Anaesthetics CT1 say they will not accept scores from previous sittings.
When you sit it
You apply first, in the Round 1 window in the autumn. Invitations to book the MSRA follow in December, and most applicants sit it in January. A second sitting in February is reserved for GP and Core Psychiatry applicants. Results arrive in February and March, interviews run alongside, and first offers come out in early April.
In 2027 you can make at most five applications in a recruitment round, so most applicants combine an MSRA specialty with one or two others. Exact dates change every year: check the NHS England MSRA page before you book.
Where your portfolio still counts
The MSRA rewards exam technique. Your portfolio rewards what you have done. If any of your applications uses a self-assessment or portfolio score, a few targeted additions can move your total before you apply.
- Score yourself first. Our free calculators show where your points are: IMT, Core Surgical Training, Radiology ST1, Ophthalmology ST1, Neurosurgery ST1, or find your specialty.
- Present your work nationally. A national presentation is one of the highest-scoring items in several portfolios. NMERC is an online national conference for doctors and medical students, and submitting an abstract is free. See how to get a national presentation.
- Check what teaching scores. Several self-assessments award points for teaching training. See which specialties score it.
Common questions
Can I use one MSRA sitting for several specialties?
Yes. You sit the MSRA once, and the score is used by every MSRA specialty you have applied to in that round. Each specialty then weights and scales it in its own way.
Is there a pass mark for the MSRA?
Not a single one. Some specialties set their own minimum: 186 in each paper for Core Psychiatry, and 201 in each paper for Clinical Radiology ST1 and Nuclear Medicine ST3. GP rejects a band of 1 in either paper. Others use the score only to rank or shortlist.
Does IMT use the MSRA?
No. IMT CT1 shortlists on its self-assessment score, then interviews. Work out your score with the IMT application scoring calculator.
Can I sit the MSRA at home?
Only as a reasonable adjustment. Remote testing through Pearson OnVUE is approved case by case for extenuating circumstances. Otherwise you sit it at a Pearson test centre.
