The MSRA for Core Surgical Training 2027

The MSRA For Core Surgery

Every applicant to Core Surgical Training sits the MSRA, which contributes 10% of the 2027 selection score and decides the top 1,200 who are invited to interview. It is a computer-based assessment delivered with Work Psychology Group and Pearson VUE, in two papers: Professional Dilemmas and Clinical Problem Solving. The 2027 window is not yet published; in 2026 it ran from 6 to 19 January.

The MSRA is delivered at Pearson VUE testing centres with remote testing provisions in place where necessary. The testing window is held in January each year. It is used to determine invitation to online interview where the number of eligible applicants exceeds interview capacity. There is no maximum achievable score. Your MSRA score contributes 10% towards your total selection score, with the PD and CPS elements weighted equally.

The MSRA Structure

There are two component parts: a Professional Dilemmas (PD) paper and a Clinical Problem Solving (CPS) paper. The MSRA is delivered as a single exam; the two papers are independently timed with an onscreen countdown. On completion of the PD paper there is a 5-minute scheduled break before the CPS paper commences; excess break time is automatically taken off the available CPS time.

Both parts of the MSRA are designed to assess those with a foundation level of competence. The PD paper provides workplace scenarios for applicants to demonstrate their judgement about appropriate behaviours, relating directly to the GMC’s Generic Professional Capabilities framework. The CPS paper tests how candidates apply clinical knowledge to make clinical decisions, based on the Foundation Programme curriculum.

The Professional Dilemmas (PD) Paper

The PD paper is a Situational Judgement Test (SJT) focusing on a candidate’s approach to working as a doctor, measuring understanding of situations that arise for doctors in the NHS and judgement in choosing more or less appropriate responses. It covers three core domains:

• Professional integrity
• Coping with pressure
• Empathy and sensitivity

The PD paper consists of 50 items with 95 minutes in which to complete the test; only 42 items count towards the final score (8 are piloted). The candidate assumes the role of an F2 doctor, with scenarios set across a range of realistic hospital, general practice and out-of-hours contexts.

The Professional Dilemmas (PD) Paper Question Types

There are 50 scenarios in the PD paper. Around half are 'rank options in order' and the other half are 'multiple choice'. There is no negative marking, so you should attempt every question.

• Ranking: judge the appropriateness of four or five independent actions (1 = Most appropriate; 5 = Least appropriate). The actions are discrete and should not be thought of as chronological.
• Multiple Choice: select the three most appropriate actions to take in combination, out of eight plausible actions, which taken together should fully resolve the situation.

The Clinical Problem Solving (CPS) Paper

In the CPS paper, candidates are presented with clinical scenarios that require judgement and problem-solving to determine appropriate diagnosis and management. This is not a test of knowledge per se, but of the ability to apply it. Items are based on Foundation-level clinical practice across 12 clinical topic areas relevant to general medicine.

The CPS paper consists of 97 questions with 75 minutes to complete; only 86 items count towards the final score (11 are piloted). The test covers five core competencies:

1. Investigation: specific investigations carried out to obtain a more conclusive diagnosis or rule out causes.
2. Diagnosis: identification of a condition, disease or injury by evaluating symptoms and signs.
3. Emergency: recognising potential serious illness requiring an immediate response.
4. Prescribing: advising, authorising or reviewing the use of medicine/drugs in a management plan.
5. Management (non-Prescribing): advising, authorising or reviewing non-medicinal treatment.

The Clinical Problem Solving (CPS) Paper Question Types

• Extended Matching Question (EMQ): a list of 7–10 plausible response options with multiple separate questions linked to the same set; each option can be selected once, more than once, or not at all.
• Single Best Answer (SBA): select the single most appropriate or likely answer out of 5–8 plausible responses for one clinical presentation.

Registering For The MSRA

Once the application window closes, you will receive a message asking you to register with Pearson VUE using specific account credentials associated with your Oriel account. If you applied to other specialties you may receive multiple messages containing the same credentials; you only need to register once. Registration correspondence is not an invitation to attend, on completion your account will state you have no pre-approved exams. Applicants who experience difficulties should contact the Pearson VUE customer services team.

Invitation To The MSRA

All applicants assessed as demonstrating evidence of eligibility will be invited to sit the MSRA. If invited, you must book an appointment and undertake the MSRA; failure to do so will result in your application(s) not progressing. All invitations are for delivery of the MSRA in Pearson VUE test centres.

MSRA Scoring

The MSRA scores are used to rank applicants for shortlisting purposes, based on the maximum interview capacity. There is no maximum achievable score. The MSRA score contributes 10% towards your total Core Surgery Selection Score, with the PD and CPS elements weighted equally. MSRA scores are scaled for each specialty so they can be combined with the rest of the selection process.

MSRA Candidate Tips

• A generic tutorial is available to familiarise yourself with the controls and screen layouts in advance, see Pearson VUE or Oriel.
• A glossary of frequently used terms and abbreviations is available throughout the exam, particularly useful for those less familiar with the UK medical system.
• Papers are NOT negatively marked: answer all questions; a wrong answer can score more marks than a missed question.
• Read the instructions and questions carefully and give your best answer using the information provided.
• For the SJT, answers are marked against a predetermined key based on a near-miss approach; your performance across the whole test determines your level of situational judgement.
• Revisit areas of knowledge or practice before the assessment if you would benefit from doing so.