MSRA
How each specialty uses the MSRA in its ST1 selection — whether it gates progression to interview, how much it counts towards the final rank, or whether it is used at all.
What is the MSRA?
The MSRA (Multi-Specialty Recruitment Assessment) is a national computer-based exam used by NHS England to rank applicants for many specialty training programmes. It has two papers, sat on the same day at a Pearson VUE test centre.
Clinical Problem Solving (CPS)
Applied clinical knowledge across acute medicine, surgery, paediatrics, psychiatry, O&G and more.
Professional Dilemmas (PD)
Situational judgement test: prioritisation, ethical reasoning, professional values.
How specialties use it varies. Some rank you 100% on the MSRA (GP, Core Psychiatry). Others use it to rank for interview, then discard it (Ophthalmology, Radiology). Some weight it directly in the final rank (Anaesthetics 15%, ACCS-EM 40%). And a few don't use it at all (Paediatrics, Histopathology, OMFS, Public Health, IMT, Cardiothoracic). The table below shows where each specialty sits; each specialty's MSRA tab explains its specific rule.
How each specialty uses the MSRA
| Specialty | How the MSRA is used |
|---|---|
| Sole selection score (100%) | |
| GP | Selection is 100% the MSRA — there's no portfolio, interview or Selection Centre. Your national MSRA rank alone decides which posts and training locations you're offered. |
| Psychiatry | Selection is 100% the MSRA — there's no portfolio or interview. Your national MSRA rank decides your offers; you must score at least 186 in each paper to be appointable. |
| Weighted into the final rank | |
| ACCS-EM | The MSRA initially ranks candidates, with the top-ranked invited to interview. It then makes up 40% of the final score (the interview is the other 60%) that decides who is offered a post. |
| O&G | The MSRA initially ranks candidates, with the top-ranked invited to interview — and the very highest scorers offered posts outright without interviewing (the 'bypass'). For everyone else it makes up 33.3% of the final score (the interview is the other 66.7%) that decides who is offered a post. |
| Anaesthetics | The MSRA initially ranks candidates, with the top-ranked invited to interview (by capacity — there's no fixed cut-off). It then makes up 15% of the final score (the interview is the other 85%) that decides who is offered a post. |
| Neurosurgery | The MSRA is 40% of the score that ranks candidates for interview (your verified self-assessment is the other 60%). It then makes up 12% of the final score that decides who is offered a post — the rest being the interview (70%) and self-assessment (18%). |
| Core Surgery | The MSRA initially ranks candidates, with the top-ranked invited to interview. It then makes up 10% of the final score that decides who is offered a post — the other 90% being the two interview stations (portfolio 45% + management & clinical 45%). |
| CSRH | The MSRA initially ranks candidates, with the top-ranked invited to interview. It then counts towards the final score alongside the interview that decides who is offered a post — NHS England doesn't publish how the two are weighted. |
| Ranks for interview only (0% of the final rank) | |
| Ophthalmology | The MSRA combines 50/50 with your self-assessment to rank candidates, with the top-ranked invited to interview. It's then discarded — the final score that decides offers is portfolio 50% + interview 50%. |
| Radiology | The MSRA ranks candidates for interview (you must score above 201 in each component), with the top-ranked invited. It then plays no part in the final score, which is portfolio 40% + interview 60%. |
| Does not use the MSRA | |
| Cardiothoracic | Not used — candidates are ranked instead on a scored self-assessment that decides interview invites and is carried into the final rank alongside the interview. |
| Histopathology | Not used — candidates are ranked for interview on a scored self-assessment; the final rank is the interview alone. |
| IMT | Not used — candidates are ranked for interview on a scored self-assessment; the final rank is the interview alone. |
| OMFS | Not used — selection combines a scored self-assessment and a four-station interview into a single overall rank (no exam, no pre-interview ranking). |
| Paediatrics | Not used — candidates are ranked for interview on a scored written application; the final rank is the interview alone. |
| Public Health | Not used — Public Health runs its own Assessment Centre (Watson-Glaser, RANRA and an SJT) as a pass/fail gate into a virtual Selection Centre, which alone sets the final rank. |