How to Score Over 600 in the MSRA Exam – My
Comprehensive Guide
When I first started preparing for the MSRA, I assumed it would be just another online test -
maybe a bit of SJT, some clinical MCQs, nothing too intense.
I was wrong.
The MSRA is one of the most high-stakes, high-impact exams you’ll sit in your postgraduate
training journey. For GP, Radiology, Psychiatry, CST, ACCS applicants etc your MSRA score
can completely determine your ranking - and in many cases, whether or not you get a job offer
without interview.
I scored 609 in the January 2025 sitting, and I want to share everything that helped me - and
what didn’t. This isn’t a sugar-coated success story. It’s a real breakdown of:
● How I paced my revision over 6 months
● The exact resources I used (and which ones I stopped using)
● What I’d do again - and what I’d do differently
My Prep Timeline - 6 Months, No Burnout
I gave myself around six months, but I only became properly consistent after Month 2. I was
working full-time in hospital, so I focused on:
● 1–2 hours on weekday evenings
● Longer weekend sessions
● Short breaks when I needed them - no guilt
Here’s how I structured it:
● Months 1–2: Light start - doing a few SJT and MCQs, reading and trying to memorise the
conditions
● Months 3–4: Daily question practice, learning high-yield CPS topics, using SMART for
PD
● Month 5: Full, intense revision, timed blocks
● Month 6: Mock papers, final polishing, confidence-building
This structure kept things sustainable - I never felt the need to cram.
Resources I Used
Let’s be honest - not all revision tools are made for the MSRA. Some helped me score highly.
Others were a waste of time. Here’s my full, honest breakdown:
MediWord ([Link])
This is a bank of past paper style/recall style MSRA questions. This was my main resource -
and hands down the most useful one I used throughout.
● 3000+ recall-style MSRA questions that closely matched the actual exam
● Over 600 SJT-style Professional Dilemma questions, all with ranked explanations using
the SMART framework (read below)
● Every clinical explanation summarised the relevant NICE guideline, saving me hours - I
didn’t read the original guidelines once
● Includes 500+ revision sheets covering the highest-yield MSRA conditions
I went through MediWord 2–3 times over. The questions were so close to the real exam that I
felt completely prepared by the time I walked in. I basically learned everything from MediWord
and didn’t need to use full NICE guidance or extra textbooks.
If you’re aiming for a high score, this is the one I’d recommend without hesitation.
MCQ Bank ([Link])
I used MCQ Bank in the early months for clinical question practice. It helped a bit with:
● Getting into the rhythm of answering timed MCQs
● Refreshing some basic clinical knowledge
● Has around 200 SJT questions
However, it only contains around 1,500 questions - which means it doesn’t cover everything you
need for the MSRA. Some key conditions were missing. It was a good exam bank to use, and
the questions were similar to the MSRA exam but the quantitiy si limited hence why I
recommend this one second. The explanations were okay but less detailed than MediWord.
It’s a useful supplement - but not enough on its own.
Passmedicine ([Link])
I tried Passmedicine because I’d used it during med school - but for the MSRA, it really didn’t
work.
● The questions were often too long and wordy
● They felt more like finals or MRCP questions, not the MSRA format
● It didn’t focus on high-yield recall content
● And it had no proper Professional Dilemmas support - which is 50 percent of the exam
I gave up on it after a few days. It just wasn’t aligned with what the MSRA actually tests.
How I Approached the SJT (Professional Dilemmas)
Section
One of the most important lessons I learned is this: the SJT section makes up 50 percent of
the MSRA, and if you want a top score, you have to treat it with the same priority as clinical
revision.
At first, I assumed it would be intuitive - just rank options based on common sense. But when I
started doing practice questions, I realised the top answers often had specific patterns -
especially when it came to how doctors are expected to behave under GMC guidance.
I learnt the MediWord’s SMART framework, which completely changed how I approached
these scenarios.
Here’s how SMART works:
S – Spot the Ethical Principle
Identify the core issue — patient safety, consent, confidentiality, professionalism, etc. This is the
ethical anchor of the scenario.
M – Main Stakeholders
Work out who is affected — the patient, colleague, team, hospital, public, or yourself.
A – Available Actions
Think about the realistic, proportionate actions a safe doctor could take. This includes speaking
to colleagues, escalating if needed, and showing insight or reflection.
R – Reasoning
Justify why one action is better than another. Is it safer? More professional? Does it address the
core issue directly?
T – Tailored Judgement
Adapt your judgement to the specific situation. Don’t overreact or underreact. Always balance
kindness with professional standards.
This framework gave me structure. Instead of guessing, I started ranking options logically.
MediWord’s explanations are all built around SMART, so you naturally learn to think like the
exam expects.
SJT Webinars
On top of daily question practice, I also attended MediWord’s live MSRA SJT webinars every
3–4 weeks. These sessions walk through real recall-style questions and apply the SMART
framework step-by-step, with explanations based on GMC principles.
The webinars were genuinely helpful. They gave me extra clarity on why certain rankings were
correct and how to approach difficult or borderline cases. It felt like getting live feedback from
people who had sat and scored highly in the exam.
If you're preparing for the MSRA, I strongly recommend joining one of these sessions. You can
email info@[Link] to find out when the next webinar is scheduled.
How I Structured My Revision
Months 1–2: Light Foundation
● Did a few MediWord PD questions per week
● Some clinical MCQs particularly on high-yield topics
● Made sure I understood how the MSRA is scored
These first two months were about understanding the exam, not intense prep.
Months 3–4: Building Momentum
● 30 mins/day of PD using SMART
● 30–40 clinical questions per day
● Went through MediWord revision sheets on endocrine, cardio, resp, and psych etc
● Focused on pattern recognition and red flag conditions
This was when I really started to feel more confident. I was seeing patterns in the questions -
especially in PD.
Month 5: Guideline Focus
● Reviewed NICE summaries through MediWord explanations - I never opened the actual
articles
● Used filters to revise specific topics
● Did short, timed blocks of 10–20 questions to simulate pressure
● Focused on conditions that come up again and again: ACS, asthma, contraception, etc.
As mentioned earlier, I completed Mediword twice and then did MCQ bank once.
Final Month: Mocks and Polish
● Full-length timed mocks (PD + CPS together)
● Reviewed mistakes carefully and reread explanations - even for questions I got right
● Got used to flagging, pacing, and time management
● Backed off slightly in the final 2–3 days before the real exam to rest
What I Did Well
● Started early and paced myself
● Used a platform that focused on recall and NICE-aligned guidance
● Took PD seriously and learned how to rank properly using SMART
● Simulated exam conditions often in the final month
What I’d Do Differently
● Avoided Passmedicine earlier - wasted a week there
● Should have started clinical question practice earlier
● Relied too much on memory in the early stages - notes would have helped
● No need to read NICE guidelines or GMC domains, takes too long. Using the
summarised versions on Mediword is enough.
Final Advice
● Consistency beats cramming - even 30 mins a day adds up fast
● PD is learnable - use SMART and review explanations
● Use resources that are built for the MSRA, not repurposed from med school
● Trust recall and NICE-based learning - that’s what the exam test