POCKET MSRA: High-yield concepts for the clinical knowledge paper (Book 1)

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Tips:LikePart1,lotsofquestionsishelpful.Inmyopinionthiswasmuchmoreinterestingtostudyforasalotofitisrelevanttothethingsyoucomeacrossinhospitalmedicine.Onceagaincertainwordinginquestionswillessentiallygiveyouthediagnosis:PStudyingforthisexamwasabitofablurasIwasonA&Eatthetime,butroughly4weeksorsoofsolidstudyingwasprobablyenough. The CPS paper comprises 97 questions and assesses higher level synthesis of medical knowledge. 1 Typically, this part of the MSRA is allocated 75 minutes. Candidates may be allowed 25% or 50% additional time. The CPS paper poses scenarios that test candidates’ ability to apply their knowledge and use problem-solving skills to make clinical decisions. The settings of the scenarios provide context, but the judgement required to answer the questions is not specific to one setting. The questions are based on the Foundation Programme curriculum and cover twelve topics relevant to general medicine ( Box 1). 1

Therearecertainscenariosinthisexamwhichcomeuptimeandtimeagain:renaltransplant,chronicliverdisease,prostheticheartvalves,aorticstenosis,myotonicdystrophy,RA,pulmonaryfibrosisetc.TheRyderseriesisespeciallygoodatgoingthroughconditionsbasedontheirlikelihoodofcomingupintheexambasedonpreviouscandidatesurveys.Becomingwellacquaintedwiththesecommonscenariosandbeingabletofluentlypresentyourfindingsandanswercommonvivaquestions(indicationsforrenaltransplant,approachtoascites,whentoconsidersurgeryinASetc)isimportant.Soundingconfidentunderpressureisalsoaveryimportantpartoftheexam. If you’re applying for a Specialty Training (ST) post in 2024, you may need to undertake the Multi-Specialty Recruitment Assessment (MSRA) as part of the recruitment process. Our MSRA exam revision guide will provide you with advice and tips on preparing effectively, as well as information about the ‘exam difficulty’ and ‘what is a good score?’. Don'tbediscouragedifyou'renotsuccessfulonthefirstattempt.It'sahardexam(oddlyreminiscentofadrivingtest)andsomepeoplegetsomeweirdcasesorharshexaminersontheday.Making optimum use of time is important – using travel time to answer a few questions here or there, or listen to a chapter of our MSRA Clinical Crammer or SJT Audiobook courses for example, can add to the formal preparation time that you sit down to do. On my General Practice rotation, I tried to dedicate each spare moment that I could, to doing questions. I would utilise anything from my lunch breaks, spare time while waiting to debrief with my supervisor, during slots in which patients DNA’d etc. and soon those 10-15 spare minutes started adding up. Unsurprisingly, I initially wasn’t scoring so well, especially on topics such as Infectious Disease, Dermatology and Ophthalmology. However, after repeating the question sets in my weaker areas on Emedica, my scores soon started improving to 85% minimum. The information I learnt was also invaluable for my GP rotation where I was commonly seeing skin/eye/ear complaints; my supervisors noted that my general confidence in diagnosing and managing these was vastly improving. Managing to practice the information learnt on Emedica daily was the most useful way to ensure that the guidelines remained clear in my mind ready for the exam e.g. acne management, hypertension guidelines, type 2 diabetes control etc. It’s so basic, but remember to read the question carefully – it’s easy to miss things when you’re rushing and the information provided will help you to give the best possible answer to the question. Useyourstudyleave.Attendacourseifyou'reableto-IreceievedsomeverygoodteachingandsawalotofinterestingneuroandcardiacsignsImightnothaveotherwiseseen.Downsides:cost,arrangingtimeaway.Thereisagoodbreakdownofthedifferentcoursesinthisarticle: I applied for GPST in 2012 in my FY2 year, scored band 3 for both papers at stage 2 (MSRA), but was unsuccessful at the Selection Centre. I had heard it was easy to pass, so I felt pretty confident and didn’t do too much preparation. Naturally I was devastated. General Practice was all I really wanted to do. However, my husband had just been offered a job internationally, so I decided to take some time out of formal training, and get some more experience through volunteering. The planned one year away turned into five, we started a family, and I worked in public hospitals in Rwanda and Malawi. However, I was keen to reapply for General Practice and aimed for the August 2017 intake.

Over half of all junior doctors applying for Specialty Training posts each year will need to undertake The Multi-Specialty Recruitment Assessment (MSRA); our complete guide will provide you with information for the MSRA 2024. Multi-Specialty Recruitment Assessment / MSRA Exam You will be given a set of responses (usually between 7 – 10) and asked to select the most appropriate option for multiple, individual scenarios. Each of the responses may be used once, more than once or not at all when selecting a suitable option for each scenario. As the msra scores are being released, I thought it might be helpful to write down briefly how everyone revised and scored, since I searched for this a lot while I was revising to decide on which question banks to use. There is an optional five-minute break between the two papers. If candidates take a longer break, this extra time will be subtracted from the time available in which to complete the CPS paper. 2 Another very common question that I get asked is ‘which question bank should I use?’ I have not had experience of all banks on the market but all I would say is try and have some variety. Often doctors rely on only one question bank and get very used to a certain style of question-writing – doing the same style of question 2-3000 times is bound to trigger your brain to think in a certain way and it can be very confusing when another ‘style’ is suddenly encountered in the exam.The PD paper is very similar to the SJT - there isn’t necessarily a perfect answer! The main things they are looking for are acting with integrity, coping under pressure, empathy, sensitivity, and recognising important concerns and responding appropriately. Pastest: questions were nothing like exam in either sections. Although the breadth covered by the clinical section is so wide that if you did the whole question bank I think you would still do well in CPS, I definitely spent a lot of time memorizing lots of things that didn’t come up though. Without expecting to, I was fortunate enough to score within the top 10% of the cohort for the Clinical Problem Solving paper and within the top 2% for the Professional Dilemmas paper! As mentioned for Obstetrics and Gynaecology ST1, in some cases, a high score can allow you to skip the interview section of the application and be ranked above fellow applicants, therefore increasing your chances of receiving a training offer in your preferred programme/location. While General Practice ST1 and Core Psychiatry Training CT1 don’t include an interview; instead, they assess and rank applicants solely on their MSRA score. So it’s worth investing the time preparing for the MSRA exam. Many specialties – namely community sexual and reproductive health, general practice, neurosurgery, obstetrics and gynaecology, ophthalmology, psychiatry (core and child and adolescent), and radiology – use the MSRA in selection processes for specialty training. 1 Negative marking is not utilised. Consequently, candidates are encouraged to answer all questions. 1

Although the scenarios are relevant to foundation level clinical practice (FY2), it does not aim to simply assess your recall of knowledge, but focuses on your ability to synthesise and apply your medical knowledge appropriately. Format of the Clinical Problem Solving PaperPrescribing– Advising, authorising or reviewing a patient’s clinical management plan – specifically the use of medicine / drugs. The Professional Dilemmas section is limited to 95 minutes and is a ranking test, consisting of 50 scenarios. For each situation presented, the candidate will have to rate the appropriateness of 4-5 independent actions (from 1=most to 5=least appropriate). Focus: Work out what it is you need to do and do only that! For me this was using a number of different question banks, generating my own notes from the ones with more detailed answers and then practising, practising, practising! The MSRA is a computer-based exam which is designed to assess essential competencies. It is currently used for entry in postgraduate medical training for the following specialities: