Getting into GP training has become increasingly competitive over the last few years, especially for doctors aiming to get into popular areas. Dr Zeinab Dafalla shares here experience and tips that helped her get an MSRA score of 623. This was one of the highest scores in the country (she ranked 19th out of over 6500 doctors that passed the MSRA for GP) and helped her to secure her 1st choice area in Salford, Manchester.
Deciding to go for GP training
I have always had my eyes set on General Practice as a career, and my experiences during my Foundation Training simply confirmed it. Initially, I was debating taking an FY3 year as I lacked confidence in my abilities to sit the MSRA, especially now that our rankings would be based solely on the exam as the Stage 3 Selection Centre stage was again postponed this year. Nonetheless, I later made the last minute decision to apply fpr GP training and sit the MSRA to see if I had a chance of getting into my top choice – Manchester (Salford).
Things don’t always go to plan
I naively planned to start preparing for the MSRA exam in August when I was due to begin my first FY2 rotation, which would’ve allowed me 6 months to prepare at a good steady pace. Unfortunately, my first FY2 rotation was Cardiology – by far the busiest one that I have ever encountered. Regular nights, long and hectic on-call shifts and very eventful and understaffed wards all meant that I was regularly staying late to finish urgent jobs. Subsequently, this meant that I neglected my study towards the MSRA and before I knew it December came around and I was rotating onto General Practice with only around 6 weeks left to focus on the exam! This is why I was reluctant to even bother applying this year, but thanks to question banks such as Emedica, I’m so glad that I did.
Picking which resources to use for MSRA preparation
Back when I was in medical school, I understood how beneficial question banks were to passing my finals and knew that these were likely the key to now passing the MSRA. With only weeks to go, I simply didn’t have the time to read through the hundreds of pages of detailed notes that I had previously made without becoming utterly overwhelmed. Again, due to time restraints, I knew that I could only invest in a couple of question banks that are the most informative as well as representative of the MSRA. After reading through online threads and asking colleagues, Emedica, Passmedicine, Pastest and MCQbank all stood out.
I decided to invest in Emedica and Passmedicine, then vigorously work my way through them both. I spent at least 3 hours each night doing questions and making an effort to read through the explanations thoroughly, browsing through key NICE guidelines and combining the new information learnt with my previous notes.
Embedding preparation into my working day
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.
Tackling my weakest area – the SJT paper
It quickly became clear that my main struggle was actually going to be the SJT component of the MSRA (Professional Dilemmas) which comprises 50% of your total MSRA total score. I had previously sat the Foundation SJT and only scored quite averagely. Now, as I was looking to move to a very competitive region, I felt a lot more pressure to do well. At the start, I was scoring around Band 2-3, and I knew that this wouldn’t be enough to safely secure the place that I wanted. I was making silly mistakes and realised the importance that only one word can make to differentiating 2 similar answers. With only 3 weeks to go I decided to purchase the “Emedica MSRA Crammer Course Day 2: SJT Preparation Course” recording. In doing so, I was able to watch different sections over lunch and dinner and then re-watch the top tips a bit closer to the exam. Having an overview of the different core domains tested and hearing the in-depth explanations really changed my approach to the SJT questions and I could instantly see the improvement in my scoring to Band 4.
The week before the exam, I focused on the timed mock MSRA papers on Emedica which highlighted just how important identifying key words/phrases is when wanting to save time. I was scoring around Band 3-4 and was very unsure about how the MSRA was going to go. As time was running out, I decided to focus on repeating questions in my weakest areas, rather than completing new questions in my stronger areas. The day before the exam, I browsed over key NICE guidelines and notes that I had made, then did my best to relax by cooking a nice dinner and watching a movie then getting an early night. I know just how badly lack of sleep and stress can affect my logical train of thinking, so I knew that remaining calm would benefit me much more than trying to cram in some last minute knowledge that would likely just go over my head and increase stress!
Reflections after the exam
After sitting the exam, it was apparent that Emedica is the most representative out of all the MSRA question banks that I have encountered – this is in terms of question style, exam format, and areas of knowledge tested. Although I left the exam not feeling very confident and began to lose hope of getting into my top choice this year, I had scored 623 (305 in the Professional Dilemmas section, and 318 in the Clinical Problem Solving section) – securing band 4 in both, ranking 19th out of 6533 GP candidates that passed and securing a spot in Salford/Trafford to start GPST1 in August 2022.
7 tips to get the best score possible:
- Start revising early: to save yourself the stress that I faced by leaving it late, start preparing at least 3-4 months before and utilise any spare moment you may have while on-call, nights (instead of napping!), lunch breaks, while on the train home etc. You’ll thank yourself later!
- Focus on one speciality at a time: you will probably initially feel overwhelmed at the thought of having to go through all of your medicine/surgery/paediatrics/psychiatry notes again – but you will surprise yourself with how much you remember when doing the questions first. This will highlight your stronger and weaker areas. Then, spend time focused on your weakest specialties one at a time – this will help you consolidate your knowledge by regular repetition and your scores will soon improve.
- Form a study group: I found myself often completing questions with my FY2 colleagues – the friendly debate over which answers we would pick was often helpful as we would teach each other new things. When we were at home, we would also encourage/challenge each other to complete a few sets of questions (i.e. 60 questions each night – equating to 2 Emedica MSRA online question sets).
- Pick a suitable exam time: the importance of exam time is not usually discussed, but I’m very glad that I picked 2pm. I am not a morning person, so this allowed me enough time to wake up, have breakfast, relax and get to the test centre early. Some of my friends had exam times of 8am and heavily regretted choosing this! Others may be morning people who work better at earlier times. Choose what’s most suited to you.
- Practice your timing: Keep track of time during the exam as it will fly by! This will be much easier if you perform the full timed mocks on the Emedica website beforehand. Rather than debating your answers, go with your gut/sensible guess, flag the question and come back to it later if you have time – nothing is worse than leaving your paper unfinished with guaranteed lost marks!
- Stay calm: I vividly remember seeing fellow candidates in the queue at the exam centre busy cramming with their paper/electronic notes and telling me that they’d only slept for 2-3 hours the night before. Unsurprisingly, these were the candidates who struggled to complete the exam (you need to remain focused for 3 hours!) and score as well. Calmness is truly key! Avoid last-minute studying if you can.
- Don’t be put off: During the exam, everyone faces some tough questions which we have to guess. After a few of these, I did start to lose confidence. However, as usual, you are your own toughest critic and you’ve probably done a lot better than you think – don’t let it put you off! Also, a few of the questions (11 in the clinical knowledge section, 8 in the SJT section) are in fact pilot questions (we aren’t told which ones) that won’t count towards your score, so they may not matter.
Best of luck to you all!
Dr Zeinab Dafalla
FY2, West Midlands North
MSRA score 623, Ranked 19/6533 in the country, secured 1st choice GP training in Salford, Manchester.