Entry to specialty training has become increasingly competitive – many doctors that pass won’t get any job offers unless they can get excellent MSRA scores. In this article Dr Amber French shares her experience and tips that helped her get an MSRA score of 627 and rank 6th (out of over 3500) overall for Psychiatry and 17th (out of over 11,000) overall for GP, with top choice offers for both specialties.
Picking which specialties to apply for
During my Foundation training I was debating careers in A&E, GP or Psychiatry as I had found elements of all three jobs enjoyable. Consequently, I chose to do an FY3 and locumed in urgent care and the Emergency department to gain further experience. I also arranged taster days in Psychiatry. Whilst I loved the fast pace of A&E, I decided to apply to Psychiatry as it suited my interests in mental health and the holistic psychosocial approach to care.
Alongside this, I added an application to General Practice to keep my options open. It was a priority for me to have a flexible career in a location of my choosing where I could pursue other interests.
Both of these specialties used the MSRA as 100% of the weighting for rankings, and as I wasn’t very keen on relocating, I knew I had to try my best to achieve a high MSRA score – especially given the recent increase in competition for Psychiatry.
Resources I used
Having found question banks useful in medical school, I thought I’d continue to use this as my main resource for my exam preparation. I remembered finding Passmedicine useful for finals and was advised by friends who had scored well that they found Emedica useful- so I decided to trial a combination of the two.
With my exam booked for the start of January, I started preparing 2-3 months in advance to ensure I didn’t feel the revision was overwhelming and to make sure I could fit the workload around my rota sustainably. I’d definitely recommend this over cramming due to the large breadth of topics included in the MSRA (and I didn’t fancy ruining my Christmas holidays with too much revision!)
As a starting point, I used the Emedica YouTube videos to familiarise myself with the format of the MSRA. Following this, I worked my way through the different Emedica clinical question banks rotating through the topics to identify gaps in my knowledge.
Closer to the exam I used Passmed to cover a greater number of questions and focus on problem topics as they had a larger question bank. However on reflection, I found Emedica to be the most similar to the MSRA in terms of style and content. Initially my scoring on both Emedica and Passmed wasn’t great but eventually this started to increase with the number of questions completed. I also tried to link revision topics to patients I was seeing in A&E which helped guidelines stick in my mind.
Another technique I utilised was making online flash flash cards on topics I found difficult or repeatedly answered incorrectly, ensuring I read through the explanations and double checked NICE guidelines. The month before the exam I would test myself on these flash cards at the end of a revision session or whilst commuting.
A couple of weeks before the exam, I also began familiarising myself with the SJT section of the paper and working my way through the Emedica SJT practice questions. Whilst there’s less content to cover for the SJT section, as it comprises 50% of the exam score I didn’t want to neglect it. I found doing these questions under timed conditions helped me cope better with the time pressures in the exam.
In the week before the exam I made sure I completed the official MSRA mock exams, alongside all the Emedica and Passmed timed mocks. To consolidate my learning, I made flash cards again on errors from the mock and fine tuned any problem topics.
The Night before
The evening prior to the exam I’d encourage having some down time to help you feel fully rested and prepare for a good nights sleep! Personally, I avoid last minute cramming as it just makes me stress about what I don’t know, instead of getting me in the right mental state.
The morning of the exam I had a big breakfast of overnight oats with fruit which really helped me feel full and maintain focus throughout the long exam – it definitely feels more like a marathon than a sprint!
When I found out my MSRA score of 627 and Ranked 17/ 11,292 for GP and 6/3563 for Psychiatry I was over the moon and relieved I had prepared adequately for the MSRA. Thankfully I got my top choice of Psychiatry program in Manchester and am excited to start training!
Three top tips!
1. Start preparing early if you are able to!
As the MSRA covers such a broad range of topics, spreading out the work makes it seem a lot less daunting. For e.g. I’d advise to start working through questions at least 2- 3 months before the exam. This means you can fit the workload around busy rotas and still have a social life!
2. Do as many questions as you can (and then learn from your incorrect answers!)
Whilst finals felt like a long time ago for me (3+ years) I soon found that doing questions helped information resurface from medical school. In my opinion flash cards are a great way of learning from your mistakes and can be done on the go. I used brainscape, an online flash card platform that uses spaced repetition to make my own.
3. Practice questions and mocks under timed conditions!
The exam is reasonably time pressured, especially the SJT section as it can have quite a lot of reading in the questions. Therefore, I’d advise you to familiarise yourself with the speed at which you’re expected to work through questions. This will mean you’re ready on the day and will hopefully finish in time!
Best of luck to all those sitting the MSRA!
