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

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The PD paper is a situational judgement test (SJT) comprising fifty questions. 1 Typically, 95 minutes are allocated for this part of the MSRA. Candidates may be allowed 25% or 50% additional time as reasonable adjustments under the Equality Act 2010. 1 The PD paper poses workplace-based scenarios featuring professional dilemmas to assess candidates’ judgement of appropriate behaviour.

Clinical problem solving - not so easy to cram. I would say that the best preparation you have for this is seeing real-life patients, which you’ve been doing for a long time now! Then you can consolidate this knowledge by doing the practice questions on Pastest. Most of the questions are set in primary care, however, there are a few sets in secondary care creeping in now. Even if you haven’t had experience of that area - e.g. ‘on the ortho ward Mr X is suffering from x’ – the judgement is the important bit and not the context, so don’t get too hung up on it. You can’t ask for more information so just work with what you’re given and select the best option in that case.

ThefollowingthingsarelovedbyPACESexaminers:awarenessofDVLAguidelines,activelyaskingpatientsaboutsmokingcessation,exploringideas,concerns,expectations,obtainingafullsocialandoccupationalhistory. Having gone through the process feeling under a lot of pressure for a few reasons, I think my advice to those preparing for the exam, especially those with children and slightly more difficult revision circumstances would be: It does not test knowledge or problem-solving. Instead, the content relates to the GMC’s Generic Professional Capabilities framework and tests attributes that are important for doctors’ training progression and job performance. The three main competencies tested are professional integrity, coping with pressure and empathy and sensitivity. 1 Knowledge of specialty training is not needed but a general understanding of primary and secondary care work is expected. Questions are set in the context of the UK Foundation Programme; candidates assume the role of F2 doctors. However, to make certain the fairness of the MSRA for all candidates including International Medical Graduates, questions do not entail any knowledge of policies or procedures that are specific to the UK. 1

Until now, the only way to access personalised learning for exams like the MSRA was to pay for expensive courses. These don’t represent value for money for most candidates who instead use question banks to prepare for their exam. WouldalsorecommendtheUCDneurologychannel: https://www.youtube.com/playlist?list=PLHdemSStztKaB0A_iqfdiepvRwljoI1dF RCPCHnowrunarevisioncourseforthisexam–itwasa2daycoursewhenIwent,butIbelieveit’snowaonedaycoursewithonlineresourcesavailable.Itwasareallygoodcourse,butexpensive–Ithinkpartoftherationaleinreducingittoonedaywastoalsoreducethecost.Probablynotworthitforthefirstattempt,butifyou’vehadacoupleofattemptsandyou’restrugglingwithTAS,Iwouldhighlyrecommendit.Imanagedtogetminecoveredinmystudyleavebudget.It’srunbythepersonthatactuallyruns/coordinatestheTASexam.I found the scoring scale for MSRA slightly confusing as there is no maximum score achievable. Instead, they used a system called ‘normalisation’ which takes into account the score of everyone who takes the exam and normalises them around a mean score of 250 with a standard deviation of 40. The scores are then placed into bands 1-4. Band 1 are the lowest scores and are unsuccessful in progressing further, and 4 includes the highest scorers. My simple answer is that relying on one method alone can leave you a little short. No question bank can cover every aspect of the MSRA, whilst purely reading books and guidelines will not give your brain adequate exposure to problem-solving. If planned well, both should be used together as both have advantages in terms of improving retention and performance. Although a general understanding of typical primary/secondary care work is required, the Professional Dilemmas Paper does not assess specific knowledge within speciality training or your problem solving skills. Rather, it focuses on professional attributes and behaviours when interacting with patients and colleagues, and requires you to demonstrate your judgement regarding the most appropriate behaviours within given scenarios.