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Competition ratios

Clinical radiology is a very rewarding career but getting a training post is competitive.

Key statistics from 2023:

  • There were 3068 applications for 350 ST1 training posts in England, Scotland & Wales.
  • There were on average 8.77 applications to every 1 post.

Click here for more information including statistics from previous years

What is a radiologist?

Overview on what a radiologist is and what they do

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Multi-Specialty Recruitment Assessment (MSRA)

Information on the MSRA for ST1 Clinical Radiology applicants

MSRA stands for the Multi-Specialty Recruitment Assessment.  Sometimes it is simply refered to as the Specialty Recruitment Assessment (SRA).  It is a computer-based exam designed to assess essential competencies and has been part of the ST1 clinical radiology application process since 2016.  There are two parts to the MSRA; a Professional Dilemmas (PD) paper, followed by a Clinical Problem Solving (CPS) paper.

In line with a number of other specialties a Multi-Specialty Recruitment Assessment (MSRA) test was incorporated into radiology recruitment in 2016. All applicants are required to sit the MSRA at a test centre in the January of the recruitment year. Applicants are ranked according to their MSRA score and following longlisting, invitations to interview are circulated on the basis of rank until all available interview slots are filled.

The MSRA is the most important component of the selection process for the following reasons:

  1. Candidates need to achieve a score high enough to be offered one of the limited number of interview slots as the ranking for interview slots is directly based on your MSRA score.  If you do not perform well in the MSRA, you will not be offered an interview. There is also a cut off score below which applications applicants will not be invited to interview.
  2. Once you are through to the interview stage, your MSRA score is then weighted to contribute to your final selection centre score along with your interview performance and validated self-assessment score (from your portfolio). The weighting is 20% MSRA, 30% Portfolio and 50% Interview.
So take this test seriously! The assessment has been fully researched and evaluated, having shown to have a high predictive validity.

Is the MSRA the same as the Specialty Recruitment Assessment (SRA)?

Yes – they are the same thing! The SRA was originally designed for applicants to general practice (GP) training, hence why the questions are very broad in scope.  Subsequently, many other specialties have started using this test (including Radiology), hence why it is also referred to as the “Multi-Specialty Recruitment Assessment” or “MSRA”.

When is the MSRA held?

Late January / early February.

What is the format of the MSRA?

It is identical to the GP, Psychiatry, Ophthalmology and Neurosurgery recruitment assessment.  It’s a timed computer-based assessment that can be done in any of the nearest local Pearson VUE centres. On completion of the Professional Dilemmas paper, there will be an optional 5-minute scheduled break before the Clinial Problem Solving paper commences.

Invitations for the MSRA are sent out in early December to applicants that submit complete applications and meet basic eligibility criteria. Here is more information about the two parts of the MSRA:

Part 1: Professional Dilemmas (PD) - 95 mins

Key points:
  • Situational Judgement Test (SJT)
  • 50 questions in 95 minutes
The Professional Dilemmas (PD) paper is a Situational Judgement Test (SJT).  This paper assesses your understanding of appropriate behaviour for a doctor in difficult situations.  Your responses should represent appropriate behaviour for a 2nd year Foundation doctor (FY2) in the NHS.  It focuses on appropriate behaviour with respect to interacting with patients and colleagues, professional integrity, empathy and sensitivity, coping with pressure and in managing one’s own workload.  It does not require specific specialty training knowledge, but does assume general familiarity with typical primary and secondary care procedures. The test covers three core domains:
  1. Professional integrity
  2. Coping with pressure
  3. Empathy and sensitivity
You have 95 minutes to complete 50 questions.  Only 42 of these questions account towards the final score, as 8 questions in each test are for piloting purposes, however as you do not know the questions being piloted, be sure to take them all seriously! Scoring is based on how close your responses are to the most appropriate response for each question.  Applicants can score highly in these questions by providing an answer that is close to, but not identical to that from the expert group.  The closer your answer is to our experts responses the more points you will gain for the question. There are two question formats: "Ranking" questions - ranking 5 possible actions in order of appropriateness for a particular dilemma OR "Multiple best answer" questions - choose the 3 most appropriate responses out of 8 possible actions. This test assesses various core criteria from the Person specification 2024 for ST1 Clnical Radiology including:
  • empathy and sensitivity
  • communication skills
  • conceptual thinking and problem solving
  • coping with pressure
  • organization and planning
  • managing others and team involvement
  • professional integrity
  • personal and professional development

Part 2: Clinical Problem Solving (PD) - 75 mins

Key points:
  • MCQs and EMQs
  • 97 questions in 75 minutes
The Clinical Problem Solving (CPS) paper presents you with clinical scenarios that require you to exercise judgement and problem solving skills to determine appropriate diagnosis and management of patients.  This is not a test of knowledge per se, but rather your ability to apply it appropriately.  The questions are based on Foundation-level clinical practice and test a breadth of knowledge of medicine and surgery. The CPS paper consists of 97 questions and there are 75 minutes in which to complete the test. Only 86 questions account towards the final score as 11 of the questions are for piloting purposes.  Again, you will not know the questions being piloted so be sure to take them all seriously!

Sample questions

To fully understand the format of the exam, we strongly advise you to read the following:

  1. MSRA Test Blueprint Information  

    • Explanation of the exam structure and marking with some example questions.
  2. MSRA Applicant Guide – Sample Questions  

    • A selection of sample questions for the Multi-Specialty Recruitment Assessment.
Please note that although the documents above are written for GP applicants, they are still relevent as clinical radiology applicants also take the same test!

Useful hints and tips

  • Prioritising the MSRA is important

    • The MSRA makes up a significant proportion of your final selection score.  Many top candidates that work hard could achieve full marks at the radiology ST1 interview, therefore the only difference between these top candidates will be their MSRA score, which may mean the difference between getting their 1st or 2nd or 3rd choice placement etc.
  • Leave enought time to revise

    • Given the importance of this exam, preparation is essential.  Many candidates will start revising roughly 2 months before (e.g. from late-October).  It is important you have enough time to do lots of practice questions and increase your knowledge.
  • Be strategic with your revision time and target your weak areas

    • If you’ve undertaken placements in certain areas, maybe concentrate your revision on other areas you are less familiar with (e.g. if you did cardiology, general surgery and psychiatry, but not orthopaedics, we suggest you should make time to revise and refresh your knowledge of orthopaedic medicine).
  • Papers are NOT negatively marked so make sure you answer all the questions

    • It is important to note that the marking convention for ranking questions in the Professional Dilemmas (PD) paper means that even if got the ranking completely out of order, you would score a minimum of 8 marks for that question.  Skipping or missing an item, however, results in a score of 0 marks for that question!  The point we’re trying to make is that you should aim to answer all questions, even if you are not sure of the correct answer to some.
  • Read the instructions and questions carefully

    • There may be times when you would like more information to answer questions.  Just give your best answer given the information provided.
  • There are sometimes no absolute right or wrong answers

    • For the SJT it is important to bear in mind that often there are no absolute right or wrong answers, and that answers provided for the ranking items in particular are marked against a predetermined key, based on a near-miss approach.  Your performance on the test as a whole will be used to determine your level of situational judgement, rather than your performance on individual test questions.
  • Read the example questions carefully

    • If you feel you would benefit from revisiting some areas of knowledge or practice in order to be better able to show your capability, then you should do this before the assessment.  A glossary of terms and medical abbreviations which are not in universal use or may be misunderstood by some candidates will be provided.

Are there any useful resources to help me prepare?


Practice questions

 Useful links