Good judgement starts here.
The method, the principles and the practice.
Your guide to making sense of the options.
Build a way of thinking.
Take it into practice.
Several answers can sound reasonable. The useful question is what each would actually change for the people involved.
This guide brings the method, professional principles and worked questions together. Start by learning how to read a scenario, explore the situations that make judgement difficult, then follow the reasoning one step at a time. Use what you notice to make your next attempt more deliberate.
New to the MSRA and PD? Start here
Format and expectations
Understand the paper before you practise · 3 min read
Method
Read the scenario. Compare the actions. Make your judgement.
Format and expectations
The Multi-Specialty Recruitment Assessment (MSRA) has two papers: Clinical Problem Solving and Professional Dilemmas (PD). This guide focuses on PD, the Situational Judgement Test…
Reading a question
The stem is the scenario before the answer options. Use this routine to work out what it asks you to resolve.
Ranking actions
NHS England states that ranking options are discrete actions and "should not be thought of as chronological". An action does not become better because you imagine taking another…
Prioritisation and escalation
Use these questions to work out what needs attention first:
Choosing three actions
The assessment asks for the three most appropriate actions to take in combination, from eight plausible options. NHS England states that "the 3 most appropriate actions taken…
Choosing between close options
When two answers feel equally professional, ask what each would change in this situation. A familiar phrase alone won’t tell you which is better.
Topics
Put professional principles into everyday situations.
Patient decisions, communication and confidentiality
Shared decision making involves meaningful dialogue, relevant information and support. Start from the presumption that an adult has capacity; capacity concerns a particular…
Colleagues, errors and workload
Respect and compassion for colleagues sit alongside patient safety. The GMC also expects doctors to obtain independent professional advice when health may affect fitness for work.
Your health, limits and commitments
"Coping with pressure" is one of the three assessed domains. Some scenarios ask how you’d respond when you’re unwell, exhausted, asked to do something beyond your competence,…
Empathy and difficult conversations
"Empathy and sensitivity" is one of the three assessed domains. Look for empathy in what an option does: listening, acknowledging a concern, explaining honestly or arranging help.…
Professional boundaries
These scenarios test "professional integrity". They often ask how you can be helpful while keeping the boundaries that protect professional judgement and trust. The GMC expects…
Guidance for international medical graduates
If you trained outside the UK, some role titles or phrases in practice questions may be unfamiliar. This page explains them and offers ways to check your interpretation. Use the…
Practice
Work through examples and learn from your reasoning.
Worked examples
Eight practice questions, each with its own page and a step-by-step walkthrough. The walkthroughs show how to apply the method from this guide to a real question, one decision at…
Practice and review
Use the official MSRA practice paper with answer keys and expert rationales. Attempt the questions before reading their explanations. Avoid copying question-bank text into a…
Quick reference
Ask: Which addresses the actual issue, in time, within the described role? Which relies on fewer unsupported assumptions? Which avoids unnecessary harm or loss of dignity while…
No chapters found
Try a topic such as confidentiality, escalation or ranking.
Start with the method, explore the topics, then try the worked examples. See how this guide uses its sources