Format 1
Ranking items
Rank four or five actions from most to least appropriate. Each option earns marks by distance from its correct place, so swapping two neighbours keeps most of them.
- 20 marks
- 4 or 5 options
How it's built
Keyed to the standard the exam uses
Keyed to Good Medical Practice 2024
Every option's explanation cites the paragraph of the GMC's Good Medical Practice behind it: 71 paragraphs across the bank. Your Review page adds up the marks you lose against each one.
Updated when readers argue with the key
A feedback button sits on every item. Keys and rationales are reviewed against GMP 2024, and the bank is updated when a reader makes a better case.
Part 1 • The paper
What the Professional Dilemmas paper tests
The MSRA has two papers. Clinical Problem Solving tests what you know. Professional Dilemmas tests what you would do: situational judgement pitched at the level of an F2 doctor. Both papers count equally.
Format 2
Choose-three items
Pick the three most appropriate actions of eight. Four marks for each correct choice.
- 12 marks
- 8 options
Scored against
Three domains
Every scenario targets one of the three domains the paper assesses, and your Review page breaks results down the same way.
- Professional Integrity
- Coping with Pressure
- Empathy and Sensitivity
Pitched at
F2 level, any specialty
Scenarios are set at F2 level whichever specialty you are applying to, and judged against the GMC's Good Medical Practice as a newly qualified doctor should apply it.
- GMP 2024
- GP, psychiatry, radiology, O&G and more
Try it
Try two real Professional Dilemmas scenarios
A near miss is not a wrong answer. Put the worst option first and you lose the marks; swap two neighbours and you keep most of them. These two are marked exactly as the app marks them.
Medical ward, district general hospital. You are a Foundation (F2) doctor on a busy medical ward. It is 10 minutes before the end of your shift. You have five outstanding tasks including two drug chart reviews and a discharge summary. The night team have arrived but appear overwhelmed already with their own incoming admissions. Your on-call registrar is not responding to bleeps.
Rank in order the following actions in response to this situation (1 = Most appropriate; 5 = Least appropriate)
1st–next
2nd–
3rd–
4th–
5th–
0 of 5 placed
Marks and explanation
Answer first, then reveal. 5 options still to place.
That's two scenarios. There are 198 more.
Part 2 • The diagnosis
Find out which principles cost you marks
Every option's explanation cites the Good Medical Practice paragraph behind it. After each attempt we add your marks lost to every paragraph the item tested, so your Review page shows the principles you keep getting wrong, not just a percentage.
Review also shows your score by domain and by format across every attempt, which ranking positions you misplace, your weakest items with a retry button, and a step-through of every mock you have sat.
Practice and progress
Practise a scenario at a time, then sit the paper
Timed mocks in the exam format
50 items in 95 minutes, half ranking and half choose-three, spread across the three domains. Flag items, no feedback until you submit.
Results by domain, format and position
After every session: marks by domain and by format, and for ranking items where in the order the marks went.
On the day
The Professional Dilemmas paper at a glance
Used by GP, psychiatry, radiology, O&G, ophthalmology, CST, ACCS, neurosurgery and more. Sittings in January and summer windows; check your specialty's recruitment timetable.
- Half of your total MSRA score
- Roughly half ranking and half choose-three, under two minutes an item
- Three domains: professional integrity, coping with pressure, empathy and sensitivity
- Length
Scenarios
Across the three domains
50items - Time
Minutes
Under two minutes each
95minutes - Marks
Per item
Ranking, then choose three
20 / 12marks
A near miss keeps most of the marks. Unanswered items score 0, so answer everything.
Source: the published MSRA test blueprint and Professional Dilemmas domain descriptions; Good Medical Practice (GMC, 2024). Exact mark values are not published; ours are a model.
Get ready
How to prepare
Try ten scenarios free
No account, no card. Each is marked immediately with every option explained.
Practise by domain and format
Read why each of the other options sits where it does, and the GMP paragraph behind it.
Sit a timed mock
50 items in 95 minutes, in the exam's mix of ranking and choose-three.
Retry the principles you lose marks on
Review shows which paragraphs cost you most. One click starts a set of every scenario that tests them.
How we compare
The clinical banks bolt PD on. We do only PD.
The big MSRA banks are clinical banks with a few hundred PD items marked right or wrong and a one-line explanation of the best answer. That is not how the paper is marked, and it does not tell you what to fix.
| Feature | MSRA Practice | Clinical banks' PD sections |
|---|---|---|
| Marks per option by distance, as the exam does | Yes | No |
| Rationale for every option, not just the best | Yes | Sometimes |
| Diagnosis by Good Medical Practice principle | Yes | No |
| Ranking marks lost by position | Yes | No |
| Ten free with full explanations, no account | Yes | A few samples |
| Pricing | £29.99 one payment | Varies |
| Clinical Problem Solving paper | No | Yes |
No. The MSRA item bank is confidential and every scenario here is original, written to the published format of the Professional Dilemmas paper and keyed against Good Medical Practice (2024). No unofficial resource can promise its keys match the official ones, and we don't. Every key comes with its reasoning so you can argue with it, and a feedback button on every item so you can tell us when you do.
Ranking items give marks for each option according to how close your position is to the key's, so a near miss keeps most of the marks and only a wildly wrong placement scores zero. Choose-three items give marks for each correct selection. We follow that structure: 4, 3, 2, 1 and 0 marks by distance for ranking (20 an item), and 4 marks per correct choice (12 an item). The exam does not publish its exact values, so ours are a model, labelled as such throughout.
Ten scenarios, seven ranking and three choose-three, across the three domains, each marked immediately with every option explained. No account and no card. If you later buy access, your ten attempts are added to your Review dashboard.
Until 31 March 2027, which covers the January 2027 sitting and the following window. One payment, no subscription.
No. MSRA Practice is only the Professional Dilemmas paper, which is half of your MSRA score and the half most clinical question banks treat as an afterthought. For clinical knowledge, use a clinical bank; for judgement, use this.
Start preparing for the Professional Dilemmas paper
- Ten scenarios free, with no account
- One payment of £29.99, access until 31 March 2027
- Secure payment by Stripe