MSRA Professional Dilemmas
Professional Dilemmas is the MSRA's paper on how you act at work: 50 scenarios in 95 minutes. It tests professional attributes, not clinical knowledge, and there is no negative marking.
The two formats
- Ranking (about half): four or five independent actions to put in order, from most to least appropriate. Marks depend on how close your order is to the key, so a near miss still scores.
- Choose three (about half): pick the three most appropriate actions from a list of at least eight.
What it tests
NHS England names three target domains:
- Professional integrity: being open and honest, admitting mistakes, treating others with respect, balancing demand, resources and expectations, managing risk, and taking responsibility for yourself, others and the wider population's health.
- Coping with pressure: managing your own emotions and stress, admitting difficulty and asking for help, staying calm, accepting uncertainty, taking criticism well and balancing roles.
- Empathy and sensitivity: seeing things from the patient's or colleague's side, holistic and patient-centred care, helping patients take part in their own care, and staying open and non-judgemental.
The GMC's Good Medical Practice is useful background for why one action is better than another, but the three domains above are the paper's own blueprint.
How it is scored here
A ranking question scores by distance, as the paper does: each action earns more the closer you put it to its place in the key. A choose-three question earns a mark for each of the three right actions you pick, and nothing is taken off for a wrong one.
Source: NHS England, What's in the MSRA. Where anything here differs from NHS England's current pages, NHS England is right.
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