MSRA for CST 2027: the 10% Weighting and What a Safe Score Looks Like

The Multi-Specialty Recruitment Assessment (MSRA) is worth 10% of the Core Surgical Training (CST) selection score, scaled onto a 0 to 10 point scale, according to NHS England's applying page for core training. It is also the shortlisting tool, so it decides whether you are interviewed at all. No pass mark or cut-off is published, because MSRA scores are normalised against the cohort and, in NHS England's words, "there is no maximum achievable score".

Reviewed and updated 10 September 2026. The weighting and the shortlisting figures are the 2026 position; the MSRA structure is from NHS England's MSRA pages; the 2027 test window is not yet published.

Key takeaways

• The MSRA is 10% of the CST selection score, scaled to 0 to 10, with the two interview stations making up the other 90%.
• The MSRA is also the shortlisting score: in 2026 our fact table records that only the top 1,200 at the MSRA were invited to interview, and the 2027 cut is not yet published.
• The test is 170 minutes: a 95-minute Professional Dilemmas paper of 50 questions and a 75-minute Clinical Problem Solving paper of 86 items.
• There is no published pass mark. Scores are normalised, "there is no maximum achievable score", and the outcome "cannot be reviewed, re-marked or disputed".
• The 2027 MSRA window is not yet published; in 2026 it ran from Tuesday 6 to Monday 19 January at Pearson VUE centres.
• A safe score is a rank question, not a number: you need to be inside the invited group, and the only lever is your position against that year's cohort.

How much is the MSRA worth for CST in 2027?

The MSRA is worth 10% of the CST selection score, and that is the published 2026 position, which NHS England has not yet republished for 2027. The applying page states the total score is "a combination of MSRA (10%), portfolio station score (45%) and management and clinical station score (45%)".

In practice the 10% understates the MSRA. Nobody who misses the shortlist scores the other 90, so the exam is a gate first and a score second.

Does the MSRA decide who gets a CST interview?

Yes. The MSRA forms the basis of the CST shortlisting score, and only the highest-ranked applicants are invited to interview and to the evidence upload. NHS England's applying page says the MSRA "will form the basis of your shortlisting score".

In 2026, our fact table records the invitation as going to the top-scoring 1,200 applicants at the MSRA. For 2027 the cut is not yet published, and prioritisation now applies at shortlisting as well as at offer, so the ranking is not the only factor.

Shortlisting is the step where scored applicants are ranked and the top group is invited to interview; for CST that score is the MSRA, with most eligibility checks completed only after MSRA results are confirmed.

What is in the MSRA?

The MSRA is a 170-minute computer-based test in two independently timed papers: Professional Dilemmas, a situational judgement test, and Clinical Problem Solving, which measures applied clinical knowledge. It is delivered by Work Psychology Group and Pearson VUE.

An optional five-minute break separates the papers. Candidates with an Equality Act adjustment get 25% or 50% extra time in each paper.

What does the Professional Dilemmas paper test?

The Professional Dilemmas paper tests professional integrity, coping with pressure, and empathy and sensitivity, with you in the role of an F2 doctor. The scenarios are written across settings so that international graduates are not disadvantaged.

What does the Clinical Problem Solving paper test?

The Clinical Problem Solving paper spans twelve clinical areas, from cardiovascular and respiratory medicine through endocrinology, gastroenterology, paediatrics, psychiatry and neurology to renal, reproductive and musculoskeletal problems. It is general medicine at foundation level, not surgery.

What is a safe MSRA score for CST?

There is no safe MSRA score for CST in the sense of a published number, because NHS England does not publish a cut-off, normalises every score against the cohort, and states that "there is no maximum achievable score". A safe score is one that ranks inside the invited group, and that rank depends on who else sits in January.

What can be said is structural. The MSRA counts equally across both papers for the ranking, so a weak Professional Dilemmas paper costs as much as a weak clinical one. And because the final 10% is scaled to 0 to 10, the difference between a good and an outstanding MSRA is at most a few points of the final 100.

However, no figure is offered here for the rank you need. Any site that quotes an MSRA cut-off for CST is either reporting an unofficial estimate from a previous cohort or inventing one, and the 2027 figure will not exist until shortlisting is done.

When is the MSRA for CST 2027?

The 2027 MSRA window is not yet published. In 2026 the MSRA ran from Tuesday 6 January to Monday 19 January, with invitations to register due no later than Monday 15 December 2025 and results expected in February.

That said, the 2027 national interview window opens on 11 January, and every recent MSRA sitting has fallen in the first half of January, so plan for a January 2027 test until the timelines page says otherwise. Book the Pearson VUE slot the day the invitation arrives, because the popular centres fill.

Can I appeal or resit the MSRA for CST?

No. NHS England states the MSRA outcome "is final and cannot be reviewed, re-marked or disputed. There is no appeals process", and there is one sitting per recruitment round. The complaints procedure exists only for alleged mishandling of the process, not for the score.

The practical consequence is that the January sitting is the only one that counts for CST 2027. A poor day cannot be repeated inside the round.

How should CST applicants prepare for the MSRA in three weeks?

Three weeks is enough to prepare for the MSRA if you split the time between the two papers and finish with timed practice at the paper's real pace: about 1.9 minutes per Professional Dilemmas question and 52 seconds per Clinical Problem Solving item. The plan below assumes a January sitting and full-time clinical work.

NHS England publishes a free practice paper, and its structure page notes that none of the question writers endorse any preparation course or book. The coresurgeryinterview bank includes an MSRA question bank alongside its 299 interview questions for £97, and the interview questions are the better use of any time left over, because that is where 90 of the 100 points sit.

What should you do the week after the MSRA?

The week after the MSRA is for the portfolio, not the exam, because the result cannot be changed and the evidence upload follows within weeks of the invitation. In 2026 the invitations were sent on 13 February and the portal opened three days later.

1. Finalise the index sheet with the letter you are claiming in each domain.
2. Chase every supervisor letter that still lacks a GMC number.
3. Draft the three-minute presentation as soon as the topic is issued with the invitation.
4. Start five-minute spoken scenarios daily; the free coresurgeryinterview samples are a place to begin.

This post will be updated the week NHS England publishes the 2027 CST timelines and MSRA window.