MSRA · Professional Dilemmas paper · 2027 sittings

Professional Dilemmas practice that scores you like the real exam

Professional Dilemmas is half your MSRA score, and most question banks just mark it right or wrong. The exam doesn't. Practise with marking that works the way the paper does, and see exactly which Good Medical Practice principles are costing you marks.

150
Original scenarios
110+40
Ranking + choose three
71
GMP paragraphs cited
£29.99
Access until 31 March 2027
About 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, scored against three domains. Both papers count equally.

How it works

  • 50 scenarios in 95 minutes, under two minutes each, roughly half ranking and half choose-three
  • Two formats: rank four or five actions from most to least appropriate, or choose the three most appropriate of eight
  • Marks for each option by how close you are to the key, not all-or-nothing
  • Three domains: professional integrity, coping with pressure, empathy and sensitivity
  • Scenarios are set at F2 level, whichever specialty you are applying to
Weight
Half of your total MSRA score
Used by
GP, psychiatry, radiology, O&G, ophthalmology, CST, ACCS, neurosurgery and more
Standard
The GMC's Good Medical Practice, as a newly qualified doctor should apply it
Sittings
January and summer windows; check your specialty's recruitment timetable
How it is marked

A near miss is not a wrong answer.

In a ranking item each of the four or five options earns marks by distance from its correct place. Swap two neighbours and you keep most of the marks. Put the worst option first and you lose them. Practising with a right-or-wrong bank teaches you nothing about which.

Sample scenario · Professional integrity

You are an F2 on a medical ward. Reviewing a drug chart you notice that a colleague who finished their shift two hours ago has prescribed a penicillin-based antibiotic for a patient with a clearly documented penicillin allergy. The dose has not been given but is due in 30 minutes.

Rank these from most (1) to least (5) appropriate:

ATell the nurse not to give the dose, cancel the prescription, document the error and tell the on-call registrar.
BAsk the pharmacist to review the chart before the dose is due.
CPhone the colleague and ask them to come back in to correct the chart themselves.
DDocument the error in the notes but leave the prescription, as the nurse should check the allergy status.
EMention it to the colleague at tomorrow's handover.

Key: A, B, C, D, E. A candidate who answers A, C, B, E, D scores 16 of 20.

OptionKeyYouMarks
A114
B233
C323
D453
E543
Total16 / 20
4 marks in the right place, 3 one place out, 2 two out, 1 three out, 0 four out. Choose-three items: 4 marks per correct pick, 12 in all. The exam does not publish its exact values; these are our model.
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.

Example: marks lost by GMP paragraph
§45 Being open if things go wrong
38% lost
§75 Responding to safety risks
31% lost
§22 Confidentiality
18% lost
§48 Treating colleagues with respect
9% lost

One click starts a practice set of every scenario that tests the paragraph you are weakest on.

Also in Review

  • Score by domain and by format, across every attempt
  • Ranking marks lost by position: do you misplace the best action, the worst, or the middle three?
  • Your weakest items, with a retry button
  • Every mock you have sat, with a step-through of each item
What you get

Everything for the Professional Dilemmas paper.

150 original scenarios, 50 in each domain, every option explained: 110 ranking and 40 choose-three, ranking-heavy by design because a ranking item carries 20 marks against 12.

Ten free, no account
Try ten scenarios with full marking and explanations before you pay anything. Your attempts carry over when you sign up.
Marked like the exam
Marks per option by distance from the key, scored on our server so you see exactly where each mark went.
Every option explained
Not just why the best option is best: why each of the other four sits where it does, with the GMP paragraph behind it.
Timed mocks
50 items in 95 minutes, half ranking and half choose-three as in the real paper, spread across the three domains. Flag items, no feedback until you submit, results by domain and position.
Principles dashboard
Marks lost by Good Medical Practice paragraph, by domain, by format and by ranking position, across everything you have attempted.
Shuffled every attempt
Option order changes each time you see an item, so a second attempt tests your judgement rather than your memory.
Built for a phone
Tap to rank, tap to choose. Practise a scenario in the two minutes you have between things, and the exam-style mock when you have 95.
Argue with the key
A feedback button on every item. Keys and rationales are reviewed against GMP 2024, and the bank is updated when a reader makes a better case.
The three domains

Fifty scenarios in each domain.

The paper assesses three professional attributes. Every scenario here targets one, and your Review page breaks results down the same way.

Professional Integrity
Taking responsibility for your actions, being honest, putting patients first, and challenging unacceptable behaviour including your own
Coping with Pressure
Keeping a professional approach under pressure, knowing when to seek help, managing your own reactions and dealing with uncertainty
Empathy and Sensitivity
Showing care for patients, relatives and colleagues, respecting their views and treating them with dignity
Source: the published MSRA test blueprint and Professional Dilemmas domain descriptions; Good Medical Practice (GMC, 2024).
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.

 MSRA PracticeClinical banks' PD sections
Marks per option by distance, as the exam does
Rationale for every option, not just the bestSometimes
Diagnosis by Good Medical Practice principle
Ranking marks lost by position
Ten free with full explanations, no accountA few samples
Clinical Problem Solving paper
Pricing

One payment, everything included.

No subscription. Try ten scenarios first; pay only if you want the other 140.

Full access
£29.99
One-time payment · Access until 31 March 2027
150 Professional Dilemmas scenarios: 110 ranking, 40 choose-three
Marked the way the exam marks them, option by option
Every option explained, with the Good Medical Practice paragraph behind it
Timed mocks in the exam format, with results by domain and by position
Review dashboard: where you lose marks and which GMC principles need work
Access until 31 March 2027
Secure payment by Stripe
FAQ

Frequently asked questions

Still have questions? Email support@msrapractice.co.uk.

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.

Ten scenarios, marked properly, in the next fifteen minutes.

No account, no card. See how the paper is marked and where you stand.