Kraig Jamieson

As a Foundation Year 2 Doctor aspiring to train in Ophthalmology, the MSRA represents one of the first major hurdles on the path to specialty training. While it might feel like “just another exam,” success here is crucial. It opens doors to interviews and ultimately gives you a real chance of entering this competitive specialty. Beyond portfolio points, preparing for the MSRA helps you consolidate a breadth of medical knowledge that will serve you throughout your career.

I’ll be honest: sitting the MSRA can be intimidating. It tests not only your clinical knowledge but also situational judgement, problem solving, and applied reasoning across a wide spectrum of medicine. Looking back, my reflection is simple: it’s challenging, but entirely manageable if approached strategically. Here, I want to share how I prepared, the resources I leaned on, and the importance of community. I hope it helps other junior doctors, medical students, or early-career clinicians eyeing Ophthalmology.

Start Early: Respect the Scope of the MSRA

One piece of advice I received from multiple peers was simple: start early and be consistent.

The MSRA spans:

• Core clinical knowledge across all major specialties (medicine, surgery, paediatrics, psychiatry, etc.)
• Clinical reasoning and scenario-based questions
• Situational judgement tests assessing professionalism, ethics, and decision-making

This breadth makes the exam particularly challenging. One question might test the investigation of a red eye; the next could involve managing an acute medical deterioration on the ward. Preparing adequately requires months of structured revision, not just last-minute cramming.

I allocated approximately four months of preparation, ramping up intensity in the final few weeks. Early preparation allowed me to understand concepts, identify weaknesses, and integrate my learning into practical clinical reasoning.

Choosing the Right Resources

With such a vast syllabus, it’s vital to focus on high-yield, concise resources rather than attempting to cover everything superficially. I personally would not recommend physical textbooks. They are too long, cover too many topics, and make it easy to get lost in unnecessary detail. Instead, I used the PassMedicine textbook, which provides clear, concise notes on all topics relevant for the MSRA. It condenses information into digestible sections and links knowledge directly to multiple-choice questions, which makes revision much more efficient.

Online Question Banks

One of the most important lessons I learned was don’t rely on just one question bank. I used multiple platforms, including:

• PassMedicine eMSRA bank – extensive questions with detailed explanations
• MCQ Bank – my favourite; the style and reasoning were very similar to the actual exam questions
• Pastest – useful for supplementary practice and coverage of less familiar topics

I found that using multiple question banks was essential. Each had slightly different strengths: some offered thorough explanations, others focused on speed and applied reasoning. MCQ Bank stood out because it closely mirrored the MSRA format and difficulty, which helped me feel confident when I sat the real exam.

My Results as Reference

For context, I scored well above the cut off for interview last year – with an even split between clinical and SJT – just 1 point higher in the clinical component. This reflected the fact that, while question banks were excellent for clinical knowledge, they struggled to replicate the nuance of the SJT. For SJT preparation, I relied primarily on official past papers and the Oxford Handbook of Clinical Medicine, which I found better aligned with real exam scenarios compared to the question banks – but do not neglect the practice. Although question banks scenarios did not reflect the actual exam, the tips I picked up from doing them were implementable in the exam.

Leverage Your Peers: This Is Not a Dog Fight

A huge mistake I see many junior doctors make is trying to tackle the MSRA entirely alone. One of the best lessons I learned is that studying with peers is not competition — everyone has their own speciality interests and strengths. If you work together, your colleagues will often explain concepts more clearly than you can manage alone.

I joined a study group of FY2s and Clinical Fellows. Each member brought their own strengths – some had recently rotated through paediatrics, others excelled in surgery, and some were strong in ethics and SJT-type questions. Sharing knowledge in this way allowed us to cover far more ground efficiently than any individual could. It also helped maintain motivation and reduced the isolation that comes from long periods of intense study.

We used active recall and peer teaching techniques:

1. Each member summarised a topic from recent revision
2. We discussed sample scenarios together
3. Gaps in knowledge were addressed collaboratively

This approach not only reinforced memory but also simulated the applied reasoning required in the exam. Teaching others forced me to articulate reasoning clearly, strengthening understanding and retention.

Other Practical Tips That Worked for Me

1. Simulate the Exam – practice under timed conditions to build stamina and identify weak areas
2. Focus on Weak Points Early – breadth matters, but missing core topics can be costly
3. Use Situational Judgement Wisely – review GMC guidance and professional standards; think practically, not hypothetically
4. Balance Clinical and Ethical Knowledge – ophthalmology cases appear, but general medicine scenarios dominate
5. Accept Imperfection – no one knows everything. Identify gaps, learn from mistakes, and keep moving forward
6. Use Multiple Question Banks – different banks reinforce knowledge, cover more ground, and expose you to varied question styles
7. Prioritise Concise Notes – avoid large textbooks; rely on resources like PassMedicine for clear, structured, and exam-focused revision

Conclusion

Taking the MSRA seriously as an FY2 is a strategic and rewarding step. It’s more than a hurdle; it’s a way to consolidate knowledge, refine clinical reasoning, and prepare for the realities of Ophthalmology training. With consistent planning, high-yield resources, active study, and the support of peers, success is achievable.

For any junior doctor aiming for Ophthalmology, the message is simple: start early, focus smart, practice relentlessly, leverage your peers, and avoid overloading yourself with long textbooks. The MSRA is tough, but it can be conquered, and it’s worth every ounce of preparation.

References

1. Roediger HL, Butler AC. The critical role of retrieval practice in long-term retention. Trends Cogn Sci. 2011;15(1):20–27
2. Bargh JA, Schul Y. On the cognitive benefits of teaching. J Educ Psychol. 1980;72(5):593–604
3. GMC. Good Medical Practice. General Medical Council; 2024. Available from: https://www.gmc-uk.org/professional-standards/good-medical-practice-2024