Joint message from Medical and Dental Recruitment and Selection (MDRS) Group (UK) and The Joint Committee on Surgical Training (JCST)

Use of MSRA for core surgical recruitment

The move to implement the Multi-Specialty Recruitment Assessment (MSRA) into the Core Surgical Training (CST) 2023 selection process was recently announced. 

We have listened very carefully to the feedback we have received since this news was made public and would like to apologise for the anxiety it caused applicants.   We fully accept that not enough notice was given for such an important change and are committed to learning lessons and to making sure key changes like this are communicated more quickly in future. 

Further information relating to the 2023 core surgical recruitment process can be obtained from the following webinars:

Greater detail on the appraisal of core recruitment and the rationale for change for the 2023 recruitment round will be discussed in webinars on:

31 October 2022 at 6.30pm – Rationale for core surgical recruitment 2023 and MSRA process - watch the webinar on YouTube.

2 November 2022 at 6.45pm – Self assessment process and guidance for the portfolio - watch the webinar on YouTube.


Core surgical training recruitment is aimed at selecting the most able candidates who have an aptitude for and ability to be trained and become competent surgeons.  Recruitment should be a fair, non-discriminatory process that selects the most able candidates based on the above principle.

Drivers for change

The proposal to use MSRA as part of selection for CST was submitted by the core surgery recruitment steering group following an evaluation of the 2022 recruitment round found a significant risk to the deliverability of core surgical selection due to decreases in assessor availability and impact on delivery of clinical services.  Core surgery recruitment has seen a significant increase in applicants from 1690 in 2019 to 2528 in 2022 outstripping the capacity to interview. Shortlisting is therefore needed.  Portfolio verification as a shortlisting tool is very resource intensive. Decreases in assessor availability means that there is a significant risk of not being able to deliver core selection in 2023 if portfolio verification is used again to shortlist.

Alternatives to portfolio verification were explored to continue to evolve recruitment as a fair non-discriminatory process whilst also reducing the impact on consultant time away from clinical commitments.

Evidence for using MSRA   

Just over 1/3 of core surgery applicants over the last 3 years have undertaken the MSRA test when applying to other CT/ST1 entry programmes.  MSRA scores from these applications were compared with the outcome of core surgery recruitment for each of those applicants. There was a statistically significant difference in the mean score for those invited to interview compared to those who were not, in all 3 recruitment rounds assessed (2020, 2021, 2022). MSRA could therefore be safely used as a shortlisting tool and is non inferior to the current portfolio verification for shortlisting.

Further information

MSRA is free to take.

The assessment will be taken in a 2-week window in January 2023 in Pearson VUE assessment centres or online (exact dates to be confirmed). Local equivalent centres can be used by those applying from outside the UK and arrangements will be in place for application from those countries where such assessment centres are not available. Employers are required to release you to take the assessment.

A bank of practice questions will be made available to all applicants. Applicants are advised against paying for practice materials as these have not been written or approved by those involved in the MSRA. 

Hard work to build portfolios will still be recognised and will contribute 30% of the total score for those invited to interview. MRSA itself will contribute 10%, and the remaining 60% will be from the interview.

To ensure that portfolio areas can be clearly evidenced for both UK and international applicants and to improve consistency in assessment, the portfolio will consist of 4 domains in 2023: 

  1. Commitment to surgery
  2. Quality Improvement/Clinical Audit
  3. Presentations and Publications
  4. Teaching experience and Training in teaching

Key changes to the portfolio scoring across all medical training application for 2023 are the omission of the part A membership success, courses, prizes and degrees.  Leadership and management will be assessed at interview via a presentation prepared in advance.  

We know that this can be a stressful time for applicants, and we are committed to doing all we can to support you and make sure you have everything you needed for the best possible outcome.