Core Revision
MSRA for Core Surgical Training: the top-1,200 gate explained
Core Surgical Training has a selection quirk that catches people out every year: the MSRA is worth only 10% of your final score, but without a top-1,200 MSRA finish you never get to score the other 90%. In the 2026-entry cycle, only the top 1,200 MSRA scorers were invited to interview and portfolio upload — from 5,399 applicants the year before. Here is how the pieces fit, checked against NHS England’s core surgery recruitment pages on 29 August 2026.
How CST uses your MSRA score
| Stage | How it worked (2026 entry) |
|---|---|
| Shortlist gate | Top 1,200 MSRA scorers invited to interview and portfolio evidence upload |
| Portfolio | Index pages uploaded (16–26 Feb window in the last cycle), scored at a 15-minute interview station |
| Interview | Two 15-minute online stations (portfolio; management and clinical) |
| Final ranking | MSRA 10% + portfolio station 45% + management & clinical station 45% |
Sitting the MSRA? See where you stand.
Try twenty original MSRA questions, ten Professional Dilemmas and ten Clinical Problem Solving, marked on the near-miss principle NHS England describes. Free, no card and the first five are open to all.
So the MSRA plays two different games. As a gate, it is brutal — the cut-off is wherever the 1,200th-ranked score happens to fall, and no official figure is published. In the final rank, it is a tie-breaker-sized 10% that can still separate close candidates. The practical read: prepare to clear the gate comfortably, because a portfolio you have spent years building is worth nothing from 1,201st place.
The exam itself
One computer-based sitting, 170 minutes, two papers, identical for every specialty that uses it:
| Paper | Time | Format |
|---|---|---|
| Professional Dilemmas (sat first) | 95 min | 50 situational judgement questions — ranking and multiple-choice |
| Clinical Problem Solving | 75 min | 86 questions across the breadth of general clinical practice |
There is no surgery in it. The CPS paper is broad foundation-level medicine — the applicants it punishes hardest are the ones who have optimised their clinical time for theatre and let general medicine drift.
Which window you sit
In the 2026 cycle the January window (6–19 January) covered every MSRA specialty, with February reserved for GP and Core Psychiatry only. CST applicants sit in January — peak your revision for early January.
Dates for 2027 entry
Round 1 applications for 2027 entry run 22 October to 19 November 2026, and the January 2027 MSRA window is published (5–20 January 2027, invitations 14 December 2026). The CST-specific dates are still to come; in the last cycle portfolio upload ran mid-February and initial offers landed on 24 March. Our MSRA 2027 dates tracker is updated the day NHS England publishes.
A note on competition
CST drew 5,399 applications for 630 posts in 2025 (8.6 per place). Those figures pre-date the Medical Training (Prioritisation) Act, in force since March 2026: NHS England reported effective competition roughly halved in the 2026 round, with 98% of posts going to priority applicants, and prioritisation will apply at both the shortlisting and offer stages for 2027; NHS England set out the rules in September 2026, with a Round 1 prioritisation review deadline of 5pm on 24 November 2026.
How to prepare
The gate is the game — and the gate is a generalist exam:
- 500 original Professional Dilemmas scenarios across the three competencies the PD paper tests
- 1,700+ Clinical Problem Solving questions across the CPS topic areas (a core written for the MSRA, the rest Foundation-level clinical questions shared with our AKT bank)
- Full timed mocks of both papers, built to the real timings
- Guideline-linked explanations on every question
Explore the MSRA question bank · Plans & pricing
Prefer to start free? Our open Ethics, Law & Safeguarding guide covers the professional-practice ground the PD paper leans on — no account needed.
Frequently asked questions
What MSRA score gets you a CST interview?
There is no published cut-off — invitations go to the top 1,200 scorers, so the bar is set by the strength of the field each January. That is precisely why you prepare to beat the field, not a number.
Does the MSRA matter once I am through to interview?
Yes, but modestly: it carried 10% of the final score in the 2026 cycle, against 45% for the portfolio station and 45% for the management and clinical station. Its main work is done at the gate.
Is there surgical content in the MSRA?
No. It is a situational judgement paper plus a broad clinical paper at foundation level. Your surgical knowledge is examined at interview and in your portfolio, not here.
Related
- The MSRA question bank
- MSRA 2027: dates, format and what is confirmed
- January vs February sitting: who sits when
- MSRA for Radiology
- MSRA for neurosurgery, CSRH and nuclear medicine
Checked 29 August 2026 against NHS England’s Core Surgical Training recruitment pages and 2025 competition-ratio data. Selection processes change between cycles — always verify against the current applicant guidance for your cycle before relying on any figure here.
