Top 5 Strategies to Boost your SJT Score in the MSRA Professional Dilemmas Exam
📕 Strategy 1: Use the Official Past Papers like a Pro
The official past papers are the best resource you have when preparing for the Professional Dilemmas Paper. Make sure that you make the most of these limited but crucial resources by following the steps below:
⏱️ Step 1: Exam Conditions – For Every Repetition
Sit each set of questions under timed conditions. This develops your exam technique and optimises timings. It also means that you actively engage with questions and provide an answer before reviewing the rationales to determine where you went wrong and why. The FY2 paper is only available as a PDF with rationales included. So here is a version with questions only (please note that this paper was created to help people revise for the scrapped Situational Judgement Test (SJT), rather than the MSRA).
🔎 Step 2. Take a deep dive into each question’s rationale
After each round, go back and review the GMC-style justifications. Don’t just read the answer – understand the reasoning. Ask yourself: If you got it wrong, why did you rationalise it that way? Why was that not the best way for this specific scenario? Can you find out how this relates to GMC guidelines, such as Good Medical Practice?
🧠 Step 3. Challenge the Logic – Then Reconstruct It
If something doesn’t sit right, don’t skip over it.
✔️ Re-read the scenario
✔️ Compare it to similar questions
✔️ Ask: What subtle factor tipped the scale?
🔄 Step 4. Repeat, Repeat, Repeat
Follow your study schedule to repeat the paper at spaced intervals. You will recall some of the questions and score higher on subsequent reviews, but it is still a valuable exercise. With successive repetition, you will start to understand the rationales on a deeper level, relating them to different questions that you have recently completed.
🎉 As a bonus, see below the official FY2 SJT paper with the rationales removed, ready for you to review under exam conditions:
🪜 Strategy 2: Use a Stepwise Approach to Ranking Questions
We have developed a tried and tested strategy for rationalising ranking questions that maximises your chances of scoring highly on the ranking section:
- Identify the core issue or the root cause: First identify the core issue or the root cause of the issue outlined in the scenario. Once you have identified the central issue or the root cause you can judge the proposed answers based on whether they address this or not.
- Rank the best option in place first: If you can correctly identify the best and worst options, because of the way that the questions are marked, the lowest you can score on the question in 16/20. Therefore, once you have identified the core issue, identify the best option. This will be the answer which addresses the core issue in the most DIRECT and TIMELY manner.
- Next, identify the worst option: Once you have selected the best option, find the worst answer. You can identify the worst option if it directly contradicts GMC Guidelines or ignores the core issue completely.
- Sort the middle pack into ‘Somewhat Appropriate’ and ‘Somewhat Inappropriate’: This is the hardest bit. Applicants often compare the middle pack to each other instead of judging them as individual answers, which looses you marks. A useful way to approach it is to assign ‘Somewhat Appropriate’ and ‘Somewhat Inappropriate’ labels to these answers which are left. A ‘Somewhat Appropriate’ answer often aims to address the core issue in the scenario but has a detracting factor. This may be that it lacks an element of empathy, directness or diplomacy. In contrast, the ‘Somewhat Inappropriate’ answer is a fundamentally inappropriate way to address the scenario but still has a positive aspect: such as addressing a secondary issue or attempting to work towards a solution, but in a inappropriate way.
- Sense Check: Sense check your answers against the scenario. Again, avoid comparing the options to one another, instead ask yourself: Does my first option address the core issue in a direct and timely way? Does my last option go against a GMC principle or add nothing to solving the main issue? In the middle pack, do the more appropriate options focus on the core issue with a minor detracting factor?
MedicRecall Ranking Flow-Chart
🍐🍐 Strategy 3: The ‘Pairing Off’ Technique for Multiple Choice Questions
Multiple Choice Questions involve picking three out of eight possible actions which, when done TOGETHER, solve the scenario in the most appropriate way.
The Paring off technique is where you ‘pair off’ two options which target the same part of the scenario and wouldn’t make sense if you did both of them together. Once you have a pair, you can then eliminate the least appropriate option.
For example, in the scenario where you are asked to give a medical update to a family member, if there are two options to ‘update the family member yourself’ and ‘ask the nurse looking after the patient to update the family’, only one of these can be part of the correct answer. Therefore, you can eliminate the least appropriate option in the pair.
Once you have done this, you can choose from the remaining options which TOGETHER should address the scenario in the most direct and timely way.
Learn more about using the Pairing Off technique and stepwise approach to ranking questions in our complete MSRA exam guide below…
🎯 Strategy 4: Pay attention to the verbs!
During your practice, study how commonly used verbs can dictate how questions are rationalised. For example, an answer that uses the verb ‘Tell’ is rationalised differently compared with the same answer which uses the verb ‘Ask’. How this affects the appropriateness of the answer will depend on the scenario. However, being alert to the importance of verbs when ranking answers when you practice will help you uncover hidden trends. This means you will be able to more consistently align with how the examiners rationalise questions in the exam.
🧐 Strategy 5: Stick close to the vignette
Immerse yourself in each scenario
In order to score highly on the Professional Dilemmas Paper, you need to be able to pick up on subtle aspects of the scenario. If you can imagine yourself being the doctor in each question, you will find it easier to pick up the subtle aspects of the scenario. When revising, practice like it’s game day: try fully immersing yourself in each mock question. It becomes mentally tiring to do this for each question, but building up mental stamina is half the battle!
Avoid making Assumptions
Avoid make assumptions or jumping to conclusions when studying the vignette. Watch out for scenarios where is seems likely that your colleague is acting inappropriately but assuming this and escalating without gathering more information is a poor option.
Don’t repeat what has already been done.
It can be easy to forget certain parts of the vignette after you finish reading it and move looking through the possible answers. Make sure that you avoid ranking highly options which have already been attempted in the vignette. They may otherwise be an appropriate choice, but if it has already been attempted, it is unlikely to work when tried again.
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