So you want to be a GP?

That’s good news because the UK needs a lot of GPs (general practitioners).

The UK application system for General Practice runs nationally, twice a year. Each academic year runs from Autumn to the following Autumn, within which there are 2 application cycles. Here we’ll break down exactly how to apply for General Practice training in the UK: from eligibility criteria, preparation, application process, tests, and offers.

How to Apply for General Practice Training (GPST1) in the UK

Eligibility

You are eligible for UK GP if you fulfill the “Persons Specification” criteria.

You must have the following conditions met:

• MBBS or equivalent
• Full GMC registration with license to practice by the intended start date
• Have evidence of achievement of foundation competences, in the three and a half years preceding the advertised post start date for the round of application
• 12 months experience after full GMC registration or equivalent, and evidence of achievement of foundation competences at time of application*
• Be eligible to work in the UK
• Hold a current and in date valid driving licence or provides an undertaking to provide alternative means of transport when providing emergency and domiciliary care to fulfil the requirements of the whole training programme
• Advanced Life Support Certificate from the Resuscitation Council UK or equivalent
• Demonstrable skills in written and spoken English, adequate to enable effective communication about medical topics with patients and colleagues, as assessed by the General Medical Council**

*If you completed F1 and F2 in the UK, then you just upload your FPCC. If you did not, you will need to complete an Alternative Certificate of Foundation Competence and attach this to your application instead. You can download a copy here.

**If you have been granted GMC registration with license to practice this means the GMC has deemed your English ability sufficient.

You’ll find more detailed information including eligibility FAQ in the Get Into General Practice eBook.

GP Training Pathway

The Diagram above represents the General Practice training pathway for a UK medical graduate. Overall it takes 5 years from medical school to become a GP. For foreign medical graudates or those transferring from a different system it’s somewhat different. You’ll find details of the pathway for foreign medical graduates in the Get Into General Practice eBook.

The Application to GPST1

There are 11 sections to the application which is done via Oriel:

1. Personal Information
2. Eligibility
3. Fitness
4. References
5. Competences
6. Employment
7. Evidence
8. Supporting Documents
9. Preferences
10. Equality
11. Declarations

There are screenshots of every application page including details on all the information you need to provide in the Get Into General Practice UK eBook, including  a Step-by-Step application check-list.

If you are deemed eligible after your application is submitted, then you are automatically long-listed and invited to the MSRA exam. Long-listing is not merit based,  but simply used to exclude ineligible candidates.

The General Practice (GP) Application Cycle

Each year has 2 rounds of applications that run as following:

Round 1: August – August, Applications from preceeding November 7th. If August start positions are not all filled then there will be a Round 1 Re-Advert in February.

Round 2: February – February, applications from preceeding July 19th.

Important dates for the current and next recruitment round can be found here.

Round 1 versus Round 2 GPST1 Applications

There is an important distinction between Round 1 and Round 2 application cycles:
The vast majority of UK applicants apply in Round 1, as they’ll have just finished the FY2 years and will carry on directly from that. Even UK applicants who take a year out, colloquially known as “F3 Year” tend to take a full year rather than 6 months so they also apply for the following Round 1 start in August.

What does this mean for you? Well, the following:

• There are many many many more jobs available in Round 1*…
• but there is also much more competition.
• Since most people start in August (Round 1 cycle) by starting a new job in February you’ll be “out-of-sync” with most of your colleagues.

Being “out-of-sync” has certain social disadvantages. For insance it may make it more difficult to make friends, as they’ll have started 6 months ago and move on in 6 months.

*As an example for how few jobs there are available in Round 2 compared to Round 1, in the current year Round 2 application cycle there are 10 jobs available in the London area. In Round 1 there were  459 vacancies. 10 vs 459.

The Multi-Specialty Recruitment Assessment (MSRA)

The MSRA is a computer exam used to short-list eligible candidates. You can read the official information about the MSRA here. But there is a lot you need to know about the exam that isn’t on that official information page.

How to register for the GP MSRA

Once your application has been deemed eligible you’ll receive a notification via Oriel at 11:00 am on the advertised date to invite to you register for the exam. You’ll also receive an email like the one below. Then you must go to the Pearson website and register for the exam yourself. Do this quickly because there are usually few exam slots available and they’re first come first serve. There will usually be slots on the weekend as well as during the week, and unsurprisingly most weekend slots will go within minutes of the email.

TIP: If you have very limited times or dates when you can take the exam, I recommend setting an alarm for  just before 11am on the announcement date, so that you are logged into your Pearson account waiting and ready book as soon as the email comes through.

Where to take the GP MSRA

The exams are undertaken at Pearson Testing Centres internationally, and it is possible to sit this exam outside the UK. You simply need to indicate this in your application, then you can attend the exam at your local testing centre and book as normal.

MSRA Exam Structure

The exam lasts 192min – that’s a really long time. And NO, that does not include breaks.

There are no scheduled breaks during this exam. You will be permitted to take your own unscheduled break with the clock ticking.

Two Sections of the Exam are as follows:

Paper	Length / Time
Professional Dilemmas (PD)	110 minutes / 58 Questions
Clinical Problem Solving (CPS)	75 minutes / 97 Questions

Note that you have more time to complete fewer questions in the professional dilemma section than in clinical problem solving. It works out to as follows:

Paper	Time/Question
Professional Dilemmas (PD)	1 min 53 seconds / Question
Clinical Problem Solving (CPS)	46 seconds / Question

The reason you’re given so much time during the professional dilemma questions is because there is usually more text in each question, allowing you more reading time, but also because its not a test of knowledge, rather a test of your guiding principles, so penalising you for running out of time is not in their best interests in assessing this.

Whereas clinical dilemma questions section is a knowledge/aptitude test, where time limits are important. I high recommend you practice questions with a timer to reflect actual time pressures on the day. In the Get Into General Practice UK eBook I’ve included a few mini practice papers with accurate time limits that I recommend you take under the recommended conditions to get used to the timing.

MSRA scoring

Something many people don’t know, is that you don’t receive one overall score for your total performance on the MSRA, but both sections, the Clinical Problem Solving and Professional Dilemma are scored separately.

You must pass both sections to pass the MSRA and be short-listed.

This means if you perform amazingly in the clinical problem solving section but perform badly in the professional dilemma section you will be unsuccessfull in your application to General Practice.

The Direct Pathway to GP Training

Think of this as a short-cut to GP training offers for the gifted. If you score above 575 in the MSRA you will not need to attend any further selection and will be offered a training post of your choice. This number was chosen as a cut-off to represent the top 10% of the applicants. The cut off for both rounds is the same, so for example if nobody applying in a Round 2 scores above 575 then the cut off is not lowered to capture the 10%, instead nobody will be offered the direct pathway.

Preparing for the GP MSRA

When you are studying and preparing for the exam a very common mistake is over-emphasis on one section: candidates often either spend the majority of their time studying clinical medicine, or vice versa. This is a huge mistake, as you need to view these two sections as separate exams and study for BOTH of them.

STUDY TIP#1:
If you are from outside the UK or have not worked in the UK hospital before, I highly recommend you familiarise yourself with commonly used words in the UK hospital environment. During the exam there will be a small icon on the bottom left of the screen labelled “Glossary”. You’ll be able to open a glossary that explains commonly used words that UK-based applicants will easily understand but may not be clear to foreign applicants. In the Get Into General Practice UK eBook I’ve included a small glossary of many such terms that you should familiarise yourself with so that you don’t waste valuable time during the exam clarifying terms.

STUDY TIP#2:
The MSRA is used not only for GP recruitment but also for Clinical Radiology, Ophthalmology, Neurology, and Psychiatry. As a result, the exam will aim to include general clinical information relevant to all these specialties. Focus on revising topics that are likely to come up in General Practice and the above specialties! I’ll include some more tips on heavily tested topics in the Get Into General Practice UK eBook.

I cannot stress how important it is to do practice papers against real time pressures. One of the BIGGEST reasons for underperformance on the MSRA is not lack of studying or revision but loss of stamina or tiredness during the exam. This happens if you’re not used to the pace at which you have to keep answering the questions. At home it might be easy to do 50 practice questions in your own pace with a cup of tea and some biscuits, but in the exam setting doing 50 questions with no pause, no break, no moment to catch your breath is mentally exhausting.

Do practice tests so you know what to expect.

They don’t have to be full-time practice tests, just “accurate time”. Allow yourself the same amount of time per question as the MSRA.

Re-applications to GPST1

If you underperformed in the MSRA, depending on the round you’re applying, you can either take the exam again and apply next round, or you may have to wait a year:

• If you applied in Round 1 (August start) and failed the MSRA -> You cannot reapply in Round 2 (February start), you have to wait for Round 1 the following year.
• If you applied in Round 2 (February start) and failed the MSRA -> You can apply in the next round, which will be Round 1 the ‘following academic year’.

I hope that was helpful!

Now all that’s left is to study and prepare! The Get Into General Practice UK eBook will be helpful for those sitting the MSRA or applying for GPST1 for the first time. It will be particularly helpful for foreign medical graduates, who I highly recommend spending some extra time familiarising yourself with UK systems and terminology.

Good luck!