MSRA figures are scattered through NHS England publications, specialty recruitment pages and Freedom of Information responses. The year, recruitment stage and region change what each cut-off tells you, so those details stay beside every figure below.
Every pre-2026 cut-off below came from a pooled applicant cohort before the Medical Training (Prioritisation) Act changed recruitment; under tiering, recruitment may never reach a non-priority applicant's tier even when the score is high, as the Prioritisation Act guide explains.
A score of 500 is a standardised result
You may receive a different set of questions from another candidate. An equating model adjusts for differences in difficulty, then the equated scores are standardised together. NHS England described that sequence in its 5 March 2024 response, FOI-2402-2070000. The GP MSRA guidance and the Neurosurgery 2026 FAQ state that scores have a mean of 250 and a standard deviation of 40 for each paper.
The FOI says that "standardisation is based on the whole cohort, but most specialties take account of the score distribution for only their applicants when making decisions." There is no published ceiling, and combined scores in the 600s have been observed. Primary sources do not establish that the same score has an identical meaning across specialties.
Published score floors and weightings differ by specialty
Core Psychiatry CT1 requires at least 186 raw marks in each paper for you to be appointable. A stronger paper cannot compensate for one below that floor.
GP uses four bands and treats Band 1 in either paper as unsuccessful. The table reproduces NHS England's published 2026 Round 1 distribution for GP applicants. It shows where your component scores sat within that GP cohort but does not provide a universal conversion for other specialties.
| Standardised score | CPS applicants | CPS band | PD applicants | PD band |
|---|---|---|---|---|
| Below 170 | 2% | 1 | 3% | 1 |
| 171-185 | 2% | 1 | 4% | 1 |
| 186-210 | 7% | 2 | 15% | 2 |
| 211-230 | 9% | 2 | 21% | 2 |
| 231-250 | 13% | 3 | 22% | 3 |
| 251-270 | 19% | 3 | 19% | 3 |
| 271-290 | 24% | 3 | 12% | 3 |
| 291-310 | 20% | 4 | 4% | 4 |
| Above 310 | 4% | 4 | 0% | 4 |
The 185/186 boundary is consistent with Psychiatry's published floor, though the two specialties make their own selection decisions. It is an appointability threshold. Securing an offer would normally take more.
For O&G ST1, the top 75 candidates by total MSRA bypass interview, with CPS and then PD used as tie-breakers. For the remaining candidates, the MSRA supplies 50 of 150 final points, or 33.3%, split into 0-25 points per paper.
The 2026 Neurosurgery FAQ described a model explicitly different from earlier years. MSRA made up 40% of shortlisting, scored 0-48, while online shortlisting supplied 60%, scored 0-76. The FAQ gives a shortlisting total of 120 even though the printed component ranges end at 48 and 76, so the figures here remain as published. Shortlisting then counted for 30% of final selection and the selection centre for 70%.
For Clinical Radiology ST1, a March 2023 HEE FOI response put the MSRA at 40% of the final selection score. The current process uses the MSRA for shortlisting only, so that older weighting is no longer a target.
FOI cut-offs record different recruitment stages
NHS England's 28 January 2026 response for August 2025 Anaesthetics and ACCS Anaesthetics, FOI-2601-2295283, reports both interview cut-offs and the lowest score offered. The two figures describe different stages.
| Recruitment area | Applicants | Interview cut-off | Lowest score offered | Lowest rank offered |
|---|---|---|---|---|
| England and Wales | 5,845 | 560 | 434 | 673rd |
| Northern Ireland | 226 | 553 | 554 | 32nd |
| Scotland | 690 | 537 | 537 | 78th |
The England and Wales figure of 434 is below the stated interview cut-off of 560. NHS England's footnote says the cut-off excludes candidates guaranteed an interview under the Disability Confident scheme, as long as they meet the minimum required score in the MSRA. That exception route explains how a lower value can appear but does not identify the individual case. Across the recruitment, interview capacity was 1,252; 661 offers were made for 539 posts.
The Core Surgical Training response reports a different set of measures. NHS England's 13 January 2026 response, FOI-2512-2288981, gives 1,151 national interview invitations and regional lowest raw MSRA scores associated with a post. Where supplied, the regional scores include upgrades.
| Region | Lowest raw MSRA | Region | Lowest raw MSRA |
|---|---|---|---|
| East Midlands | 538 | East of England | 482 |
| Kent, Surrey and Sussex | 534 | London | 539 |
| North East | 540 | North West | 494 |
| South West | 505 | Thames Valley | 502 |
| Wessex | 539 | West Midlands | 538 |
| Yorkshire and Humber | 538 | Scotland | 538 |
| Wales | 538 |
The CSV also labels 413 as the "Highest MSRA invited" and 629 as the "Lowest". Those labels appear swapped, so they are reported as received. The 66-72 values elsewhere in the file are composite MSRA, portfolio and interview totals; comparing them with the raw MSRA figures above would mix different scales.
For Core Psychiatry's August 2025 intake, FOI-2508-2247866 reports 531 as the lowest score with an accepted offer, in West Midlands, Northern Ireland and Greater Manchester. The highest observed offered score was 634 in Scotland North. Cells involving five or fewer applicants were redacted under section 40 of the Freedom of Information Act; the FOI page carries the full deanery table if you're comparing locations.
Competition ratios rose from 2023 to 2025
The next table uses NHS England's official 2023, 2024 and 2025 Round 1 figures. Each cell shows applications divided by posts. These are application ratios, so one doctor applying more than once can appear in more than one specialty.
| Specialty | 2023 | 2024 | 2025 |
|---|---|---|---|
| General Practice ST1 | 2.67 (10,514/3,935) | 3.67 (15,036/4,096) | 4.91 (20,995/4,276) |
| Core Psychiatry CT1 | 4.98 (2,610/524) | 9.45 (4,650/492) | 21.83 (10,677/489) |
| Clinical Radiology ST1 | 8.77 (3,068/350) | 11.92 (3,719/312) | 11.27 (4,011/356) |
| Ophthalmology ST1 | 9.91 (971/98) | 14.41 (1,383/96) | 21.54 (2,197/102) |
| O&G ST1 | 4.32 (1,347/312) | 7.00 (2,170/310) | 16.65 (4,945/297) |
| Core Surgical Training CT1 | 4.17 (2,539/609) | 5.25 (3,384/645) | 8.57 (5,399/630) |
| Anaesthetics CT1 | 4.78 (2,604/545) | 6.50 (3,522/542) | 12.56 (6,770/539) |
| ACCS Emergency Medicine CT1/ST1 | 4.99 (1,803/361) | 7.57 (2,718/359) | 14.23 (5,081/357) |
| CSRH ST1 | 34.00 (272/8) | 25.61 (461/18) | 98.50 (1,379/14) |
| Neurosurgery ST1 | 12.75 (255/20) | 19.67 (354/18) | 26.71 (561/21) |
Every specialty in the table had a higher ratio in 2025 than in 2023, but 2026 cannot be added as another like-for-like column. After the Act, NHS England published aggregate figures: 33,953 appointable applications for 9,315 posts, about 4:1 overall, and 16,066 prioritised applications, about 2:1. Priority candidates filled 98% of posts, up from 72% in 2025. Non-prioritised applicants accounted for 1.80% of accepted Round 1 offers to date, 163 compared with 2,168 the year before. NHS England notes that the impact article has already been corrected once to match management information as at 27 May 2026. The 163 and 1.80% figures may change as the data are updated.
NHS England has not published a specialty-level 2026 competition-ratio table, so the tiered aggregate cannot supply the missing specialty cut-off.
Several specialties still lack a verifiable cut-off
At the time of writing, verifiable cut-offs were still unavailable for Ophthalmology, CSRH, Nuclear Medicine and Broad Based Training.
The 2024 Ophthalmology FOI PDF could not be read reliably, while a promised 2025 release was absent from the response. The GP August 2025 regional score download could not be checked, and the pre-2024 Anaesthetics trend no longer exists in Oriel: NHS England's FOI response says the older data had been deleted under its retention policy. Nuclear Medicine has a 2023 ratio of 17 applications for eight posts, but no 2024 or 2025 figure was found; BBT ratios were also absent.
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Questions about using these figures
What score do you need for your specialty?
It depends on the year, region, recruitment stage and your priority tier. Published figures include 186 per paper for Psychiatry appointability, 531 as its lowest accepted 2025 offer, Anaesthetics interview cut-offs of 537-560 by nation, and the CST regional figures above. None is a promise for 2027.
Is there one pass mark you need to clear?
There is no single pass mark covering every specialty. Psychiatry requires 186 raw in each paper. GP rejects Band 1 in either paper, with Band 2 beginning at 186 in its published 2026 table. Other specialties use the score for shortlisting or as a weighted part of selection.
Why might you see different cut-offs in different regions?
Available posts, applicant preferences, upgrades and the selection model can all change the lowest score that eventually receives a post. A regional lowest offer records the outcome of that recruitment round. There is no centrally fixed pass mark behind it.
Can you still use old cut-offs after the Act?
No. A historical cut-off describes a pre-tiering cohort, so it cannot promise that the same score will reach the same stage in 2027. The current recruitment rules for your specialty and priority tier are the basis for a 2027 target.