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The Prescribing Safety Assessment (PSA) is an essential exam that measures the ability to prescribe medications safely and effectively. As an open book exam, students and foundation doctors who sit the PSA have access to the BNF to reference their answers. But with only 120 minutes to answer 60 questions, how do you avoid using up your time to search for answers? In this blog, we explore how to utilise the BNF efficiently without eating up your time.

The Prescribing Safety Assessment (PSA)

The PSA is a two-hour exam that assesses the prescribing skills of early-career doctors. It is a mandatory exam in the UK, meaning foundation doctors must pass in order to progress on to FY2. The exam contains 8 different question styles with varying marks for each. The marks awarded indicate how much time to spend on each question.

What resources are available during the PSA?

As we’ve established above, the PSA is an open-book exam, which means that you will have access to at least one resource to reference your answers. For those sitting the exam in the UK, you will have access to the Medicines Complete BNF, Medicines Complete BNF for Children and the NICE BNF to check your answers.

For students sitting the exam in Ireland or overseas, you will only have access to the NICE BNF, unless your institution has otherwise purchased their own license of the Medicines Complete BNF and Medicines Complete BNF for Children.

How to use the BNF in the PSA

The BNF is a comprehensive guide to prescribing medication in the UK and can be accessed online.

To use the BNF effectively during the PSA, it’s important to understand how it’s organised. The BNF is arranged by drug class, and each drug has a corresponding monograph that provides information on its indications, contraindications, dosages, and potential side effects.

When answering PSA questions, it’s recommended to start by identifying the relevant drug class and then look up the specific drug in the BNF. It’s important to pay attention to any contraindications or warnings that may be relevant to the question at hand and make note of the recommended dosages and administration guidelines.

Additionally, the BNF includes a section on prescribing in special populations, such as elderly patients or those with renal impairment, which can provide useful information for answering questions about medication safety.

The best way to use your time is to confirm answers using the BNF instead of searching for uncertain ones. When revising, you should familiarise yourself with all versions, to ensure you can use either Medicines Complete or NICE to look up your answers.

How can you prepare for the PSA

You can practice using the BNF to reference your answers by making sure to take full advantage of the practice papers available on your official PSA account.

You can also get more information on the exam and how to use the BNF with our free eLearning sessions, PSA Prep, available on the BPS Assessment Learner’s Portal. Or take your revision one step further with our practice papers. For just £40 take our full 60 time paper and two 30-item practice papers!

BPS Assessment has launched a new assessment accredited by the Royal College of Physicians (RCP), UK. The assessment is available for members enrolled on the RCP Assessment and Continued Professional Development (CPD) scheme, which runs from 1st April to 31st March every year.

The new Safe and Effective Prescribing Assessment from BPS Assessment, is a comprehensive 30-item assessment that provides data-rich feedback, giving participants the knowledge and skills necessary to improve their prescribing abilities. It can help professionals assess their current understanding of medicines and treatments while earning 6 CPD points.

The assessment can be taken online via the BPS Assessment learners portal and is accessible any time and from any location, meaning it’s a really convenient resource for busy healthcare professionals looking for ways to add points to their CPD diaries.

CPD is a cornerstone in the development and maintenance of valid and reliable clinical practices. Through completing CPD training, healthcare professionals can stay up-to-date with the latest research, technologies, and best practices in their field. This ongoing learning helps healthcare professionals to adapt to the constantly evolving healthcare landscape and provide the best possible care to their patients.

Nowhere is this more relevant than in prescribing, where new drugs are continually added to the market and an ageing population sees more individuals suffering from chronic illnesses which require different medications and careful monitoring and higher rates of polypharmacy. In providing a new CPD accredited assessment, we hope to support clinicians at all stages of their careers, allowing them to identify areas for improvement, enhancing their knowledge and skill and which we hope will ultimately lead to improved patient outcomes.

Find out more
Get ready to bring your prescribing knowledge up-to-date. Get your 6 RCP accredited CPD points by completing our Safe and Effective Prescribing Assessment. Visit our webpage now, to get access!

The PSA is an integral part of the medical education programme in the UK, a mandatory exam that all foundation doctors have to pass in order to progress. So as a student, it’s understandable to have a lot of questions about what to expect when taking the PSA. In this blog, we look at some of the commonly asked questions among those preparing to sit the PSA exam.

What is the pass mark of the PSA?

The Modified Angoff method of standard setting is used to establish the pass mark for the PSA. However, the exact pass mark is not disclosed before the test as adjustments may be necessary to account for variations in difficulty between papers, as well as any issues with items identified after the test has been taken. The Standard Setting Group, which is made up of assessment experts from UK medical schools and representatives of the MSC Assessment Alliance, defines the passing standard for each question.

How long is the PSA exam?

The standard length of the PSA is 120 minutes but this may vary depending on whether you are entitled to reasonable adjustments. Reasonable adjustment measures should be in line with what is in place at your medical or foundation school.

Do I get a calculator in the PSA exam?

Yes, a basic (non-scientific) calculator is allowed in the exam. You will have access to an online calculator that’s built into the PSA assessment, it’s available in the dashboard at the top of the screen during the exam.

Is the PSA an open book exam?

Yes, the PSA is an open book exam. You will get access to both the Medicines Complete BNF (if based in the UK) and the NICE BNF to reference their answers. No other resources except for the BNF are allowed, and from 2024 no paper copies of the BNF are allowed in the exam room.

When should I download my PSA certificate?

PSA certificates are available once your results have been released. You should download a copy of the certificate as soon as it’s available from your results dashboard and save a copy locally to your device. It’s also recommended that you save a copy in a cloud storage system or on a hard drive so that you can access this should anything have to your device.

How do I study for the PSA exam?

There are lots of resources available to help you prepare for the PSA exam. We’ve put together a list to help you with your revision.

1. Take advantage of the PSA practice papers available on the official PSA website. You should get access to the platform 1 month before sitting the assessment.
2. PSA Prep – a set of free eLearing resources from BPS Assessment each eLearning session covers the 8 different question items which make up the assessment. They give a thorough account of what to expect from which of the questions styles including how to approach the questions, where marks are awarded and suggestions on how much to spend on each question.
3. Prescribing Practice Papers – take your revision one step further with the practice papers available for BPS Assessment. Paper 3 is designed to be a full-length practice exam, with 60 question items, where you can time yourself over 2 hours.

Choose from our selection of free and paid resources and get practicing for your prescribing exam. Visit the BPS Assessment portal shop.

So you didn’t pass the Prescribing Safety Assessment exam on your first sitting. What do you do now? 

Firstly, don’t panic! You’re not alone, PSA resits are really common, and there are lots of ways you can maximise your chance of success next time around. Let’s go through 4 easy steps you can take to prepare yourself for your resits.

 

1. Make sure you know exactly what’s expected of you

The more you know about what’s being marked in each section of the exam, the better you’ll be able to tackle each of the 8 question styles on exam day. The best place to start is with the free PSA Prep sessions. They’ve been created by a team of experts, including the medical director of the PSA, to address common challenges encountered in the exam and help you understand what’s expected of you.

There’s an introductory session as well as one for each of the 8 question styles, helping you understand how marks are awarded for optimal and sub-optimal answers and giving you the confidence you need ahead of resit day to approach the PSA questions confidently and effectively.

 

2. Understand question weightings so you can use your time properly on exam day

Understand the different question weightings so you can use your time most effectively in the exam itself. You don’t want to be spending too much time on a question that’s worth a quarter as many marks as another that you end up neglecting because of the time restrictions! So it’s important that you know how each section of the exam is weighted, and you have a plan on how best to spend your time.

There are 200 marks available in total over the 120 minutes of the exam. If we look at that time broken down across the 8 sections of the exam, we get: 

• Section 1: Prescribing (PWS) is worth 80 marks = 48 minutes
• Section 2: Prescription Review (REV) is worth 32 marks = 19 minutes 12 seconds
• Section 3: Planning Management (MAN) is worth 16 marks = 9 minutes 36 seconds
• Section 4: Providing Information (COM) is worth 12 marks = 7 minutes 12 seconds
• Section 5: Calculation Skills (CAL) is worth 16 marks = 9 minutes 36 seconds
• Section 6: Adverse Drug Reactions (ADR) is worth 16 marks = 9 minutes 36 seconds
• Section 7: Drug Monitoring (TDM) is worth 16 marks = 9 minutes 36 seconds
• Section 8: Data Interpretation (DAT) is worth 12 marks = 7 minutes 12 seconds

You may not want to allocate every single second of the exam, however! You’ll need time to take a breath and reset every now and again, as well as a cushion of time for any unexpected challenges. This is just a starting point.

Again, if you’re still unsure we’d recommend watching the free PSA Prep sessions, as they will talk you through exactly what you can expect from each of the 8 sections of the exam.

 

3. Get really familiar with MedicinesComplete and the NICE BNF

This may sound obvious but you don’t want to be spending lots of time in the exam frantically looking up items in MedicinesComplete when you could be answering questions. We know that the time pressure is one of the biggest challenges for PSA candidates, but it’s there for good reason – it emulates the pressure you’ll be under in real life clinical situations. 

So it’s really worth getting familiar with MedicinesComplete and the NICE BNF so you can use them as efficiently as possible on exam day. In particular, spend time on the ‘treatment summaries’ section of the BNF, which you’ll need to consult if you don’t know the medication required for a particular treatment, as it’s not always immediately obvious where to find particular topics (for example, opioid conversion comes under ‘palliative care’ – if you didn’t know that in advance, you could waste valuable exam time searching).

 

4. Understand your weak spots and work on them… practise makes perfect! 

There’s nothing quite as valuable as real practice time when it comes to exam technique! Chances are that you already made use of the 3 practice papers that you were given access to when you were registered for the PSA exam the first time around. Well, good news! There are 3 further practice papers you can take advantage of, each with automated marking and detailed feedback on optimal and sub-optimal answers, so you can really understand where you’re going wrong and learn how to fix those mistakes. 

You get unlimited practice attempts on each of the 3 practice papers from BPS Assessment, again written by a team of experts, and the format mirrors that of the real exam. 

 

Take a closer look here and get resit-ready! You’ve got this. 

 

Here are our 5 top tips to help you get prepared for your Prescribing Safety Assessment exam.

 

1. Understand the exam format and what’s expected of you

First thing’s first – get really familiar with the structure of the exam and understand what’s expected of you in each of the 8 sections of the PSA. For this, you’ll want to watch the free PSA Prep eLearning sessions, written by experts including the medical director of the PSA

The PSA Prep sessions are especially useful as they deep-dive into the exam format, looking at the layout of each question style, explaining how optimal and sub-optimal answers are marked, and addressing common challenges, like the time pressure and exam calculations. 

There’s one session dedicated to each of the 8 sections of the PSA exam, as well as an introductory session. You can get instant access to these 9 free PSA Prep sessions here.

 

2. Get familiar with MedicinesComplete and the NICE BNF

We know that time pressure is reported to be the biggest challenge for candidates sitting the PSA, so you don’t want to lose valuable minutes trying to navigate your way around the BNF! Both MedicinesComplete and the NICE BNF are available in the exam (depending on your location), so it’s important that you familiarise yourself with both of these resources ahead of time. That way, you’ll be as efficient as possible in the exam itself. 

 

3. Make good use of your PSA exam account 

As soon as you’ve been registered for the exam, you’ll be able to login to your PSA platform account. Read up on the exam, use the information you’ll find there, and complete the practice papers included. 

 

4. Practise, practise, practise

Once you’ve completed the practice papers included with your PSA account, consider broadening your revision materials and investing in more practice papers. You’ll find 3 bonus practice papers exclusively on the BPS Assessment Learner Portal.

These 3 papers offer 120 questions with unlimited practice attempts, so you really can ‘practise til perfect’. They include clear, in-depth feedback on each question style, so you can understand how to tackle the 8 different exam areas. Read through the feedback, assess your weakest areas, and keep on trying until you feel confident!

 

5. Time yourself!  

As we’ve said before, the time pressure is reported to be the biggest challenge for PSA candidates. That’s because the exam simulates prescribing under pressure in the real world. So it’s really important that you understand what it feels like to try answering those 60 question items in 2 hours! 

For that, you’ll need Practice Paper 3, which includes 60 question items and has 200 marks up for grabs, just like the real exam. Set your timer and see how you get on. You’ll soon work out where you’re losing time and which areas you need to focus on in order to make the best use of those 120 minutes (remember that the different sections of the exam are worth a different number of marks, so you should be spending more time on the sections with more marks). 

If you’re worried about prioritising your time in the exam, watch the free PSA Prep sessions to understand more about how marks are allocated for each section of the exam before you time yourself with Practice Paper 3. 

 

Finally… good luck!

As the learning and assessment branch of the British Pharmacological Society, we’re committed to helping you become a confident, capable prescriber – not just so that you can pass the PSA, but so that you can excel in whatever prescribing career path that follows. We hope that resources like PSA Prep and our Prescribing Practice Papers help you take control of your revision, so that you can approach exam day with confidence. We believe in you! 

 

 

Revising for the Prescribing Safety Assessment exam? We take a look at all the revision and practice materials out there, and recommend the best study resources for 2023. 

 

1. PSA Prep (free)

These new eLearning sessions have been written by Professor Simon Maxwell, Medical Director of the PSA in collaboration with BPS Assessment, the learning and assessment arm of the British Pharmacological Society. There is 1 session for each of the 8 sections of the PSA exam, as well as an introductory session. PSA Prep is totally free to access and covers: 

• The exam format and layout of each question
• Understanding how to answer the questions
• Common challenges, like the time pressure and exam calculations

To get instant access, simply create a free BPS Assessment platform account and you’ll be able to press play on PSA Prep next time you log in.

 

2. Official PSA Practice Papers (free)

This may sound obvious but don’t overlook what you already have! One month before your exam you’ll be registered by your school at https://prescribingsafetyassessment.ac.uk.  Once you’re logged in, read up on the exam, use the information you’ll find there, and complete the 3 official PSA practice papers included. 

 

3. MedicinesComplete and the NICE BNF 

We know that time pressure is reported to be the biggest challenge for candidates sitting the PSA exam, so it makes sense that some of the best study resources you’ll find are MedicinesComplete and the NICE BNF. You don’t want to lose valuable minutes in the exam trying to navigate your way around the BNF, so it’s important that you familiarise yourself with these resources ahead of time. Time well spent! 

 

4. Bonus Practice Papers (£40 for all 3 papers)

Once you’ve completed the 3 official practice papers, you’ll want more practice on a variety of question items in the same style as the exam format. You’ll find 3 bonus practice papers exclusively on the BPS Assessment Learner Portal, mirroring the format of the PSA and offering clear, in-depth feedback on each question. 

There are 120 questions across the 3 papers, spanning all 8 sections of the PSA. You also get unlimited attempts, so you can learn from the automated feedback and keep trying til you get 100%. What better way to get confident ahead of exam day?! 

It’s also worth noting that Paper 3 is worth a full 200 marks and is designed to be taken over 2 hours, just like the real exam. So you can set your timer and complete your very own ‘mock’ PSA exam whenever and wherever suits you! Once you’ve completed the paper and read through the feedback on your answers, you can have another try (you get unlimited attempts after all). 

 

Are you getting ready to take your mock exams for the Prescribing Safety Assessment in November? 

Although they might not be the real thing, mock exams can be super helpful in familiarising you with the time pressures of the exam as well as highlighting any sections that take you longer than you imagined or weak spots in your knowledge. It’s worth taking your best shot when it comes to your mock exams – the better you do, the more confident you’ll feel going into the real PSA exam. 

So how can you set yourself up for success? 

 

Get to know the PSA exam format inside out

To get really familiar with what’s expected of you and what you’ll encounter in the PSA exam, complete our free PSA Prep eLearning sessions online and get to know: 

• The exam format and layout of each question
• How to answer the questions
• Common challenges, like the time pressure and exam calculations

We’ve given you 1 session dedicated to each of the 8 sections of the PSA exam, as well as an introductory session. Get instant access to these 9 free PSA Prep sessions today – all you have to do is set up a free account! 

 

Make time to practise

Once you know what to expect in the exam and you’ve familiarised yourself with MedicinesComplete and the British National Formulary (BNF), both available to you on exam day (depending on your location), you’ll want to get practising. 

If you’re already registered for your final PSA exam, you’ll be able to access the official practice papers by logging into your account. If you haven’t yet, don’t panic! We’ve created an additional 3 practice papers to help you prep. Each paper is laid out just like the final exam, with automated marking and detailed feedback on every question, so you know where you’re going wrong and how to improve. 

 

Prescribing is arguably the greatest challenge for any doctor. They must choose the right medicine, the right dose, the right route, the right frequency and the right duration. They need to take into account the infinite variation in the patients they treat, because of age, other medicines and diseases. They also have to be able to counsel their patient about the medicine, monitor the effects of the treatment and interpret data relating to their treatment. 

Yet there is currently a significant error rate in prescribing in hospitals (9% according to a GMC-sponsored study). That means nearly 1 in 10 medicines are being prescribed inappropriately. 

Many of these errors are made by relatively junior doctors. These errors not only harm patients but also complicate care, prolong hospital stay and cost a lot of money. 

The Prescribing Safety Assessment was introduced to help tackle this issue. 

 

What does the PSA Exam test? 

The aim of the Prescribing Safety Assessment is to test core prescribing competencies as outlined in the GMC’s Outcomes for graduates, to ensure that Foundation doctors are confident and competent prescribers. 

The exam tests 8 distinct areas of prescribing across a range of clinical contexts: prescribing; prescription review; planning management; providing information about medicines; calculation skills; adverse drug reactions; drug monitoring; and data interpretation.

 

When do students take the PSA Exam? 

At UK medical schools, final year undergraduate students must take and pass the Prescribing Safety Assessment in order to complete their medical degree. At other medical schools, the PSA may not be required for completing a medical degree. However, any doctors working in the UK need to pass the PSA before the end of their Foundation (F1) year. 

 

Read more about the practice papers and free eLearning sessions we offer to PSA exam candidates here. 

 

We know from previous Prescribing Safety Assessment candidates that the time pressures are seen as the biggest challenge of the PSA exam. 

But there’s a good reason why you’re expected to be able to answer 60 questions in 2 hours! The PSA is designed to simulate the real-life pressures of prescribing in a clinical setting. You won’t have time, as a prescriber, to look up every decision in MedicinesComplete or the BNF. You will need to be able to complete dosage calculations quickly and accurately, spot risks, and communicate effectively with patients in order to do your job. 

So the most important thing to bear in mind if you’re worried about the time pressures of the PSA is that they’re in place for a reason! With that in mind, there are some steps you can take to manage your time effectively in the exam.

 

Ahead of time 

1. Understand the exam format inside out

Different sections of the PSA are weighted differently, and each section is asking you to demonstrate a different area of prescribing competency. So you need to understand exactly what’s being asked of you in each section, as well as how many marks are at stake. You can do this by:

• Logging into your PSA platform account and reading through the official information
• Reading our blog post for a detailed breakdown of what’s in the PSA 
• Completing our free PSA Prep eLearning sessions

The PSA Prep eLearning sessions have been created by a team of experts to address common challenges encountered in the exam – including time pressures – and will help you understand the exam format and what’s expected of you in each section.

2. Get familiar with the BNF

Both MedicinesComplete and the NICE BNF are available in the exam, so it’s vital that you familiarise yourself with these resources ahead of time. In particular, spend time on the ‘treatment summaries’ section of the BNF, which you’ll need to consult if you don’t know the medication required for a particular treatment, as it’s not always immediately obvious where to find particular topics (for example, opioid conversion comes under ‘palliative care’ – if you didn’t know that in advance, you could spend valuable time searching).

3. Practise… with a timer! 

If you’ve not practised answering 60 question items within 120 minutes, you’ll find it more difficult to manage your time effectively on exam day. 

So, once you’ve completed the official PSA practice papers, take a look at the extra practice papers available from BPS Assessment. We’ve created the only available 2 hour practice paper, marked out of 200 (just like the real exam) so that you can understand exactly where you struggle time-wise when it comes to answering 60 questions in 120 minutes. 

You get unlimited attempts on our practice paper too, so you can practise as many times as you need in order to feel confident about that 2 hour countdown on the day.

 

On exam day

1. Consider a timing plan

Having a rough idea of how long you should be spending on each section of the exam will help you manage your time effectively. 

There are 200 marks available in total over the 120 minutes of the exam. If we look at that time broken down across the 8 sections of the exam, we get: 

• Section 1: Prescribing (PWS) is worth 80 marks = 48 minutes
• Section 2: Prescription Review (REV) is worth 32 marks = 19 minutes 12 seconds
• Section 3: Planning Management (MAN) is worth 16 marks = 9 minutes 36 seconds
• Section 4: Providing Information (COM) is worth 12 marks = 7 minutes 12 seconds
• Section 5: Calculation Skills (CAL) is worth 16 marks = 9 minutes 36 seconds
• Section 6: Adverse Drug Reactions (ADR) is worth 16 marks = 9 minutes 36 seconds
• Section 7: Drug Monitoring (TDM) is worth 16 marks = 9 minutes 36 seconds
• Section 8: Data Interpretation (DAT) is worth 12 marks = 7 minutes 12 seconds

You may not want to allocate every single second of the exam, however! You’ll need time to take a breath and reset every now and again, as well as a cushion of time for any unexpected challenges. This is just a starting point. 

2. Breathe… you’ve got this! 

Lots of Prescribing Safety Assessment candidates find the time pressure to be the biggest challenge when it comes to exam day. So you’re not alone! Just remember that the time pressures are there to simulate the real-life challenges of prescribing and to help you become a safe and accurate prescriber. 

Good luck!

Once you’ve been registered for the Prescribing Safety Assessment by your organisation, you will be able to login to your PSA platform account and take advantage of the four 30-item practice papers that are included. But once you’ve done those, where do you look next? 

The good news is that you don’t have to look far! 

As the learning and assessment branch of the British Pharmacological Society (who deliver the PSA in partnership with MSC Assessment), we have worked with a team of experts to create three additional practice papers to help PSA candidates (as well as candidates for the Prescribing Skills Assessment overseas) prepare for their final prescribing exam. 

Paper 1 and Paper 2 are 30-item practice papers, just like the papers you’ll already have encountered in your PSA platform account. They’re aligned to the BNF and are designed to provide the most authentic practice environment possible. 

Paper 3, however, is something special. It’s the only available 60-item practice paper, with 200 marks up for grabs (just like the real exam). That means you can take things to the next level and time yourself over 2 hours. Not only will you get a really good understanding of the time pressures involved in the Prescribing Safety Assessment, but you will also get a taste of what it’s like to prescribe under pressure in real life. 

You get lots of detailed feedback on your answers, so you can understand where you went wrong and learn how to correct yourself. You also get unlimited attempts on all three papers, so you can assess your weakest areas (with the help of our feedback) and improve as you practise. 

So what are you waiting for? You can grab all three papers today for just £40 (and you’ll get 9 PSA Prep eLearning sessions to go with them) or you can buy them individually. Papers 1 and 2 are £15 each, whereas Paper 3 is £25. 

Find Out More About Our Practice Papers