About the exam
PSA Exam structure
An independent study guide aligned to the current Prescribing Safety Assessment blueprint for safe and effective medicines use at Foundation Year 1 level.
Issuer and path
Prescribing Safety Assessment Study Guide is administered through MSC Assessment and the British Pharmacological Society. Check official resources before booking, retesting, or relying on a stale requirement.
Prescribing
8 scored + 0 pretest
Eight prescription-writing items worth 10 marks each: five marks for drug choice and five for dose, route and frequency.
Prescription Review
8 scored + 0 pretest
Eight chart-review items, each with two linked tasks and worth four marks, focused on unsafe, ineffective or inappropriate prescriptions.
Planning Management
8 scored + 0 pretest
Eight items selecting the most appropriate initial management option for the individual clinical situation.
Providing Information
6 scored + 0 pretest
Six items selecting the most important medicine information for a patient, carer or healthcare professional.
Calculation Skills
8 scored + 0 pretest
Eight numeric-response items covering safe dose, quantity, concentration, dilution, volume, duration or administration-rate calculations.
Adverse Drug Reactions
8 scored + 0 pretest
Eight items covering adverse effects, causative medicines, clinically important interactions and management of adverse events.
Drug Monitoring
8 scored + 0 pretest
Eight items selecting the best objective measure and timing for beneficial or harmful effects of treatment.
Data Interpretation
6 scored + 0 pretest
Six items interpreting investigation results and choosing the appropriate change to ongoing prescribing.
Before your sitting
Your medical or foundation school arranges registration and the local sitting. Activate the account when instructed, complete the official practice papers, confirm reasonable adjustments and local calculator rules, and use only the permitted BNF and BNFc routes during the assessment.
Official Outline Coverage Map
Coverage is mapped to official outline item counts so content depth can be checked without hard-coding a single exam.
| Topic | Official outline items | Your questions | Your flashcards | Confidence |
|---|---|---|---|---|
| Patient and Indication Assessment | 3 | 81 | 5 | Priority |
| Medicine Selection and Reliable Source Use | 3 | 80 | 5 | Priority |
| Complete and Practical Prescriptions | 2 | 80 | 5 | Strong |
| Medication-List Reconciliation | 3 | 32 | 5 | Strong |
| Interactions, Contraindications and Patient-Specific Adjustment | 3 | 32 | 5 | Priority |
| Errors, Optimisation and Deprescribing | 2 | 32 | 5 | Priority |
| Initial Treatment Prioritisation | 3 | 16 | 5 | Strong |
| Acute Emergencies and Toxicology | 3 | 16 | 5 | Priority |
| Individualisation and Non-Drug Options | 2 | 16 | 5 | Good |
| Purpose, Benefits and Shared Decisions | 2 | 12 | 5 | Strong |
| Instructions, Warnings and Safety-Netting | 2 | 12 | 5 | Priority |
| Team Communication and Documentation | 2 | 12 | 5 | Good |
| Units, Concentrations and Conversions | 3 | 16 | 5 | Priority |
| Dose, Quantity and Patient-Size Calculations | 3 | 16 | 5 | Priority |
| Infusions, Dilutions and Fluids | 2 | 16 | 5 | Priority |
| Adverse Effects and Causative Medicines | 3 | 16 | 5 | Priority |
| Clinically Important Interactions | 3 | 16 | 5 | Priority |
| Adverse-Event Management, Prevention and Reporting | 2 | 16 | 5 | Strong |
| Baseline and Safety Monitoring | 3 | 16 | 5 | Priority |
| Efficacy Monitoring and Timing | 3 | 16 | 5 | Strong |
| Monitoring Trends and Escalation | 2 | 16 | 5 | Strong |
| Laboratory Results, Organ Function and Drug Concentrations | 2 | 12 | 5 | Priority |
| Charts, Nomograms and Clinical Observations | 2 | 12 | 5 | Good |
| From Data to Prescribing Action | 2 | 12 | 5 | Priority |
How to use this guide
How to prepare for the PSA
Combine patient-centred prescribing judgement with fast BNF navigation, reliable calculations, complete prescriptions and explicit monitoring and communication.
1. Define the patient and purpose
Confirm the indication, immediate treatment objective, allergies, medication history and patient factors that alter benefit or risk.
2. Review medicines and hazards
Check current treatment, contraindications, interactions, organ function, pregnancy, duplication and the five guaranteed high-risk medicine groups.
3. Select and verify
Choose the safest effective option for this patient and use the permitted BNF or BNFc resource to verify precise medicine information.
4. Calculate and write clearly
Convert units, check magnitude and produce a complete, practical and unambiguous prescription or numeric response.
5. Communicate, monitor and close the loop
Give the most important information, define benefit and safety monitoring, document the decision and escalate uncertainty or urgent risk.
Official item-style map
Train the response format as well as the clinical decision
The eight official sections assess different actions, so organise practice around what each task asks you to produce.
Safe Prescription Writing
Patient assessment, medicine selection and complete, practical prescriptions for one drug or intravenous fluid.
Choose a topic to open below
Safe Prescription Review
Systematic review of medication lists for errors, interactions, contraindications, inefficacy and opportunities to optimise treatment.
Choose a topic to open below
Individualised Management Planning
Selecting an initial treatment, including when to withhold treatment, use a non-drug option or escalate an emergency.
Choose a topic to open below
Medicines Communication
Prioritising information that supports informed choice and safe, effective medicine use by patients and clinical teams.
Choose a topic to open below
Safe Prescribing Calculations
Unit-aware dose, quantity, concentration, dilution, infusion and fluid calculations with a reasonableness check.
Choose a topic to open below
Adverse Effects and Interactions
Recognising, preventing and managing adverse reactions and clinically important medicine interactions.
Choose a topic to open below
Therapeutic Monitoring
Planning baseline, efficacy and safety monitoring with the correct measure, timing and escalation route.
Choose a topic to open below
Prescribing Data Interpretation
Turning laboratory, physiological and medicine-concentration data into a safe prescribing action.
Choose a topic to open below
Patient and Indication Assessment
Establish the prescribing purpose and identify patient factors that change the benefit, risk, formulation, route or dose.
Key rules
Rule 1
A safe prescription begins with a clear indication and an accurate account of current and recent medicines, allergies and previous adverse reactions.
Exam cue: State the indication and the intended benefit before choosing a medicine.
Rule 2
Age, body size, pregnancy, frailty, kidney or liver impairment, comorbidity and the practical route of administration can materially change a prescription.
Exam cue: Check allergies, existing medicines, organ function and patient-specific contraindications.
Rule 3
The clinical scenario must be interpreted before consulting a medicines reference; a formulary does not decide whether treatment is appropriate for this patient.
Exam cue: Separate information that changes the prescription from background detail.
Common traps
Searching for a dose before confirming the indication and patient.
Prevention: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Ignoring non-prescription medicines, recent treatment or a documented adverse reaction.
Prevention: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Treating a standard adult dose as automatically suitable for every patient.
Prevention: Do not let a familiar medicine, reference search or calculator output replace patient-specific safety checks and escalation.
Memory anchors
Indication First
Define the problem and intended treatment benefit before selecting a medicine.
Medication History
Include prescribed, over-the-counter, complementary and recently stopped medicines.
Allergy Check
Distinguish a documented allergy from an intolerance while treating both as relevant history.
Patient Factors
Age, size, pregnancy, frailty and organ function can change medicine choice or dose.
Clinical Context
Use the BNF within the patient scenario rather than as a substitute for clinical judgement.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A 72-year-old with vomiting has BP 86/54 mmHg, cool peripheries and no pulmonary oedema. What treatment need should be addressed first?
A patient with type 1 diabetes is vomiting, glucose 24 mmol/L, ketones 6 mmol/L and venous pH 7.18. Which need is most urgent?
Answer all questions to submit.
Next step personalized recommendations
Open another topic next
Official resources
Verify the details with the official sources
Use these links for eligibility, scheduling, handbook rules, and issuer updates. Our guide helps you study; official sources tell you what the testing partner currently requires.
PSA Blueprint — 14 July 2025
The current official assessment blueprint with item styles, marks, clinical-setting minima, high-risk medicine coverage and competency mapping.
Prescribing Safety Assessment
The official joint MSC Assessment and British Pharmacological Society site for candidate information, FAQs, resources and assessment dates.
Current PSA Item Writing Manual
Official detailed guidance on the purpose, response style and scope of each item type.
GMC Outcomes for graduates
The national graduate outcomes underpinning the prescribing competencies assessed by the PSA.
NICE British National Formulary
One of the official BNF routes available within the PSA environment; follow the assessment's restrictions on permitted pages and links.
NICE British National Formulary for Children
The paediatric formulary resource available within the PSA environment for relevant child and neonatal prescribing tasks.
FAQ
Common PSA questions
Is this an official MSC Assessment or BPS resource?
No. This is an independent study guide. The current PSA Blueprint, official candidate information and the materials made available through your medical or foundation school remain authoritative.
What are the eight PSA item styles?
The assessment contains Prescribing, Prescription Review, Planning Management, Providing Information, Calculation Skills, Adverse Drug Reactions, Drug Monitoring and Data Interpretation. Each style has its own response format and mark allocation.
What clinical domains does the current PSA cover?
The official blueprint calls them clinical settings: Medicine and Elderly Care each have a minimum of eight items; General Practice also has eight; Surgery, Paediatrics, Psychiatry and Obstetrics & Gynaecology each have a minimum of four. These minima account for 40 items, with the complete paper sampling matrix assigning the remaining items while preserving blueprint coverage.
What does the PSA assess?
It assesses safe and effective prescribing at the level expected of a Foundation Year 1 doctor: choosing and writing prescriptions, reviewing existing prescriptions, planning treatment, communicating medicine information, calculating doses, recognising and managing adverse reactions, monitoring therapy and acting on clinical data. It is not primarily a diagnostic examination.
How are prescribing items marked?
There are eight prescribing items worth ten marks each. Five marks relate to drug choice and five to the dosage components of dose, route and frequency. The task requests one medicine or, when explicitly stated, one intravenous fluid.
Are all PSA items multiple-choice questions?
No. Prescribing items use a structured prescription response and Calculation Skills items require a numeric answer. Prescription Review has two linked selection tasks, while the other item styles generally ask for the best option from five. Use the official practice papers to rehearse the actual interface.
Can I use the BNF during the PSA?
Yes. The official interface provides access to online BNF and BNFc resources through Medicines Complete and NICE. The permitted scope does not include unrelated NICE guidance, Clinical Knowledge Summaries or external links, and the BNF cannot replace interpretation of the patient scenario.
Is there a fixed PSA pass mark?
No fixed score can be published before a sitting. The official Standard Setting Group uses the Modified Angoff method and the final mark may account for paper difficulty and post-assessment item review.
Why does this guide not claim to provide a full simulated PSA?
The current Pass Harbor question framework does not reproduce the official structured prescription-writing fields or unrestricted numeric-response format. This guide supports the underlying skills, but the official 60-item practice paper is the appropriate source for authentic interface familiarisation.