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The Prescribing Safety Assessment

Prescribing is a fundamental part of the work of first year foundation doctors, who write and review multiple prescriptions each day.

The Prescribing Safety Assessment (PSA) is a collaborative project by the British Pharmacological Society and the Medical Schools Council, with the aim of enabling students to demonstrate competencies in relation to the safe and effective use of medicines.


What is the PSA based on?

The assessment is based on the competencies identified by the General Medical Council outlined in Tomorrow's Doctors (2009).

These competencies include:

  • Writing new prescriptions
  • Reviewing existing prescriptions
  • Calculating drug doses
  • Identifying and avoiding both adverse drug reactions and medication errors
  • Amending prescribing to suit individual patient circumstances

The content of each item will be relevant to the prescribing tasks expected of an F1 doctor, i.e. the questions will refer to ailments and drugs that graduates are likely to be dealing with in year one of the Foundation Programme.


How is the PSA delivered?

The PSA is delivered using a secure online delivery system. The assessment was nationally developed but the test is conducted locally, and run by your medical school.


What does the assessment look like and how long does it last?

The PSA is an online assessment. The formats of the questions vary depending on what skill is being assessed; some ask the candidate to 'write' an appropriate prescription for a given problem, others ask the candidate to choose the most appropriate option from a list or to perform a calculation.

The PSA includes 60 items and is 2 hours in length.


Will students need to pass the assessment?

From 1 August 2016 all new F1 doctors will be required to pass the Prescribing Safety Assessment (PSA). Doctors who do not pass the PSA at medical school will be required by Foundation Schools to take the assessment during their induction week.

Any F1 entrant who is unable to pass the PSA at this stage will be expected to undergo a programme of remediation prior to retaking the PSA during F1.


How will the results of the PSA be transferred to the Foundation schools?

Please note that only those who have passed the assessment will have their pass results transferred. By registering for the PSA 2016, students agree that information will be automatically transferred to the Foundation schools.


Will Foundation Schools ask their F1 doctors who have not taken or not passed the PSA to sit the assessment?

The PSA will be mandatory for all graduates entering the Foundation Programme from next year.


How many schools are taking part in the PSA?

All UK medical schools are taking part in the PSA, along with five schools in Ireland and one in Malta.


What does the BMA Medical Students Committee think about the PSA?

Although the BMA Medical Students Committee supports the principle of safe and competent prescribing, the MSC firmly believes that the PSA should be consistently adopted as either a formative or summative assessment by all medical schools.

If you wish to contact the MSC on this or any other issue, please email us.


How can I prepare for the assessment?

Two 30-questions-long Practice Papers are available to students who are registered by their medical school to take the assessment. Students are strongly encouraged to complete the practice papers on their own once they are registered. This is in order to become familiar with the features of the PSA Interface, to understand the timing of the assessment and how long it may take to respond to different types of questions. Another important part of preparing for the assessment is learning to use the content of the British National Formulary.


Will reasonable adjustments be provided for students with disabilities?

Students with a form of disability that is within the meaning of the Equality Act 2010 may be considered for reasonable adjustments. Students with a temporary or long term health condition may also be considered, provided that their medical school has been made aware of their condition in advance of taking the PSA.


What remediation opportunities will be offered to students who fail the assessment?

A member of staff from your school will act as a prescribing mentor in the short term. Your school should offer an initial de-brief session where you can discuss questions that you found challenging.

Your school should also put together a plan for practice for you and this could include:

  • Practising writing prescriptions in response to common ward scenarios
  • Reviewing example prescription charts or electronic medicines lists
  • Revising the general management of common presentations
  • Reviewing safety issues around high-risk medicines (e.g. anticoagulants, insulin, opioids)
  • Revising the approaches to monitoring the effects of commonly used drugs
  • Practising dosage calculations
  • Practising accessing information in the BNF

Finally you should have follow up meetings with your mentor as many times as practical prior to retaking the PSA.


Further information

Prescribing Safety Assessment

The Medical Schools Council - FAQs