Preparing for the PSA

Published: 22 April 2020

Written by Dr. Lorraine Spotten MB BCh BAO BSc (Hons)
PSA Team @Becomingadr 

Lorraine recently graduated from medical school at Queen’s University Belfast (QUB), Northern Ireland and is due to start her interim F1 post in the coming weeks. She also holds a BSc (Hons) in Human Nutrition and Dietetics awarded by Trinity College Dublin and Dublin Institute of Technology. Lorraine has a keen interest in pharmacology and therapeutics, awarded the Whitla Medal for the highest score in the Prescribing Safety Assessment (PSA) mock exam held at QUB in 2020. She was also a top scorer in the subsequent PSA exam held in March of this year.  She has a keen interest in medical education and would like to help other students excel in the PSA.

How did I prepare for the PSA?

There are many textbooks available to help prepare for the PSA, useful for becoming accustomed to the exam structure, common high yield drugs and practising calculations. However, many are set at a level easier than the actual exam.  The books I used were:

  • ‘Pass the PSA’ by Will Brown
  • ‘Student Success in the Prescribing Safety Assessment (PSA)’ by Vilius Savickas and Reem Kayyali
  • ‘Get ahead! The Prescribing Safety Assessment’ by Muneeb Choudhry, Nicholas Rubek Fuggle and Amar Iqbal

I also used my own pharmacology notes from medical school to revise key drugs from each branch of medicine e.g. respiratory drugs, GI drugs etc, which was perhaps more useful. QUB has its own formulary of drugs which highlights ‘need to know’ information which helped me to fill in any gaps. The book ‘The Top 100 Drugs’ by Hitchings, Lonsdale, Burrage & Baker was also helpful for this.

Last, but not least, I used all resources on the PSA website – from practice papers to reading FAQs and becoming familiar with the PSA blueprint (which highlights key drugs on which questions are based). Becoming familiar with Medicines Complete was also worth gold in the exam!

I would highly recommend using the official PSA practice papers – these are gold standard preparation for the exam and are written by those who will be writing your actual paper! I would also recommend the ‘Pass the PSA’ book. It has useful information on enzyme inducers and inhibitors, side effects, prescription reviews, and management of medical emergencies. There are also many practice questions and mock exams. However, it should not be used as your sole revision for the exam.

See here for other useful hints and tips.

How long did it take me to prepare?

I spent roughly 2 hours each weekend from September to February revising my pharmacology notes and using the books mentioned to become familiar with the exam. This helped me to prepare both the PSA and my finals in February. After that I spent 4-5 hours per day for the 3 weeks prior to the PSA consolidating my knowledge and completing the practice papers.

How did I find the actual exam?

I found the actual exam harder than I expected, though manageable. I fortunately had time to spare at the end of the exam to review some of my answers, though I know many of my peers ran out of time and year on year this is a common complaint. There were many questions which I wouldn’t have answered correctly had I not known how to navigate Medicines Complete, so I do think a keen awareness of this resource is pivotal for passing the PSA.

Tips for using Medicines Complete

  • Use Ctrl F to search for keywords quickly rather than scrolling
  • Use split screen during the exam – one screen for the PSA exam and one for BNF/Medicines complete. This saves time having to constantly switch between screens
  • Make sure you’ve selected BNF or BNFc as appropriate – an easy mistake to make in the exam
  • Know where to find things e.g. often important information to communicate about a drug is in the ‘patient and carer advice’ section. I commonly used this section during the exam.
  •      ‘Medicinal Forms’ is another subsection to be aware of, particularly for the prescribing and calculations sections. It is important to know what form and dose medications are available in.
  • In Medicines Complete you can type in a condition e.g. heart failure and it will give you a treatment summary. It takes time scrolling through this but if stuck in the exam use it!
  • Opioid dose conversions are included in palliative care section – this is commonly asked
  • HRT is under ‘sex hormones summary’ and INR management under ‘oral anticoagulants summary’.
  • If unsure of conversion of units e.g. mg to micrograms etc type ‘approximate conversions and units’ into the search bar
  • When prescribing double check for renal and hepatic impairment and check subsections as appropriate
  • Be very familiar with fluids, insulin, anticoagulants, antibiotics and analgesics as they are commonly examined

Having now sat the exam, what do you wish you’d known before you started preparing?

My ability to answer a lot of the questions was based on my knowledge from finals and my familiarity with Medicines Complete. Some of my friends got stressed about the PSA as an added exam on top of finals and the SJT but if you set aside a little time each week and review your pharmacology knowledge you are not only preparing for the PSA but you are also preparing for finals.

Good luck 🙂

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Elliot is a St George’s graduate currently working as an F1 Doctor in East London. As the first in his family to apply to university, Elliot is well aware of the barriers that can be faced in trying to get to medical school. He is passionate about widening access to medicine for underrepresented groups.
 He was the representative for St George’s on the BMA Medical Students Committee, and has done lots of work with local schools and colleges to raise awareness of medicine as a career, as well as working on admissions policies with the widening participation team St George’s. Elliot is part of the @BecomingaDr outreach team and National Health Careers Conference Team.