You may notice that some of the practice questions for this section require using the BNF or clinical knowledge. However, the questions for this section in the actual PSA will not require them, it is purely calculation. The date of each post on this blog is the date where the post was first published, not the date where the post was last updated. I may have updated the post after the date it was first published. For the fourth type of question, you have to determine the immediate next step of management that is most appropriate for the adverse drug reaction. It may be pharmacological or non-pharmacological management.The BNF may be able to help, but only in some cases. The post-assessment review can take a number of days depending on the assessments sat and number of candidates involved and the results will be made available up to three weeks after the PSA date.

You will be asked to make a drug dosage calculation; the question will contain all relevant numerical data as well as distracting data that you will not need. You will be given the units. You will be provided with a clinical scenario and some investigation results and tasked with determining the most appropriate course of action forward with regard to prescribing. (e.g withdrawing a medication, reducing its dose, no change, increasing its dose or switching to a new medication). BNF Logo [image on the internet]. Accessed 06/07/2012. Reproduced with kind permission of the British Medical Association and the Royal Pharmaceutical Society of Great Britain. There is a 'Monitoring requirements' section in the BNF for many drugs. The information under that section is often the answer for questions about the monitoring required before prescribing a drug as well as questions about the monitoring for adverse effects.

In both cases, the first examination date will be in September, with two additional dates in the spring. For each question in this section, there will be a clinical scenario with results of investigations and you have to make a change to the drug prescriptions. The investigations may include plasma drug concentration. It is important to elicit which one of these is being tested as different tests are often required. (e.g., weight is the best monitoring measure for the beneficial effects of furosemide in someone with fluid overload, however, to monitor for harmful effects – renal function) The PSA exam is 2 hours long, with an extra 30 minutes available if you’re eligible for reasonable adjustments. Questions will cover Medicine, Surgery, General Practice, Psychiatry, Paediatrics, Obstetrics & Gynaecology, and Geriatrics.

British Pharmacological Society, Medical Schools Council. About the PSA [internet]. Accessed 25/07/2012. In this section, each question will list several drugs that have been prescribed, where you have to identify one or more of the drugs that are inappropriate or have a particular problem, such as adverse effects, contraindications, interactions with other drugs, ineffectiveness or dose error. Don’t make it too complicated. Remember, this exam is aimed at final year medical students and Foundation Year 1 doctors so the paper will not ask you to prescribe chemotherapy drugs or other specialist medications so don’t worry about learning those. Assessment Map [image on the internet]. Accessed 24/07/2012). Reproduced with permission of the Medical Schools Council and the British Pharmacological Society.You have to start your revision no less than 1 month before the PSA. I recommend spending at least 3 hours per day during weekdays and 6 hours per day during weekends and holidays on the PSA. AskyourmedschoolforplainA4paperandaminicalculatorwhichtheyshouldbeabletoprovidewithbasicfunctions-theyareallowedto-thiswillspeedupyourtimedoingcalculations

If the peak concentration of a drug is outside normal range, you should adjust the dose. If the trough concentration is outside normal range, you should adjust the interval between doses. The BNF can be used at any point during the PSA examination. Therefore, it is absolutely vital that candidates are confident with using the BNF prior to the exam. If the assessment is formative, candidates who do not pass the PSA will be given two further opportunities during FY1 to pass the assessment to be awarded the Foundation Year 1 Certificate of Completion (F1CC). Non-UK medical students applying to the foundation programme will be expected to take the PSA within their foundation school doing their FY1. Get familiar with the BNF (both online and paper versions) and know where to find things as it isn’t always obvious or easy. For example, converting opioid doses is in the palliative care summary, HRT is in the sex hormones summary, and high INR management is in the oral anticoagulants summary. There are 36 seconds per mark; if you are struggling to find an answer within a suitable time frame for the available marks, make a best guess (there is no negative marking) and move on.You have to choose the most appropriate answer from the 5 choices of answers, using your clinical knowledge and judgement. The BNF may be able to help, but only in some cases. For F1s, the PSA certificate does not have an expiry date as such. A PSA pass within two years prior to starting the F1 year is valid, but the pass does not expire during the F1 year (e.g. if a trainee joins the foundation programme in August 2022 and passed the PSA in February 2021, the PSA certificate would not expire in February 2023 before their F1 year is complete). If trainees are required to record an expiry date in their e-portfolio it is suggested that the last date of the F1 year is entered. The question may ask you what is the monitoring required before starting the drug or how to monitor for beneficial effects or adverse effects after starting the drug.