The exam assesses your competencies in relation to the safe and effective use of medicines. It is designed as a tool for demonstrating that you have achieved the core prescribing competencies as outlined in the GMC’s Outcomes for Graduates. Newly qualified FY1 doctors will write and review many prescriptions each day, however, prescribing is often considered one of the most challenging areas. In addition, prescription errors are commonly observed in practice. Therefore, the PSA was introduced to ensure junior doctors are safe prescribers with the aim to improve clinical practice and reduce the number of prescribing errors.

Be very familiar with fluids, insulin, anticoagulants, antibiotics and analgesics as they are commonly examinedWhen identifying drugs that are causing an adverse effect, you may sometimes find that the number of drugs that could be causing the effect is greater than the number of drugs that the question is asking for. In this case, you should take into consideration how commonly each drug causes the adverse effect and when the drug was started relative to when the adverse effect developed. If everything seems equal, then you should exclude from your answer the drug that is less likely to cause the adverse effect based on your own understanding of its pharmacology. Be aware that abnormal test results don’t always alter the management plan – for example, serum transaminases can be raised by up to 3x the upper limit of normal before statins should be discontinued. [Ref: https://bnf.nice.org.uk/drug-class/statins.html] Know what to do in the event of a missed contraceptive pill (this varies depending on the type of pill being taken). The PSA takes place 3 times per year, in September, March and May. New F1 doctors without PSA sit the exam in September (one month after starting work). If they fail, they re-sit in March and again in May if needed. Doctors who do not pass the exam before the end of their F1 year cannot progress into F2, and will have an extension of F1 training (to a maximum of one year) until they pass PSA.

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.Rememberitstheinformationthatislikelytocausethemostproblemtothepatient.Althoughsimilaranswersmaybepresent,choosetheinformationthatislikelytocausePATIENTHARMifnototherwisementionedegstartingapatientonOCPandtheriskofDVT/PEmustbementionedwouldbeyourtopinfo

This section can be tight on time and it is not possible to search up every listed medication on the BNF. As such knowledge of common effects, adverse reactions and interactions of common medication is helpful. Sometimes it is inappropriate to treat/change management and it important to bear in mind non-drug therapies (e.g. physiotherapy, TENS machines for pain relief) have a role. After that, revise all important conditions in the Oxford Handbook of Clinical Medicine, Oxford Handbook of Clinical Specialties and the textbooks for the specialties. Your main focus should be on pharmacological management, but diagnosis, investigations and non-pharmacological management are important too. Learn the common and serious side-effects and monitoring requirements for: ACEi, antidepressants, anticoagulants, bisphosphonates, HRT, insulin, methotrexate, and statins.

What is the Prescribing Safety Assessment (PSA)?

Utilise the “Interaction” section for the medication on the BNF. This will give a list of all interactions with the particular medication you are interested in. Again, use the ‘Ctrl F’ function to speed up your search.