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Prescribing Safety Assessment (PSA)

What is the PSA?

The Prescribing Safety Assessment (PSA), introduced in 2016, is an online assessment of competency in the safe and effective prescribing of medications. It is an essential requirement for sign off at the end of F1 year, to allow F1 doctors to progress to F2 training.

Most UK Medical graduates will have passed the PSA exam during Final Year in Medical School, but a small number will not have been successful. Newly qualified doctors entering the UK Foundation programme who did not attend a UK Medical School may not have had the chance to sit the PSA before. Therefore each year there are some F1 doctors starting work who have yet to pass the PSA exam.

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. 

What support is available?

The UKFPO guidance for PSA support states:

“At the start of the programme, trainees who have yet to pass the PSA must be offered a support package, e.g. period of remediation, until they have passed the exam. This should include counter-signatory where possible.”

We provide a pharmacology e-learning package called “SCRIPT” (see SCRIPT section on NIMDTA Foundation website) for all F1 doctors in Northern Ireland. SCRIPT is a support package which improves safety and competency in prescribing. It is highly recommended for PSA preparation.

In addition to this, Dr Richard Plumb, Senior Clinical Lecturer (Education) in Therapeutics and Pharmacology at Queen’s University Belfast, has put together some resources for those sitting the exam during their F1 year and these will be shared with them prior to the examination. There are online practice PSA papers available that those taking the exam are encouraged to complete.

Countersigning of prescriptions

The busy hospital environment makes countersigning every prescription impractical, particularly out of hours. F1s who have still to pass the PSA can prescribe independently, with counter-signatory where possible. Where counter-signatory is not possible their prescriptions are equally valid to those of their colleagues. Like all F1 doctors, with or without PSA, they should seek advice when uncertain about prescribing.  There is no need for any out of hours adjustments to F1s working who have not yet passed the PSA.

PSA - Practice Paper

This resource is for those trainees who are yet to complete the Prescribing Safety Assessment (PSA). Should you require access, please contact

PSA Paper Answers and Discussion Video