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Prescribing Safety Assessment (PSA): Guidance notes for Foundation trainers
This guidance is for Foundation Programme Directors (FPDs), Educational and Clinical Supervisors (ES and CS) and Directors of Medical Education (DMEs) who are involved in the training of Foundation doctors (F1s).
The MSC Assessment (MSCA) have set specific dates for the PSA throughout the training year. The Foundation School would expect that, as this is a mandatory requirement for successful completion of ARCP and hence registration with the GMC, Foundation doctors should be allowed to take leave to sit the assessment. The Foundation School would expect that F1 doctors should not be required to swap shifts or sit the assessment during annual leave. The dates and times are set nationally by the MSC and are publicised well in advance to allow planning. If there are challenges in rotas then the FPD and/or Consortium Lead should be expected to support the Foundation doctor to secure time to sit the assessment.
Further information about the PSA is available on the trainee pages of this website.
The Prescribing Safety Assessment (PSA) is an online assessment of competency in the safe and effective prescribing of medications. It is an essential requirement for ARCP at the end of F1 year, to allow F1 doctors to progress to F2 training.
The busy hospital environment makes checking every prescription impractical, particularly out of hours. These F1s are legally allowed to prescribe, and their prescriptions are equally valid to those of their colleagues. It is up to each Health Board to decide on the supervision level required of F1s who are yet to pass. The CS and ES may wish to allocate additional support for these F1s if they feel that it is appropriate. Like all F1s, with or without PSA, they should seek advice when uncertain about prescribing.
The local team (Board) should make a judgement on what level of support and supervision is required for each F1. This may range from no additional input required other than the close supervision of F1 prescribing for all F1s to close supervision and countersignatures on prescriptions if this is deemed appropriate. In most situations the ward pharmacist and senior clinical team will provide closer observation but not require a countersignature.
ES and CS meet with the Foundation doctor early and regularly to explain support available, review progress, and discuss any concerns.
Ensure the F1 doctor is working on the PSA practice assessments (available when they have been registered for the assessment) and is advised to seek help where there is any uncertainty around prescribing.
Inform the ward pharmacist (if there is one) so that they can offer extra support.
Ensure they participate fully on the out of hours on call rota exactly as their peers.
Most UK Medical graduates will have passed the PSA exam during Final Year in Medical School, but a small number will have failed.
Doctors entering the UK Foundation programme who did not attend a UK Medical School have not had the chance to sit the PSA prior to starting F1.
If the PSA was passed more than two years before starting foundation training, it will need to be successfully retaken before completion of the F1 year.
The Foundation School will inform the relevant Associate Postgraduate Deans (APGDs) and FPDs in August.
The FPD should inform the DME team, named Educational Supervisor (ES) and Clinical Supervisor (CS) to ensure the correct support is in place.
During the F1 year there are three sittings of the PSA. Further information is available on PSA.
The Foundation School will advise APGDs and FPDs of the PSA results after every sitting.
F1s who fail their first sitting should discuss this with their FPD.
Information and support is available at the Scotland Deanery (Trainee Development and Wellbeing Service) TDWS for both the F1 and the FPD.
E-LfH modules - SPB 01 Safe prescribing
All Foundation doctors are given usernames and have been granted access to E-LfH modules. The folder containing these modules is SPB 01 Safe prescribing. E-LfH has modules on safe prescribing including high risk prescribing such as insulin, antibiotics, prescribing in renal impairment and guidance on how to use the BNF.
Practice papers
Foundation doctors should be encouraged to attempt the practice assessments that are available on the PSA website.
UKFPO
A new set of PSA preparation resources for IMGs, which includes resources shared by UK medical schools to support new F1 doctors who graduated outside the UK to prepare for sitting the PSA. This is suitable for both IMG and non IMG.
SCRIPT is an e-learning programme to improve prescribing competency and safety and aligns with GMC guidance on safe prescribing and medical education
SCRIPT modules are used in all nations of the UK by trainees to support prescribing
Foundation doctors should register using the following Scotland specific SCRIPT link: https://scot.safeprescriber.org/
You can also download the SCRIPT User Guide here
SCRIPT e-learning can be used to help prepare candidates for PSA please see here for a list of helpful SCRIPT modules to help you prepare
It is recommended that foundation doctors who are appointed to a F2 standalone post sit the PSA however, this is not mandatory.
The Foundation School will contact F2 standalone doctors in early 2026 about sitting PSA.
