What the BNF Tells You
Metformin requires careful consideration in patients with renal impairment. Current guidance recommends reviewing treatment as renal function declines and stopping metformin when eGFR falls below 30 mL/min/1.73m².
How Many Students Revise
Students memorise:
"Metformin and kidneys."
How an Examiner Thinks
An examiner asks:
"Can the candidate identify an unsafe prescription?"
How It Becomes a PSA Question
A 74-year-old patient attends for diabetic review.
Current medication:
Blood results:
What is the most appropriate course of action?
Suddenly this is no longer a diabetes question. It is a patient-safety question!
Example 2: SGLT2 Inhibitors
What the Guideline Tells You. SGLT2 inhibitors provide cardiovascular and renal benefits but require careful counselling regarding dehydration, sick-day rules and diabetic ketoacidosis risk. Recent updates to NICE guidance have increased their prominence within Type 2 diabetes treatment pathways.
How Many Students Revise
Students memorise:
Dapagliflozin
Empagliflozin
Canagliflozin
How an Examiner Thinks
An examiner asks:
"Can the candidate recognise when treatment should be temporarily stopped?"
How It Becomes a PSA Question
A patient taking dapagliflozin develops severe vomiting and dehydration. What advice should be provided regarding their medication? Again, this is not simply a pharmacology question. It is a prescribing safety question.
What the BNF Tells You: Insulin is a high-risk medicine.
How Many Students Revise
Students memorise insulin types.
How an Examiner Thinks
An examiner asks:
"Can the candidate identify a potentially dangerous prescribing error?"
How It Becomes a PSA Question
A prescription states: Insulin 10 units
What is the prescribing issue? The examiner is assessing medication safety, not recall.
Every article in the Pharmascholar PSA Exam Insight Series follows the same framework.
1. Core Knowledge
What do you genuinely need to know?
Not every detail.
Not every guideline update.
Not every obscure interaction.
Just the knowledge most likely to generate marks.
2. Reverse Engineering the PSA®
How is the examiner likely to use this information?
What are they trying to assess?
Why does this topic repeatedly appear in prescribing examinations?
3. Question Insight
What Is the Examiner Really Testing?
Many students misinterpret this step.
A question about diabetes may actually be testing:
Renal function
Clinical judgement
Medicine safety
Adverse effects
A question about anticoagulants may actually be testing:
Bleeding risk
Monitoring
Contraindications
A question about antibiotics may actually be testing:
Recognising the assessment point is often the key to selecting the correct answer.
4. Pharmascholar Strategy
The Fastest Route to the Correct Answer - Experienced prescribers develop mental shortcuts....
See Metformin?
Check the eGFR.
See Insulin?
Think medication safety.
See Gliclazide?
Think hypoglycaemia.
See SGLT2 Inhibitors?
Think sick-day rules and DKA.
These simple strategies can often reveal the assessment point within seconds.
5. Most Likely Questions
Rather than presenting endless facts, we focus on the question styles most likely to appear.
Diabetes
Can metformin be prescribed at this eGFR?
Does renal function alter management?
Is this hypoglycaemia?
Is this DKA?
Should the SGLT2 inhibitor be temporarily stopped?
Which insulin should continue?
Hypertension
Anticoagulants
Is anticoagulation indicated?
Is bleeding risk significant?
Should treatment continue?
This is where revision becomes strategic rather than passive.
Why Reverse Engineering the PSA® Is Different
Most revision resources teach guidelines. Most question banks test knowledge. Pharmascholar aims to bridge the gap between the two. To achieve this, Dr Mike Davies uses his extensive experience in prescribing education, clinical pharmacology and assessment preparation to analyse topics from the examiner's perspective. The goal is not simply to learn more. The goal is to understand:
✅ What examiners are testing
✅ What is most likely to come up
✅ Common prescribing traps
✅ How BNF guidance becomes PSA questions
✅ How to maximise marks efficiently
Because successful candidates do not just know the information. They understand how the information is assessed.
Introducing the Pharmascholar PSA Exam Insight Series
Over the coming months towards January / March 2027, we will apply the Reverse Engineering the PSA® methodology to some of the highest-yield areas in prescribing:
Diabetes
Hypertension
Anticoagulants
Heart Failure
Asthma & COPD
Acute Kidney Injury
Antimicrobials
Pain Management
Prescribing Calculations
Prescribing in Pregnancy
Each guide will include:
✅ Core Knowledge
✅ Reverse Engineering the PSA®
✅ Question Insight
✅ PharmaScholar Strategy
✅ Most Likely PSA Questions
✅ Exemplar PSA Questions
Because candidates deserve more than revision notes. They deserve insight.
Most revision resources teach the guideline. Most candidates revise the content. The highest-performing students go one step further. They ask:
"What is the examiner trying to test?"
That is the philosophy behind Reverse Engineering the PSA®. By understanding how examiners transform BNF guidance into assessment questions, you can focus revision on the topics most likely to generate marks and develop the reasoning skills required for safe prescribing. Because success in the PSA is not simply about knowing the answer. It is about understanding: Why the question was asked in the first place.
Reverse Engineering the PSA®: Diabetes (Type 1 & Type 2)
Discover the diabetes topics most likely to appear in the PSA, how examiners build diabetes prescribing questions, and the strategies that can help you pick up marks quickly, safely and confidently. Don't just learn the BNF. Learn how the PSA uses it. ♟️🚀
