Avoid these common Prescribing Safety Assessment (PSA) mistakes and give yourself the best chance of passing first time.
The Prescribing Safety Assessment (PSA) is designed to test more than just your medical knowledge. It assesses your ability to prescribe safely, identify errors, interpret clinical information and make appropriate decisions under exam conditions.
Many students lose marks not because they lack knowledge, but because they make avoidable mistakes. By recognising these pitfalls early, you can improve your performance and approach the exam with greater confidence.
One of the most common PSA mistakes is rushing. Students often see a familiar scenario and immediately start looking for an answer before carefully reading the full question. Pay particular attention to:
The patient's age
Weight
Renal function
Allergies
Current medications
The specific task being asked
A question about prescribing may actually be asking you to identify an adverse effect, monitoring requirement or contraindication.
Top Tip: Take a few extra seconds to read every word before making a decision.
Prescribing a medication that the patient is allergic to is an obvious prescribing error and frequently appears within PSA-style questions. Before selecting any medication:
✅ Check allergy status
✅ Consider cross-sensitivity
✅ Review previous drug reactions
Tip: The PSA focuses heavily on patient safety. Missing an allergy warning can result in avoidable loss of marks.
Many medications require dose adjustment in renal impairment. Students often identify the correct medication but fail to adjust the dose appropriately. Common examples include:
Antibiotics
Anticoagulants
Metformin
Digoxin
Certain analgesics
Always review:
eGFR
Creatinine clearance
Relevant clinical information
Remember: The safest prescription is not always the standard dose.
The PSA frequently tests your ability to identify potentially significant drug interactions. Common examples include:
Warfarin and antibiotics
DOACs and interacting medicines
NSAIDs with ACE inhibitors
Multiple medicines that prolong the QT interval
Many students focus solely on the new medication and forget to review the patient's existing medicines.
Top Tip: Get into the habit of checking the medication history before selecting a treatment.
Avoid common PSA mistakes and improve your chances of passing the Prescribing Safety Assessment first time.
Some students know the content but run out of time. The PSA contains multiple question types and can feel demanding under examination conditions. Common timing mistakes include:
Spending too long on difficult questions
Repeatedly checking answers
Becoming stuck on calculations
If necessary:
Make your best decision
Flag the question mentally
Move on
You can return later if time allows.
Calculation questions often provide easy marks when approached methodically. Unfortunately, students frequently lose marks by:
Misreading units
Using incorrect conversions
Entering numbers too quickly
Forgetting to check their answer
Common areas include:
mg/kg dosing
Infusion rates
IV fluid calculations
Unit conversions
Always double-check:
The formula
The units
Whether the answer appears clinically reasonable
Students sometimes select the drug they recognise best rather than the most suitable option. The PSA is designed to assess safe prescribing in specific patients. Consider:
Comorbidities
Current medicines
Contraindications
Pregnancy status
Organ function
Top Tip: The "best" answer depends on the patient in front of you.
Prescribing safely involves more than selecting the correct drug. Many medications require ongoing monitoring. Examples include:
INR monitoring with warfarin
Electrolyte monitoring with diuretics
Renal function monitoring for certain medicines
Blood glucose monitoring in diabetes
Tip: Questions may test whether you recognise the need for monitoring before, during or after treatment.
Reading notes alone is rarely enough. The PSA has a unique format and rewards familiarity with:
Prescribing tasks
Medicines information questions
Data interpretation
Clinical reasoning
Students who regularly complete practice questions are often more comfortable navigating the exam and applying their knowledge under pressure. Practice helps turn knowledge into performance.
Many capable students underperform because they lose confidence during the assessment. Signs include:
Constantly changing answers
Overthinking straightforward questions
Spending excessive time checking work
Panicking after one difficult question
Remember: One difficult question does not mean you are failing. Stay calm, trust your preparation and focus on the question in front of you.
Avoid These Top 10 PSA Mistakes and Improve Your Exam Performance
The most common PSA mistakes are often preventable. Before sitting the exam, make sure you:
✅ Read questions carefully
✅ Check allergies and renal function
✅ Look for drug interactions
✅ Manage your time effectively
✅ Double-check calculations
✅ Consider monitoring requirements
✅ Complete regular practice questions
✅ Stay calm under pressure
Avoiding these mistakes could make a significant difference to your PSA performance and help improve your chances of passing first time.
Whether you're struggling with calculations, prescribing decisions, clinical reasoning or revision strategy, personalised support can help you focus on the areas that matter most.
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