The MSF
Multi-Source Feedback
Your colleagues have opinions about you. The MSF just makes sure they write them down. Fortunately, it's also one of the most growth-promoting tools in GP training — if you use it well.
📅 Last updated: 10 April 2026
📥 Downloads
Handouts, templates, and practical guides — written by trainees, for trainees. These will save you a lot of head-scratching.
path: THE MSF
Web Resources
A hand-picked mix of official RCGP guidance and real-world GP training resources — because the best insights are sometimes hiding outside the official documents.
🏛️ Official RCGP Guidance
- RCGP: MSF Official Guidance Page The definitive source — requirements, process, and how to use your results
- RCGP: Leadership Activity & Leadership MSF The additional ST3 MSF focused on leadership skills
📂 FourteenFish & Portfolio
- FourteenFish Help Centre Step-by-step guidance on using the MSF tools within the portfolio
🎓 GP Training Resources
- GMC Standards for GP Training The regulatory underpinning for why WPBAs like the MSF exist
💬 Trainee-Friendly Resources
- Bradford VTS: GP Training Hub Practical trainee guides to all aspects of GP training
- UK Doctor Training Forums Real trainee discussions — read critically but often insightful
Quick Summary — If You Only Read One Section
Panicking before a tutorial? Here are the essential facts at a glance.
(ST1, ST2, ST3)
(usually 5 clinicians + 5 non-clinicians)
(in 2nd half of ST3)
(not your trainer)
ePortfolio
+ Clinical performance
📌 The 8 Things You Must Know
- 1 MSF per training year — one in ST1, one in ST2, one in ST3. Plus a Leadership MSF in the second half of ST3.
- Minimum 10 respondents — usually 5 clinicians + 5 non-clinicians. Ask more than 10 to account for drop-out.
- You organise it — the trainees is responsible for starting the survey, completing self-assessment, and inviting respondents via FourteenFish.
- Responses are anonymous — but your ES can see who was invited (not who said what).
- Your ES releases the results — they do not appear in your portfolio automatically. Email your ES to ask them to release.
- Discuss results with your ES or CS — a feedback discussion and reflection are required. Link any development areas to your PDP.
- Vary your raters — choose different people each cycle, across different roles and seniorities. Don't just pick your friends.
- In GP placement, non-clinicians are included — receptionists, admin staff, healthcare assistants all count and their views matter.
What is the MSF?
The Core Idea
The Multi-Source Feedback (MSF) — sometimes called a "360° appraisal" — is one of the WPBA tools within the MRCGP assessment framework. It collects structured feedback from a range of colleagues about your professional behaviour and clinical performance.
Unlike a COT or CbD (which assess a specific consultation or case), the MSF captures how people experience working with you over time. It answers the question: "What kind of colleague and doctor are you to those around you?"
Why It Exists
The MSF exists because self-insight has limits. We all have blind spots — patterns we can't easily see in ourselves. Colleagues who work with you day-to-day can spot things no exam ever could: how you treat the receptionist under pressure, how clearly you communicate with the nurse, whether you follow through on responsibilities.
Used well, the MSF is one of the most professionally useful assessments in training. Used poorly, it becomes a tick-box exercise. This page will help you use it well.
MSF Requirements by Training Year
What you need to complete, and when — verified against the RCGP website (May 2025).
| Training Year | MSFs Required | Clinician Respondents | Non-Clinician Respondents | Notes |
|---|---|---|---|---|
| ST1 Hospital & GP posts | 1 MSF | Minimum 5 | Minimum 5 (if in GP post) May substitute more clinicians in hospital if needed | Agree date with ES or CS in advance |
| ST2 Hospital & GP posts | 1 MSF | Minimum 5 | Minimum 5 (if in GP post) | Vary your raters from ST1 where possible |
| ST3 GP post | 1 MSF + 1 Leadership MSF (2nd half) | Minimum 5 | Minimum 5 | Leadership MSF requires Leadership Activity to be completed first |
Who Can Complete Your MSF?
The rules differ between hospital and GP settings — and getting this right matters.
🏥 Hospital Setting
- Consultant supervisors and registrars
- Junior doctors working alongside you
- Nurses and senior nursing staff
- Allied health professionals (physio, OT, pharmacists etc.)
- All must be clinical staff
- Non-clinical staff not routinely included in hospital
- Range of seniority is important — don't just ask seniors
🏡 GP / Primary Care Setting
- GP partners and salaried GPs
- Practice nurses, ANPs, paramedic practitioners
- Healthcare assistants (clinical)
- Receptionists and admin staff (non-clinical — count towards the 5 non-clinical minimum)
- Practice managers and secretaries
- Community nurses, pharmacists working with the practice
- Both clinicians AND non-clinicians assess professional behaviour; only clinicians assess clinical performance
| Role | Clinical or Non-Clinical? | Assesses Professional Behaviour? | Assesses Clinical Performance? |
|---|---|---|---|
| GPs / Doctors | Clinical | ✅ Yes | ✅ Yes |
| Practice Nurses / ANPs | Clinical | ✅ Yes | ✅ Yes |
| Receptionists / Admin | Non-Clinical | ✅ Yes | ❌ No (not expected) |
| Practice Managers | Non-Clinical | ✅ Yes | ❌ No |
| Healthcare Assistants | Clinical | ✅ Yes | ✅ Yes (limited scope) |
Step-by-Step: How to Do Your MSF
From agreeing a date to discussing your results — the complete guide using FourteenFish.
- 1Agree a date with your Educational Supervisor (ES) Plan ahead. Agree when you'll start the MSF and set a date for the closing deadline and feedback discussion. Don't leave it to the last month of the post — you need time to gather 10 responses and then have the discussion.
- 2Log into FourteenFish and start your survey In the FourteenFish ePortfolio, navigate to the WPBA / MSF section and start a new MSF survey. You'll be prompted to complete your self-assessment first before inviting anyone else.
- 3Complete your self-assessment Rate yourself honestly on both domains (professional behaviour and clinical performance). This self-assessment is private to you and your ES — it is not seen by respondents. The purpose is to compare your self-perception with how others see you. Where big gaps exist, that's your most valuable learning.
- 4Select your respondents — aim for 14–16 Add each person's name, email address, and role. The system will send them an invitation email with a unique link. Always invite more than 10 to account for non-responders. Make sure your ES knows who you've invited (for oversight purposes).
- 5Give respondents a brief explanation letter It really helps to hand out (or email) a short covering note explaining what the MSF is, why it matters, and how to complete it. There is a downloadable template in the Downloads section above — it has been written by previous trainees and takes the awkwardness out of asking.
- 6Wait for responses — FourteenFish sends auto-reminders at 10 days You can see how many people have responded (but not who specifically, or what they said). A polite reminder to colleagues who haven't responded is entirely reasonable.
- 7Email your ES to release the results Your results are not released automatically. Once the survey closes, your ES receives access to the anonymised data first. You need to email them and ask them to release the results to your portfolio. This protective step exists so that if the results are sensitive, they can be handled with care before you see them alone.
- 8Review your results before the feedback discussion Once released, review the data in your FourteenFish portfolio. Look at the ratings, read the free-text comments carefully, and note any patterns. Think about what surprises you — positively and negatively.
- 9Have a feedback discussion with your ES or CS This is a structured conversation about what the data shows. It is not an interrogation — it is a professional development conversation. Reflect openly. Identify 2–3 key learning themes. The discussion should be recorded in your Learning Log.
- 10Write your reflection and update your PDP Record a reflection in the "Reflection on Feedback" log entry type in FourteenFish. If developmental areas were identified, create a PDP item. Your ES can comment on and endorse your reflection in the portfolio.
The Two Domains — What's Being Assessed
The MSF assesses you in two broad domains. Understanding these helps you both improve and make sense of your results.
👤 Domain 1: Professional Behaviour
Assessed by all respondents — clinical and non-clinical
- Caring attitude towards patients
- Respectful treatment of patients
- No prejudice in patient care
- Effective communication with patients
- Respect for colleagues' roles in the team
- Constructive contribution to the team
- Effective communication with colleagues
- Appropriate language and level for patients
- Not avoiding responsibilities
- Commitment to work and to the team
- Taking responsibility for own learning
🩺 Domain 2: Clinical Performance
Assessed by clinical staff only
- Thorough history-taking and examination
- Identifying patients' problems accurately
- Patient-centred diagnostic approach
- Appropriate selection of diagnostic tests
- Appropriate involvement of the wider team
- Learning from clinical practice
- Competent clinical and procedural skills
- Appropriate time management in clinical work
The Leadership MSF — ST3 Only
The ST3-specific MSF that focuses on your growth as a leader in primary care. Yes, GPs are leaders — even as a registrar.
What Is It?
The Leadership MSF is a separate MSF cycle in ST3, completed in the second half of the year. It is specifically designed to generate feedback on your leadership skills — an area that is often underdeveloped in doctors who have not thought explicitly about their role as a leader.
Leadership in GP doesn't mean managing an NHS trust. It means things like: initiating a change in the practice, mentoring students, leading a MDT discussion, improving a system, or showing professional initiative in the team. It is a skill set that can be learned and developed.
The Sequence: Activity First, Then MSF
Complete the Leadership Activity
This must be done before the Leadership MSF can start. The activity is recorded in a specific reflective log entry in FourteenFish, assessed against the Organisation, Management & Leadership capability.
Complete Self-Assessment
As with the standard MSF, complete your own self-assessment first in FourteenFish.
Invite Colleagues
Invite the standard minimum of 10 (recommend 14+), ensuring respondents include people who have seen your leadership contributions.
ES Releases Results → Feedback Discussion
As with any MSF: ES releases results, feedback discussion follows. Record reflections and create a PDP item if needed. Even if there are development areas, the Leadership MSF does not need to be repeated.
🏅 On the Leadership MSF — What ST3s Wish They'd Known Earlier
One of the most commonly reported ST3 mistakes. The Leadership Activity must be completed before the Leadership MSF can start — and both must be finished in ST3. Trainees who drift through the first half of ST3 without starting their leadership activity sometimes find themselves trying to compress everything into the final months, alongside SCA preparation and ARCP evidence gathering. The advice from experienced ST3s: identify your leadership activity at the very start of ST3, ideally in the first tutorial with your trainer, and begin it early in the year.
Many trainees are surprised to learn how broad the definition of a leadership activity actually is. Organising a significant event analysis, chairing a practice meeting, running a teaching session for medical students, co-ordinating a vaccination drive, creating a patient information resource, or mentoring a junior colleague can all qualify. The RCGP provides a non-exhaustive list of examples. Trainees who engage with the breadth of options tend to find a leadership activity that aligns with something they're genuinely interested in — which makes the reflection richer and more authentic.
Top Tips for Getting Good MSF Feedback
The quality of your MSF is heavily influenced by how you approach it day-to-day — not just on the day you send invitations.
🎯 Earn Good Feedback Before You Ask For It
The single most effective strategy is simply being a good colleague — reliably, every day. Arriving on time, following through on responsibilities, treating everyone respectfully regardless of their role. The MSF reflects how you behave across weeks and months, not just on the day you hand out invitations.
🤝 Treat Non-Clinical Staff With Genuine Respect
Receptionists, admin staff, and secretaries see things others don't. They notice if you are impatient at the desk, dismissive of their queries, or inconsistent in how you communicate. In primary care, these are the colleagues who will complete Domain 1 for you. Mutual respect is not optional — it is the foundation of good team working in GP.
📋 Choose a Diverse Range of Raters
Include different roles, different seniorities, and different contexts. Someone who has seen you in a duty session has different insight from someone who sees you in routine clinic. Don't just ask your friends — a slightly uncomfortable honest response is worth more than five glowing but uninformative ones.
📝 Give Respondents a Brief Covering Letter
The downloadable covering letter (in Downloads above) makes a significant difference. It explains what the MSF is, why it matters, and what respondents should focus on. People who understand the process give better, more specific feedback. Brief them well and you'll get better data.
🔁 Close the Loop — One of the Highest Scoring Behaviours
One of the most consistent themes from trainee experience: colleagues rate you higher when you follow up. This is simple but powerful. If you said "I'll let you know," actually let them know. If a patient you discussed was admitted, drop the nurse a message. If someone flagged an issue, circle back to confirm it's resolved. This closes the communication loop and signals exactly what the MSF markers look for — responsibility, reliability, and genuine teamworking. It costs almost nothing and is noticed far more than people expect.
- "Just to update you — that patient we discussed was admitted and is doing well."
- "Thanks for flagging that earlier — all sorted now."
- "I said I'd check on that prescription query — here's what I found."
💬 Give Raters Context When You Ask
Colleagues who understand the MSF process give better, more specific feedback. A brief word when you send the invitation makes a real difference — not to influence scores, but to reduce the vague "tick everything 5" responses that tell you nothing.
The phrase including anything you could do better is the key. It signals that you want development feedback, not just praise, and tends to produce richer, more useful written comments.
🔄 Don't Repeat Raters Across Cycles
Use different colleagues for each MSF cycle where possible. Your educational supervisor will be able to see who was invited — even if they can't see who said what. Using a wide variety of raters across your training means you build a more complete, reliable picture of how you're perceived.
📖 Review the Domains Before You Send Invitations
Before you click "send" on the invitations, spend 5–10 minutes re-reading the clinical and non-clinical domain markers on the RCGP guidance and on this page. This serves two purposes: it reminds you of what raters are actually being asked to judge, and it prompts you to reflect honestly on which specific behaviours you want to work on before the feedback arrives. Trainees who do this consistently report that the results feel less surprising and more useful — because they were already thinking in the same framework as their raters.
🔥 Include People Who Have Seen You Under Pressure
It is easy to default to raters who have seen you at your best — planned clinics, routine ward rounds, colleagues who know you well and like you. But MSF is specifically designed to assess professional behaviour and reliability across conditions. Some of the most informative raters are those who have seen you when things are hard: the duty doctor session that overran, the nurse who was with you when a patient deteriorated, the receptionist who dealt with a complaint you were involved in. These observations test the qualities that matter most: consistency, composure, and teamwork under pressure.
📋 Use a Simple Tracking List — and Set a Mini-Deadline
Two practical habits that experienced trainees swear by:
Set a mini-deadline 4–6 weeks before your formal ARCP or ESR deadline. This gives you time to chase non-responders, add more colleagues if needed, and avoid the last-minute panic that leads to a rushed or poorly representative MSF.
Keep a simple tracking list:
| Name | Role | Clinical? | Date invited | Responded? |
|---|---|---|---|---|
| Dr Smith | GP Partner | ✅ Yes | 01 Mar | ✅ Yes |
| Jane (Reception) | Receptionist | ❌ No | 01 Mar | ⏳ Pending |
At a glance, you can see your clinician/non-clinician balance and who still needs a gentle nudge.
💬 Engage Meaningfully With the Results
The worst thing you can do with your MSF is file it without reflection. The second worst is being defensive in the feedback discussion. The best thing is to approach it with genuine curiosity: "What can I actually learn from this?" That mindset — consistently applied — is what makes the MSF genuinely useful rather than a box-ticking exercise.
Common Pitfalls — Trainee Traps
These are the mistakes that come up repeatedly. Every one of them is avoidable.
- Leaving the MSF until the last few weeks of the post — not enough time to gather 10 responses and have a meaningful discussion
- Inviting only 10 people — 2–3 non-responders means you fall below the minimum
- Forgetting to email your ES to release the results — they don't appear automatically
- Not completing the self-assessment before sending invitations (FourteenFish requires this)
- Repeating the same raters every cycle — your ES can see this and it reduces validity
- Using people who barely know your work — vague feedback is useless for development
- Only asking people you're confident will say nice things — you lose the honest data
- Being defensive in the feedback discussion — this is a development tool, not a tribunal
- Writing a generic, superficial reflection without engaging with specific comments
- Not linking development areas to a PDP item — the loop must be closed
- Not reading the written comments at all — the numbers alone are not the story
- Treating the Leadership Activity and Leadership MSF as an afterthought in ST3 — start planning early
Understanding Your Results
What the numbers mean — and why the written comments matter more than the scores.
Reflecting Well on Your MSF
The reflection is where the real value of the MSF is unlocked. Here is how to make it count.
A Simple Framework for MSF Reflection
| Reflection Prompt | What to Consider |
|---|---|
| What did I learn about myself? | What patterns did you notice? Any surprises — positive or negative? Where did self-perception differ from others' perceptions? |
| What am I doing well? | Acknowledge the commendations honestly. What consistent strengths are showing up? How will you continue to build on them? |
| Where can I develop? | What specific, actionable areas came up? Focus on 2–3 themes rather than trying to address everything at once. |
| What will I change? | What specific behaviours will you do differently from now? How will you know if you've improved? |
| What will I put in my PDP? | For each development area, create a SMART PDP goal. Link it to the relevant RCGP Professional Capability if appropriate. |
- Use the "Reflection on Feedback" log entry type for your written reflection
- Your ES can view and comment on this reflection within the portfolio
- Create a PDP item for any developmental areas — link it to relevant capabilities
- The feedback discussion itself can also be recorded as a learning log entry
- These entries contribute to your overall WPBA evidence and inform ARCP discussions
✍️ A Worked Reflection Example — What "Good" Actually Looks Like
This is an example of a reflection that would satisfy an ARCP panel — specific, honest, with a concrete action and a way to measure improvement.
"Several colleagues commented positively on my approachability and willingness to help. However, two pieces of feedback noted that I can appear rushed when the clinic is busy — one comment specifically mentioned that I sometimes give brief answers without checking whether the person understood. I recognise this pattern. When I am under pressure, I tend to prioritise completing tasks over communicating fully. Going forward, I will make a deliberate effort to pause briefly during interactions even when busy, and use a closing check — 'Does that make sense?' or 'Is there anything else you need?' — before moving on. I will review this with my ES at the next meeting and will ask for informal feedback from the practice nurse at the end of month two to gauge whether the change has been noticeable."
"Overall the feedback was positive and I am pleased with the results. I will continue to work on improving my communication skills and aim to keep building on my strengths as I progress through training."
Why this fails: no specific feedback referenced, no self-insight, no concrete action, no way to measure change.
Insider Pearls — Real-World Wisdom
Things that make a big difference in practice — drawn from real trainee and trainer experience.
The MSF as a Mirror
Experienced trainers describe the MSF as the only WPBA tool that can show a trainee something genuinely new about themselves. A COT tells you about your consultation skills. The MSF tells you about who you are as a colleague. For some trainees, it is the most professionally transformative experience in training — if they are willing to look honestly at what it shows.
The Results-Release Wait
Trainees frequently forget to email their ES to release the results — and then spend weeks wondering why they can't see anything in the portfolio. The system does not notify them automatically. If you're waiting and nothing has appeared: check whether you emailed your ES, and check whether they are the correct person (ES, not trainer).
The Reception Desk Test
Experienced GP trainers have described an informal benchmark: how does a registrar treat the reception team? Not occasionally, but routinely and under pressure. Receptionists often have an unusually accurate read on the "real" personality of a doctor — because they see them when they're tired, stressed, and not performing for an audience. This matters — and they will be rating you.
Using the MSF to Accelerate Development
The most effective trainees use the MSF proactively — they identify a specific professional behaviour they want to work on before the cycle starts, make a conscious effort to improve it, and then use the MSF to measure whether the change has been noticed. This turns the MSF from an administrative task into a deliberate development intervention.
What Trainees Actually Say — Community Wisdom
Recurring themes from trainee experience across UK GP training — the things people wish they had known before they started. Presented as professional teaching points; verified against RCGP guidance where factual.
🏥 The Hospital MSF Challenge — What Trainees Actually Find Hard
Hospital-based MSF presents practical challenges that official guidance doesn't fully prepare you for.
A consistent theme from trainees in hospital posts: some consultants — particularly those unfamiliar with GP training — tend to award very high scores uniformly, sometimes scoring everything "excellent" regardless of actual performance. This can make the MSF less informative. It is better to involve a mix of seniorities, including registrars and middle grades who have worked closely with you, rather than relying entirely on consultant supervisors who may have had limited direct exposure to your work.
In community or integrated posts, trainees have found it very useful to include community nurses, physiotherapists, pharmacists, and social workers as respondents — even in hospital posts where non-clinical staff aren't formally counted. While these colleagues may not count towards your non-clinical five in a hospital setting, their written comments often provide some of the most valuable qualitative feedback, particularly around communication and teamwork.
🏡 The GP Practice MSF — Common Trainee Experiences
In small practices — sometimes with only 2–3 GPs and a handful of admin staff — reaching 10 unique respondents is genuinely difficult. Trainees in this situation have solved it by including: the practice pharmacist, the attached district nurse, the healthcare assistant, paramedic practitioners visiting the practice, and community mental health workers with whom they have regular contact. If in doubt, discuss with your ES — they can advise on whether community colleagues are suitable, and in very small practices an Educator's Note may be appropriate.
This is one of the most consistently repeated experiences among GP trainees who reflect genuinely on their MSF results. Reception staff see how you behave when you think no one important is watching. They notice if you're impatient at the desk, dismissive when things go wrong, or inconsistent in how you treat different people. Many trainees have described the non-clinical feedback as the section that taught them the most about their professional behaviour — precisely because it was less filtered than feedback from clinical seniors.
Trainees who run the MSF too early in a GP post — in the first few weeks — sometimes report that colleagues don't know them well enough to give specific, useful feedback. Comments end up vague. Those who time it at 2–3 months into a placement, when people have had real exposure to their work, consistently report richer and more specific feedback. Don't rush it — but don't leave it to the last two weeks either.
📝 On Writing Reflections — What Trainees Learn the Hard Way
A common experience at ESR and ARCP: trainee writes a reflection that says "feedback was positive, I will continue to build on my strengths." The Educational Supervisor returns it asking for something more specific. The RCGP expects reflections to demonstrate genuine self-awareness, critical thinking, and a clear plan. Phrases like "I aim to continue improving" without specific behaviours or a PDP item linked to a concrete goal are not enough. Write what you are actually going to change, and how you'll know it has worked.
Trainees who have received positive ARCP feedback on their MSF reflections consistently describe the same approach: (1) acknowledge a specific piece of developmental feedback honestly, (2) explore what might be behind it — context, behaviour, or pattern, (3) describe a specific change they have made or will make, (4) link this to a PDP item with a timeframe and a way to measure improvement. This structure — specific, honest, actionable, measurable — is what assessors look for. Generic reflections are the single most common reason MSF reflections are sent back.
🌍 IMG-Specific Experiences — Things Worth Knowing
These themes appear repeatedly among International Medical Graduates navigating the MSF for the first time in the UK.
IMGs sometimes receive lower ratings on items related to communication clarity and language — not because their clinical competence is lower, but because cultural communication norms differ. A doctor trained in a hierarchical system may come across as more formal or less conversational than UK patients expect. This is a communication style adjustment, not a clinical failure. If this pattern appears in your MSF, discuss it openly with your ES. It is usually addressable through coaching and awareness rather than any fundamental change to your practice.
In some healthcare systems outside the UK, it is normal for doctors to receive less candid feedback from colleagues — and to give less. This can work both ways in the MSF: IMGs sometimes rate themselves lower than colleagues rate them (imposter syndrome), and sometimes find it culturally uncomfortable to ask junior or non-clinical staff for feedback. Both experiences are widely reported and completely understandable. The UK system expects you to solicit feedback across all levels — including from receptionists — and to engage with it openly. If this feels unusual, it's a cultural adjustment, not a personal failing.
🔍 Behavioural Markers Decoded — What They Actually Mean in Practice
The MSF questionnaire uses language that sounds simple but means something specific in GP practice. Here's what colleagues are actually thinking when they rate you on each marker.
| Marker | What it actually means | Behaviours that score well | What catches trainees out |
|---|---|---|---|
| "Works well in a team" | Not vague teamwork — it means being reliably present and useful when things get difficult | Helps others when the workload increases; doesn't disappear; communicates when plans change | Going quiet during busy periods; not volunteering when a colleague is struggling |
| "Respects colleagues" | Day-to-day micro-behaviours, not grand gestures | "Thanks for your help with that"; asking reception for input; not overriding nurses without discussion | Interrupting; dismissing suggestions quickly; looking rushed or disinterested |
| "Communicates effectively" | Adjusting language and style for the audience — different for patients, nurses, admin, and doctors | Clear, jargon-free with non-clinical staff; adapts pace and tone; follows up on things said | Using medical jargon with reception; not confirming understanding; trail-off conversations |
| "Does not shirk responsibilities" | Following through — doing what you said you would do | Closing loops; completing tasks on time; flagging when something is beyond your scope rather than avoiding it | Leaving notes late; not handing over properly; hoping problems resolve without action |
| "Demonstrates commitment to the team" | Being a reliable presence — contributing to the team culture, not just attending | Showing interest in the practice; participating in meetings; being helpful beyond your own list | Only engaging with your own patients; arriving and leaving without interaction |
One of the most repeated pieces of wisdom from trainees who have done this well: don't start caring about your MSF in the week you send it out. The feedback people give reflects their cumulative experience of you — weeks, sometimes months, of interactions. A sudden burst of helpfulness the week the invitations go out is unlikely to change perceptions built over months.
Start 2–4 weeks before you plan to run the MSF:
- Be more visible — say good morning, make eye contact
- Be proactive — offer help before being asked
- Communicate clearly — confirm plans, not just intentions
- Close loops — follow up on things you said you'd do
Negative memories tend to be stickier than positive ones — this is human psychology, not a flaw in the MSF system. A single sharp tone when under pressure, a dismissive comment to a receptionist on a busy morning, or a trail-off conversation that left someone uncertain: these tend to persist in colleagues' minds longer than ten examples of excellent professional behaviour.
The implication: your standard of professionalism when stressed, tired, or overwhelmed matters more to your MSF scores than how you behave on your best days. Being consistently respectful under pressure is what distinguishes trainees who score well from those who score variably.
💬 Real-World Phrases That Improve MSF Scores
These are the kinds of phrases that appear in positive MSF free-text comments — not because trainees were performing, but because they had become natural communication habits. You can start using any of these tomorrow.
- "Thanks for picking that up — I hadn't spotted that."
- "Do you mind if I just check something with you?"
- "That's really helpful — I hadn't thought of it that way."
- "I'll update you once I hear back."
- "Let me know if you'd approach this differently."
- "Can I just check how best to handle this?"
- "Thanks for sorting that — really appreciate it."
- "Let me know if that causes any issues at your end."
- "How does this usually work here — do you have a preference?"
- "I know this is extra work — thanks for bearing with me."
- "I'm tied up right now but I will come back to this."
- "Let's prioritise — what's most urgent from your side?"
- "I'll double-check that and come back to you."
- "I'm not sure — let me find out properly rather than guess."
- "Just give me two minutes and I'll be with you."
When an ARCP panel reviews MSF results, they are not averaging the scores. They are looking for patterns of concern. A single isolated comment rarely triggers action. But multiple comments across different respondents pointing at the same theme — communication, reliability, respect for non-clinical staff — is a signal that gets discussed. Isolated positives, however many there are, do not cancel out a consistent negative pattern.
This also means: a reflection that says "all was positive, nothing to develop" is itself a concern — it suggests either the MSF wasn't done thoroughly, or the trainee lacks self-awareness. The strongest MSFs show genuine strengths and genuine areas for development, with a credible reflection and action plan for the latter.
🔢 The 3-2-1 Reflection Framework
A practical structure widely shared among UK GP trainees and endorsed by GP educators for making sense of MSF results. Simple enough to apply in a single tutorial session.
Three strengths to consolidate. Identify the qualities and behaviours that your colleagues consistently praised. Acknowledge these explicitly in your reflection and think about how you will continue to demonstrate and build on them.
Two development points to actively work on. Pick the two themes that appeared most consistently as areas for development. Don't try to address everything — focused improvement on two things is far more achievable than vague intentions to "do better overall."
One concrete change for the next month. Something specific, observable, and measurable. For example: "I will signpost my thinking out loud to the practice nurse after each shared patient" or "I will check in with reception once during each duty session to ask if there's anything needing attention."
📅 Read Once — Then Wait a Day
When your MSF results are first released, read through everything once. Then close the portfolio and wait at least 24 hours before discussing the results with your ES.
This approach — consistently described by trainees and educators as the most productive — gives your initial emotional response time to settle. Comments that feel personal or unfair when you first read them often look different the next day. When you sit down with your ES having had time to reflect, you are far more likely to engage with patterns rather than fixating on a single phrase. The discussion becomes developmental rather than defensive.
🙋 Asking for Help Is MSF-Positive
A widely shared insight from GP educator videos and trainee experience: colleagues respond very well — both in day-to-day interactions and in MSF feedback — when they see you appropriately seeking advice. Asking a nurse "What would you do here?", checking something with a senior before acting, or flagging uncertainty early rather than struggling in silence: these behaviours are consistently cited in positive MSF free-text comments. The MSF is not testing whether you know everything. It is testing whether you function safely and professionally within a team — and appropriate help-seeking is a core part of that.
One of the most effective strategies shared in IMG-focused GP training content is to explicitly invite informal feedback from colleagues throughout the year — not only when the MSF survey goes out. A simple, honest invitation makes colleagues feel empowered to give you real insight and primes them to be more thoughtful when the formal MSF arrives.
This also means that when MSF feedback arrives commenting on communication tone, body language, or professional style — the kinds of feedback IMGs sometimes find surprising — it feels less like a shock and more like a continuation of an ongoing conversation.
For Trainers — Teaching & Facilitation Guide
How to make the MSF process educational and meaningful for your registrar.
Common Trainer Responsibilities
- Clinical Supervisors (CS) can be involved in agreeing the date and conducting the feedback discussion, in addition to or instead of the ES in some settings
- Educational Supervisors (ES) must be the one to release the MSF results to the trainee — this is non-negotiable
- ES should review the results before releasing, particularly if scores are low or comments are sensitive
- Ensure the trainee has completed their self-assessment before invitations are sent
- Review who the trainee has invited — you need oversight without breaking anonymity
- Facilitate a meaningful feedback discussion — this is a developmental conversation, not a tribunal
Tutorial & Teaching Ideas
- Pre-MSF tutorial: Discuss what the two domains mean, what "good looks like," and how the trainee wants to be seen by colleagues. Set intentional goals before the MSF cycle starts.
- Post-MSF tutorial: Review the results together. Ask open questions: "What surprises you most?" "What do you think is behind that comment?"
- Role modelling discussion: How do you think about professional behaviour in your own practice? Sharing your own experiences of 360° feedback is powerful modelling.
- Reflective writing review: Read the trainee's reflection together and ask: "Is this specific enough?" "What will you actually change?"
Facilitation Questions for the MSF Feedback Discussion
Use these as prompts to open up a richer developmental conversation:
- "What did you notice when you first saw the results?"
- "Where does the data most closely match how you see yourself?"
- "Where was there the biggest gap between your self-assessment and others' ratings?"
- "What do you think is behind the developmental comments?"
- "If you could change one thing about how colleagues experience working with you, what would it be?"
- "What do you think the receptionists were thinking when they filled this in?"
- "How do you think you're perceived by people more junior than you?"
- "What would 'above expectation' look like in your next MSF cycle?"
- "What specific change would you make this week as a result of this feedback?"
- "How will you know in 3 months whether you've actually changed?"
- Trainees who are polite to seniors but unintentionally dismissive to non-clinical staff — often not aware of this pattern at all
- Trainees who score low on "not avoiding responsibilities" due to subtle task-avoidance behaviours (e.g. consistently leaving notes late, avoiding difficult phone calls)
- Trainees who score well clinically but less well on team communication — often because they retreat to their consulting room and don't engage with the wider team proactively
- Trainees who are surprised by positive feedback — imposter syndrome is common and worth exploring gently
- IMGs who sometimes receive lower scores on language-related items, which warrants a careful and culturally sensitive discussion about communication style
🤝 Good Feedback Practice for Supervisors — The MSF Debrief That Works
The way the MSF feedback discussion is handled matters as much as the content of the feedback itself. These principles are drawn from deanery guidance and GP educator consensus on what makes the debrief genuinely developmental.
- Create a supportive atmosphere from the start. Acknowledge the trainee's effort in organising the MSF. Normalise any anxiety — this is a vulnerable conversation and the tone you set in the first two minutes shapes everything that follows.
- Balance the supervisory and developmental roles. You are not just assessing — you are helping the trainee learn. Be clear about where standards need to be met, but keep the focus on growth and understanding, not on judgment.
- Let the trainee speak first. Ask them what they noticed, what surprised them, and what they felt reading the feedback. Their initial response tells you a great deal about their level of self-awareness.
- Don't save feedback only for the MSF meeting. The debrief is most effective when it is part of an ongoing conversation. If you have been giving informal feedback throughout the placement, the MSF results will feel like a natural extension of what they already know, not a sudden verdict.
- Negotiate the action plan together. The plan should emerge from the trainee's own reflection, guided by you — not handed to them as a list of instructions. Ask: "What change feels most achievable this month?" A trainee-owned action plan is far more likely to be acted on.
- Arrange a follow-up. The debrief is not the end — agree a date to revisit progress. Even a 10-minute check-in at the next tutorial cements the developmental loop and signals that you are invested in their growth.
FAQ — Quick Answers
"Would I trust this doctor to work safely, respectfully, and reliably in my team — every day?"
If the answer from the people around you is a consistent yes — your MSF will be strong. Every behaviour, every interaction, every follow-up either builds or erodes that answer.
🏁 Final Take-Home Points
- One MSF per training year in ST1, ST2, and ST3 — plus a Leadership MSF in the second half of ST3. Four in total.
- Invite more than 10 people — always. Non-responders are common and you cannot afford to fall below 10 completed surveys.
- Complete your self-assessment first in FourteenFish before sending invitations. The gap between self-rating and others' ratings is often your richest learning.
- Email your ES to release your results — they will not appear automatically. ES ≠ trainer. Make sure you know who your ES is.
- The written comments matter more than the numbers. Read them carefully. Look for patterns across multiple respondents.
- Choose raters who genuinely know your work — including non-clinical staff in GP posts. The receptionist's perspective is valid, important, and often the most honest in the building.
- Don't repeat raters across cycles. Vary the people you invite each year to build a broader, more reliable picture.
- Engage genuinely with the feedback discussion. Defensiveness is the enemy of development. Curiosity is your best ally.
- Link development areas to your PDP — closed loops in FourteenFish demonstrate engagement with your own professional development at ARCP.
- The MSF reflects who you are, not just what you know. The best doctors in GP are excellent colleagues as much as they are excellent clinicians. Use this tool to grow in both dimensions.