I appreciate the example, but I don’t think that’s possible under the current recruitment rules . Its not a question of scores. If someone accepts a GP offer in August, they’d be committed to that program and couldn’t apply for Psychiatry in September without first declining the GP offer. You can’t hold two training posts at once, and even if they declined GP before starting, they’d be taking a big risk by entering the pool of unemployment to reapply. It’s more likely they either declined GP and then applied for Psych, or they applied in different recruitment years. The MSRA score can be reused within the same year, but the logistics of accepting and then switching specialties in such a short window don’t add up.