National trainee-led preparation programmes for surgical training transitions: design, delivery and lessons learned.

Progression through UK surgical training involves highly competitive national selection processes, particularly at entry into Core Surgical Training (CST) and subsequent entry into higher surgical training at ST3 level. Inequities in access to preparation resources and variability in mentorship remain recognized challenges. The Association of Surgeons in Training has developed national, trainee-led initiatives to support trainees at these key transition points. Preparing for a Career in Surgery (P4CS) and Preparing for Core Surgical Training (P4CST), established 10 years ago, supports foundation and early postgraduate doctors preparing for CST, while Preparing for ST3 (P4ST3), supports core trainees transitioning to higher surgical training. Both programmes are delivered nationally and incorporate thematic talks from successful candidates, portfolio clinics with personalized feedback, and mock interviews aligned with current CST and ST3 selection frameworks. Programme delivery has evolved from in-person to predominantly online formats to improve accessibility. Participation has increased steadily over time, with national reach across UK regions. Routine post-course evaluation demonstrated consistently high participant satisfaction across all programmes. Mean ratings for educational sessions ranged from 4.48 to 4.84 out of 5, while over 94% of participants reported adequate opportunities to ask questions and receive personalized feedback from faculty. Preparing for Core Surgical Training and Preparing for ST3 illustrate how trainee-led educational initiatives developed within professional associations can provide scalable, sustainable, and equitable support across the surgical training continuum. This model offers a transferable framework for supporting trainees navigating competitive postgraduate selection processes.