The FiY1 cohort was nationally implemented to bolster an already pressured health-service for the COVID-19 pandemic. Existing trainee programme templates (such as Foundation Year 1) were inapplicable. Realising this a volunteer team of trainees stepped-up to create a bespoke programme for the Trusts 43 FiY1s.

Aims Novel programme creation.

Trainees utilised as clinical leaders.

FiY1 pastoral and welfare support.

Methods FiY1s’ and Trust’s needs were initially unknown. Echoing military planning and the Wicked Problem concept, Tutors used question-based planning which identified 5 domains: operational; pastoral; educational; administrative and exit. The programme’s centre of gravity, and therefore critical needs, were established in educational and pastoral domains. A voluntary evaluation of the domains by FiY1s gauged programme quality.

Results Median score for programme quality was 9/10 (mode 10/10). Median and mode for pastoral and welfare support was 10/10. Median scores for teaching and clinical supervision was 8/10. The lowest scores were 6/10 for quality of clinical supervision (n=1) and quality of pastoral support (n=1).

Conclusion The programme provided a highly impactful and positive experience for FiY1s; qualitative responses showed increased levels of confidence due to enhanced clinical learning opportunities in a well-supported environment.

Clinical leadership routinely is hierarchical and repetitive. Creation and execution of this programme in non-routine times highlights the need for flexible, agile and innovative clinical leaders. The 5 domains are applicable to any educational programme creation enabling focussed and detailed needs’ analysis and planning.

Lessons learnt 1. Question-based planning effective in novel challenges 2. Trainees are capable of competently executing at operational and tactical levels in a trust 3. Organisations should encourage such opportunities for trainees but reciprocally need to provide guidance and support.