Background We developed a discussion evening for senior trainees taking the START (Specialty Trainee Assessment of Readiness for Tenure) assessment to both clarify the START assessment and consider their learning requirements before becoming a consultant.

Methods We have run the event three times with 60 trainees in total. We surveyed the trainees who attended the most recent evening before and after the discussion evening receiving 19 responses pre-course and 17 post-course.

Results 95% of the trainees were ST7–8.

Their knowledge of START improved with 78% of trainees post course agreeing with the statement “my knowledge of START is good” compared to 21% pre-course.

However, 63% of trainees pre-course disagreed with the statement “I feel confident to start a consultant job”. This did not significantly change following the course with 58% disagreeing with this statement.

Trainees had many worries about becoming a consultant. The most frequently cited were undertaking managerial aspects of the job, supervising trainees, increased responsibility and lack of support in decision making. 68% trainees stated they had had no training to prepare them for becoming a consultant. Trainees identified multiple learning needs to address before becoming a consultant: development of leadership and management skills, understanding finances and business planning, NHS structure, trainee supervision and dealing with emergencies at a consultant level.

Discussion The trainees found the evening reassuring and useful to clarify the structure of START, as well as identify their learning needs before becoming a consultant. The discussion group also highlighted a lack of specific training addressing the transition to consultant and demonstrated that opportunities to act up as a consultant are rare. To address this training gap and meet the learning needs of senior trainees we are developing a Transition to Consultant (T2C) course. In addition we surveyed 80 paediatric consultants to assess what they identified as the main training needs of a new paediatric consultant and have run two focus groups. We have combined the data from all these sources to develop the new T2C course that will run in 2016.