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Conclusions CMTs found it difficult to gain access to procedures essential for completion of ARCP and progression to medical registrar roles. This led to poor experience and a lack of confidence performing the procedures. The introduction of a bespoke procedural skills programme, based at the Royal Free Hospital and created for CMTs to obtain procedural competences, helped trainees gain experience and confidence in performing essential procedures, offered them daily to weekly opportunities throughout the training year, and ensured that they received formative and summative DOPS assessments from experienced supervisors. This model can be replicated in other trusts that provide the same procedural services, and has the potential to improve ARCP outcomes and increase confidence for CMTs progressing to medical registrar roles on a national level. ■

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