Background/motivationThe Trainee Lead (TL) initiative was devised by the Medical Education Team to bridge the gap between trainees and management and empower trainees to become involved in improvement processes.National training surveys (GMC/Scottish training survey) have highlighted the need for an inclusive approach and collaborative culture. The aim of the TLs is to engage trainees, promoting better communication and model a positive environment for learning and quality improvement (QI).How we did itThere are nine TLs across the divisions of Medicine, Surgery, Women’s and Children and Support Services. The role of TLs is to engage with trainees within their Divisions by having regular meetings with trainees and feeding back to the medical education team within the health board. By participating in medical education and managerial meetings, TLs have developed management skills and driven quality improvement projects.The monthly Trainee Forum was set up to raise awareness of the roles and structure of the management team. Guest speakers from the management Divisions have provided trainees with an insight into how the health board functions and provided a platform to raise issues directly with the management team.Some examples of initiatives include trainee-led QI projects to enhance teaching opportunities include rota restructuring, development of hospital at night for surgery to ensure safe and adequate cover out of hours, involvement of trainees in organisation of morbidity and mortality meetings.Furthermore, a monthly Trainee Newsletter was set up to signpost trainees on upcoming forums and advertise QI sessions and workshops.OutcomesThe TL initiative is an ongoing project with regular feedback in the form of TL meetings, forums and trainees. As TL’s we have shared methodologies that have worked well to create a supportive and nurturing environment.The initiative has resulted in increased awareness of management and their vital role in the running of the National Health Service. This in turn has led to improved trainee engagement. On a fundamental level, trainees have been able to raise issues and be part of implementing change.The futureThrough collaboration between trainees, across Divisions and with management, we will continue to engage trainees, sustain change and build resilience.

Isolated internal iliac artery aneurysm is a rare condition with limited evidence in the literature to support management strategy. Repair has traditionally been associated with significant morbidity. However advances in endovascular technique offer the potential for new treatment options. We report our experience of using an off-label device for endovascular repair of an isolated internal iliac artery aneurysm.

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