The initial period adjusting to the roles and responsibilities of a new foundation doctor can be a challenging and anxious time for graduating medical students and new trainees. Over recent years, many educational initiatives such as shadowing placements, assistantships and compulsory induction programmes have been implemented to improve medical student preparedness for clinical practice. Despite this, many graduates still report a lack of confidence and preparedness when starting their clinical placements, specifically within the context of on-call shifts. Bleep Roulette simulation sessions are progressively being used to further bridge the gap from student to trainee and ensure trainees develop prioritisation, organisational and clinical reasoning skills, improving trainee efficiency during an on-call shift. In this article, we provide 10 tips for medical educators, detailing how to design an efficacious Bleep Roulette session for final year medical students and new foundation trainees.