Abstract Aims Over 2 years in our DGH we developed a programme of surgical simulation for medical students including acute scenarios and basic surgical skills. We aimed to roll this out on a bigger scale to include near-peer teaching between medical students, PAs, and FYs, and gain feedback to assess our progress. Methods The previous programme involved simulated acute scenarios with the Sim Man run by registrars for medical students with help from FY1s. We invited FYs involved in delivering sessions, to write new scenarios and take over leadership. We linked sessions with a weekly Surgical Skills Club and handed ownership of specific sessions to FYs to run near-peer teaching on suturing, knot tying and US guided vascular access. Electronic feedback from trainers and trainees rated satisfaction with teaching, confidence in skills, and enjoyment. Results Feedback was gained from 24 students for 4 Sim sessions over 4 months. 100% of students rated the scenarios very good or excellent. 100% felt they improved their skills in management of acutely unwell surgical patients, eg pancreatitis, appendicitis. 6 FY trainers took part and 100% rated the experience as “excellent”. Weekly feedback from Surgical Skills session attendees was consistently rated Very Good or Excellent, and trainer feedback was highly rated for improving confidence and leadership. Conclusion Near Peer Teaching of a combined programme of surgical simulation and skills is an excellent tool to improve confidence in managing acutely unwell patients in a safe environment, develops surgical skills, and promotes leadership roles at an early stage.