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Introduction In some UK hospital Trusts, it is still expected that general internal medicine (GIM) trainees should perform pleural procedures in emergencies. Assessing the preparedness of trainees before performing their first pleural procedure is necessary to evaluate pleural training for GIM trainees.Methods A cross-sectional survey was distributed to GIM and Respiratory trainees across London, focusing on their level of preparedness before performing certain pleural procedures for the first time, with only Respiratory trainees answering questions about talc pleurodesis and indwelling pleural catheter (IPC) insertion. A video of a diagnostic pleural aspiration in a real-world setting was distributed to Internal Medicine Trainees at a district general hospital, who were surveyed before and after distribution of the video to assess their preparedness for performing this procedure.Results 84 responses were received for the pan-London survey. 35.7% (30/84) of trainees felt completely unprepared before performing their first seldinger chest drain, while 61.8% (21/34) and 57.1% (24/42) of respiratory trainees felt completely unprepared before performing their first IPC insertion and talc pleurodesis respectively ( figure 1). Access to simulated training varied between the procedures- 75.0% (63/84) of all trainees had simulated a diagnostic pleural aspiration, compared with 22.9% (8/35) and 10.5% (4/38) of respiratory trainees for IPC insertion and talc pleurodesis respectively.At the district general hospital where the video of the diagnostic pleural aspiration was distributed, the average score on the preparedness scale increased from 2.0/5.0 to 3.3/5.0 (P = 0.04).Abstract P79 Figure 1Preparedness of respondents before doing pleural procedures for the first time (1 = not prepared at all; 5 = fully prepared)Conclusions More pleural training is required early in the GIM training pathway to improve the confidence of resident doctors at performing pleural procedures for the first time. There is lack of access to simulated training for specialist pleural procedures, including IPC insertion, for respiratory trainees. Video resources for practical procedures can be used to increase confidence of trainees before performing the procedure in a real-world setting.