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Introduction The burden of gastrointestinal (GI) disease in Sub-Saharan Africa continues to rise, yet access to quality endoscopic services remains constrained by limited workforce capacity and a lack of structured training pathways. Sustainable skill development requires not only procedural training but also the cultivation of local trainers capable of delivering independent, ongoing mentorship. In August 2025, an international–local collaborative initiative in Rwanda provided a model for competency-based, sustainable endoscopy education aligned with national health-sector priorities.Methods Between 26–28 August 2025, King Faisal Hospital (KFH), Kigali, hosted an intensive gastroenterology training mission supported by the British Society of Gastroenterology (BSG), World Gastroenterology Organisation (WGO) and Africa and Middle East Association of Gastroenterology (AMAGE). The structured programme integrated lectures, supervised live cases, hands-on animal model sessions, and a complete Training the Colonoscopy Trainers (TCT) course. Training covered GI bleeding management, polypectomy and EMR, ERCP fundamentals, and structured feedback techniques. Pre- and post-training Direct Observation of Procedural Skills (DOPS) assessments and self-reported confidence scales were collected from all participants.Results A total of 11 gastroenterology fellows, several residents and 7 consultant gastroenterologists participated. Post-training DOPS demonstrated significant improvement across all key domains: Scope insertion: +22%, Mucosal visualisation: +28%, Loop management: +34% and Polypectomy technique: +31%. Among consultants completing the TCT course, confidence in delivering structured feedback and teaching complex manoeuvres increased by 38%, and all seven were successfully certified as TCT trainers ( figure 1).Participants reported enhanced ability to provide competency-based supervision and integrate structured feedback into routine endoscopy teaching. Qualitative feedback highlighted improved team communication, procedural safety, and commitment to continuous skills transfer. The programme also established a national network of certified trainers who will mentor future Rwandan and regional trainees.Conclusion The Rwanda model demonstrates that global collaboration anchored in local ownership, institutional commitment, and national policy alignment can achieve sustainable improvements in endoscopy capacity. By focusing on ‘training the trainers,’ the initiative fosters long-term self-sufficiency, regional integration, and retention of expertise within the local health system. Follow-up activities planned for 2026 will evaluate longitudinal impact, clinical outcomes, and continued trainer development.This initiative exemplifies the BSG International Strategy principles of equitable access, competency-based education, and mentorship-driven capacity building — providing a reproducible blueprint for strengthening endoscopy training across Sub-Saharan Africa.Funding Supported by the British Society of Gastroenterology International Grant.Acknowledgements The authors acknowledge the partnership of King Faisal Hospital, Kigali, and the Ministry of Health of Rwanda.Abstract P430 Figure 1Comparison of pre- and post-course confidence levels in delivering colonoscopy training