The document discusses trainee-led initiatives in pre-vocational medical training in NSW. It describes the NSW JMO Forum, which is composed of elected trainee representatives from the 15 training networks. The Forum identifies areas for improvement and undertakes projects to address issues. Examples provided include developing a standardized educational program across hospitals, auditing handover practices, and creating a guidebook for specialty training pathways. The document argues that trainees have the interest, ideas, and enthusiasm to innovate in medical education if given the opportunity and support to do so.