The risks to patients at August handover time are well known, yet there is no national consensus on the best way to deliver induction programmes for Foundation Year One (F1). The aim of this study was to design, deliver and assess a targeted structured induction programme for new F1 doctors. The induction training programme was designed using educational models of topic analysis informed by results of a survey of F1s and medical students, and the F1 curriculum. Data regarding serious untoward incidents and self-reported preparedness were collected between 2008 and 2010, and rates were compared between those receiving optional (2008) and compulsory (2009 and 2010) training. By delivering targeted education and spending time with the outgoing F1 doctors, 97 % of our new doctors felt adequately prepared for practice. The incidence of self-reported mistakes made by F1s in the first 4 months of their practice fell by 45 % and serious untoward incidents also decreased. Targeted structured induction training addresses final-year medical students’ concerns about their preparedness for practice as junior doctors, and improves patient safety. This study supports the General Medical Council recommendation that targeted structured induction training should be mandatory for all new doctors.