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REVIEWGlobal Surgical Education - Journal of the Association for Surgical Education (2026) 5:132 https://doi.org/10.1007/s44186-026-00536-0 Kathryn McLeodrzetelski.west@gmail.com1 Department of Urological Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia2 School of Medicine, Deakin University, Geelong, Australia3 Department of Surgery (Austin), University of Melbourne, Heidelberg, Australia4 Department of Medical Education, The University of Melbourne, Parkville, Australia5 Department of Urology, Port Macquarie Base Hospital, School of Clinical Medicine, The University of New South Wales, Port Macquarie, AustraliaAbstractPurpose The identif i cation and remediation of underperformance are essential responsibilities of postgraduate medical train-ing programs. Despite calls for a programmatic approach, remediation practices remain inconsistent, with many institutions lacking formal policies. The aim of this study was to identify the core components for developing remediation frameworks for postgraduate trainees.Methods A narrative review format was chosen. Eligible papers for inclusion included studies, opinion pieces, systematic reviews, and meta-analyses. Fifty-four papers were included for analysis.Results We identif i ed seventeen components which were organized into three overarching phases: (1) assess and support, (2) plan and implement, and (3) evaluate and follow-up. ‘Assess and support’ components included: ensure an accurate diagno-sis; give feedback; ensure the trainee’s perspective is heard; address external stressors and system causes; provide emotional support; address attitudes and motivation of the trainee; and destigmatize remediation. ‘Plan and implement’ components included: involve remediation and educational experts; create individualized remediation plans; document plans clearly; and teach goal setting and self-regulation. ‘Evaluate and follow-up’ components included: monitor progress and reassess; feed forward carefully; separate those conducting from those judging remediation; ensure transparent policies and due process; and develop compassionate exit pathways. Guiding principles such as transparency, fairness, and alignment with educational theory often supported these components.Conclusions This narrative review has identif i ed the components to be considered when developing remediation frameworks in postgraduate medical education. Understanding core components and their connections helps design literature-informed frameworks that can be tailored to local contexts, optimizing remediation outcomes in postgraduate training programs.Keywords Surgical education · Performance management · Remediation · FeedbackReceived: 27 January 2026 / Revised: 16 April 2026 / Accepted: 6 May 2026© The Author(s) 2026Components of postgraduate remediation frameworks: a narrative reviewKathryn McLeod 1,2,3  · Robyn Woodward-Kron 1  · Prem Rashid 4  · Debra Nestel 5IntroductionThe identif i cation and remediation of underperformance are essential responsibilities of postgraduate medical train-ing programs. Despite its importance, remediation practices across training programs remain highly variable [1, 2]. The literature highlights the need for a programmatic approach to remediation [3, 4], yet up to half of relevant institutions lack a written remediation policy [1, 5, 6]. As such, further guidance is needed on the specif i c components to include in remediation frameworks.The components of remediation are the core interlinked elements that collectively form a structured process. They operate within def i ned frameworks that serve as scaf f olding, organizing the components. Processes are the sequence of steps to achieve a specif i c outcome, whereas practices are