Initial experiences of a student assistantship.

BACKGROUND: Evidence suggests that medical graduates are underprepared to work as junior doctors. To ease transition in the UK, the General Medical Council (GMC) recommended the introduction of a student 'assistantship'. This is a period of training where final-year students take on duties of a foundation doctor under supervision. This study explored the experiences of the first cohort of students and junior doctors participating in the assistantship in one UK medical school in 2012. METHODS: All 248 students and their supervisors were asked to complete an online feedback questionnaire. All students who went on to work locally were also invited to participate in focus groups as recent graduates. Evidence suggests that medical graduates are underprepared to work as junior doctors RESULTS: Questionnaire response rates were 49 per cent for students and 43 per cent for supervisors. Fifteen new graduates participated in focus groups. Aspects of the assistantship considered important to participants frequently mapped to areas specified by the GMC and the locally identified learning outcomes. Additional themes identified included the importance of having meaningful responsibility for patient care, a placement in a general medical or surgical ward and receiving effective feedback. DISCUSSION: The assistantship seems to have been highly valued by students, but could be improved by ensuring that all students are given relevant placements and clinical responsibility.

NLP is a novel transcription regulator involved in VSG expression site control in Trypanosoma brucei.

Trypanosoma brucei mono-allelically expresses one of approximately 1500 variant surface glycoprotein (VSG) genes while multiplying in the mammalian bloodstream. The active VSG is transcribed by RNA polymerase I in one of approximately 15 telomeric VSG expression sites (ESs). T. brucei is unusual in controlling gene expression predominantly post-transcriptionally, and how ESs are mono-allelically controlled remains a mystery. Here we identify a novel transcription regulator, which resembles a nucleoplasmin-like protein (NLP) with an AT-hook motif. NLP is key for ES control in bloodstream form T. brucei, as NLP knockdown results in 45- to 65-fold derepression of the silent VSG221 ES. NLP is also involved in repression of transcription in the inactive VSG Basic Copy arrays, minichromosomes and procyclin loci. NLP is shown to be enriched on the 177- and 50-bp simple sequence repeats, the non-transcribed regions around rDNA and procyclin, and both active and silent ESs. Blocking NLP synthesis leads to downregulation of the active ES, indicating that NLP plays a role in regulating appropriate levels of transcription of ESs in both their active and silent state. Discovery of the unusual transcription regulator NLP provides new insight into the factors that are critical for ES control.

The FACT subunit TbSpt16 is involved in cell cycle specific control of VSG expression sites in Trypanosoma brucei.

The African trypanosome Trypanosoma brucei monoallelically expresses one of more than 1000 Variant Surface Glycoprotein (VSG) genes. The active VSG is transcribed from one of about 15 telomeric VSG expression sites (ESs). It is unclear how monoallelic expression of VSG is controlled, and how inactive VSG ESs are silenced. Here, we show that blocking synthesis of the T. brucei FACT subunit TbSpt16 triggers a G2/early M phase cell cycle arrest in both bloodstream and insect form T. brucei. Segregation of T. brucei minichromosomes in these stalled cells is impaired, implicating FACT in maintenance of centromeres. Strikingly, knock-down of TbSpt16 results in 20- to 23-fold derepression of silent VSG ES promoters in bloodstream form T. brucei, with derepression specific to the G2/M cell cycle stage. In insect form T. brucei TbSpt16 knock-down results in 16- to 25-fold VSG ES derepression. Using chromatin immunoprecipitation (ChIP), TbSpt16 was found to be particularly enriched at the promoter region of silent but not active VSG ESs in bloodstream form T. brucei. The chromatin remodeler FACT is therefore implicated in maintenance of repressed chromatin present at silent VSG ES promoters, but is also essential for chromosome segregation presumably through maintenance of functional centromeres.