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Introduction: Medical engagement in healthcare organisations can improve service development and patient experience. Doctors in training have limited opportunities to engage in service improvement work and develop leadership skills., Method: We describe the Specialist Trainees Engaged in Leadership Programme (STEP) , a programme developed to introduce concepts of medical leadership and quality improvement skills in the Belfast Trust. STEP started in 2013 and over 140 trainees have now participated in the programme., Results: Over 42 quality improvement projects have been completed with the support of the programme. Evaluation of STEP has demonstrated an improvement across all domains explored throughout the duration of the programme, with benefits for the individual trainee and the wider organisation., Discussion: We describe the programme in detail. The STEP curriculum can easily be adapted to meet the needs of NHS trainees, allowing them to understand the objectives and strategy of their employers and improve their ability to plan and deliver safe, effective, patient-centred care., Competing Interests: Provenance: externally peer-reviewed. None of the authors have any competing interests or funding to declare.

The General Medical Council explicitly state that doctors completing training should demonstrate capabilities in leadership and teamwork. 1 However, most trainees receive little formal training in leadership. In March 2017, at the Faculty of Medical Leadership and Management (FMLM) Northern Ireland Regional Conference, a workshop on developing leadership skills as a trainee was hosted and the views of doctors in training regarding current opportunities, potential barriers and improvements were sought. In Northern Ireland presently there are a number of opportunities available for trainees to gain experience in leadership - both by learning through observation and learning through experience. These range from informal activities which do not require significant time commitment to focused, immersive leadership experiences such as ADEPT (Achieve Develop Explore Programme for Trainees) 2 , and the Royal College of Physicians' Chief Registrar scheme. 3 Several barriers to developing leadership have been identified, including limited understanding of what constitutes leadership, a lack of senior support and little formal recognition for trainees leading teams. Time pressures, frequently rotating jobs, limited resources and difficulty upscaling can also undermine the sustainability of improvement and other leadership projects. Incorporating awareness of and training in leadership skills, as well as greater engagement with senior leaders and managers, at an early stage in training could promote understanding and encourage trainees. Formalising leadership roles within training posts may improve experience. Deaneries and Trusts can also enable leadership opportunities by facilitating study leave, raising awareness amongst supervisors, and providing career enhancing incentives for interested trainees., Competing Interests: Provenance: externally peer-reviewed

The BVRF2 gene of Epstein-Barr virus (EBV) shows homology to the UL26 and UL80 genes of herpes simplex virus type 1 (HSV-1) and cytomegalovirus (CMV), respectively. These genes are believed to provide a scaffold protein for the assembly of capsids leading to the formation of infectious viral particles. We have cloned the BVRF2 gene from the B95.8 strain of EBV and shown that the BVRF2 gene product is a polyprotein capable of autoproteolytic cleavage. Two Ala-Ser-containing recognition sequences were identified in the BVRF2 polyprotein at amino acid positions 568/569 and 570/571 where this cleavage was expected to occur. Here, we show that EBV proteinase is capable of cleaving at the first Ala-Ser bond but not the second. Comparison of the processing of the EBV and human CMV assembly domains in vitro by either EBV or human CMV proteinase revealed that, while both proteinases could cleave their native assembly domain, only EBV proteinase was able to cleave the assembly domain of the other virus.