title: Learning in underserved UK areas: a novel approach.
abstract: BACKGROUND
  There is an insufficient number of medical students intending to pursue general practitioner (GP) careers. The undergraduate curriculum has traditionally prioritised teaching in large hospital settings despite most National Health Service patient contact occurring in primary care. Primary care is faced with providing health care for an ageing population with high levels of co-morbidities. Patients who live in deprived areas suffer many disadvantages affecting their health and additionally tend to be underserved. Globally, there has been an initiative to provide medical students with extended clinical placements in rural and remote areas. These placements have identified many beneficial outcomes; however, little is known about placements in other underserved, deprived areas. This paper describes an innovative pilot programme to address these issues.
  
  
  BACKGROUND
  The North East of England has a large proportion of the most deprived communities and worst health care outcomes in England. In Teesside, Phase 1 Medicine at Durham University provides the pre-clinical curriculum. Durham students then join Newcastle University for Phase 2 Medicine, the clinical years.
  
  
  METHODS
  The Difficult and Deprived Areas Programme (DDAP) places fourth-year students in general practice and community settings in post-industrial, deprived areas for 14 weeks, thus adopting and applying principles from rural initiatives (continuity and immersion) to other deprived settings. The DDAP allows students to learn about psychosocial determinants of health and to pursue community interests whilst gaining an excellent clinical grounding. There is an insufficient number of medical students intending to pursue general practitioner careers
  
  
  CONCLUSIONS
  The DDAP provides a model for educators seeking to implement initiatives in similar underserved, deprived settings, which may potentially alleviate GP workforce shortages.
authors.affiliation: Centre for Medical Education Research, Durham University, Durham, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Crampton
authors.affiliation: Centre for Medical Education Research, Durham University, Durham, UK.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Hetherington
authors.affiliation: Centre for Medical Education Research, Durham University, Durham, UK.
authors.forename: John
authors.initials: J
authors.lastname: McLachlan
authors.affiliation: Centre for Medical Education Research, Durham University, Durham, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Illing
mesh_terms: D002321:Career Choice; D002982:Clinical Clerkship / Q000458:organization & administration*; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D058006:General Practice / Q000193:education*; D006801:Humans; D008507:Medically Underserved Area; D011204:Poverty Areas; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D013222:State Medicine; D006113:United Kingdom