Learning in underserved UK areas: a novel approach.

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. CONTEXT: 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. INNOVATION: 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 IMPLICATIONS: The DDAP provides a model for educators seeking to implement initiatives in similar underserved, deprived settings, which may potentially alleviate GP workforce shortages.