Differences exist between EM and Caucasian medical students in their learning experiences in medical school. There is a need to increase awareness, for both medical students and teaching staff, of the impact of cultural diversity on academic performance at medical school.

Medical schools are considering how to shape medical curricula to reflect the needs of the diverse community which their students will go on to serve. 1 Increasingly, this means centring social accountability in their courses and considering the role of academic institutions within that framework. A socially accountable university directs its research and educational activities towards the priority health concerns of their community and works collaboratively with relevant stakeholders (Figure 1). 2 One way to achieve this is through service learning. These programmes, which embed students in a community project and

Quality Improvement skills are deemed essential for future clinical practice of doctors by professional regulatory bodies. This paper presents the challenges of a curriculum development initiative to ensure that all medical students have involvement with a quality improvement project during a general practice placement in their fourth year. The curriculum development is described within a 'Plan-Do-Study-Act' framework. The learning is presented as a reflective discussion with conclusions and recommendations on how potential current barriers to implementing authentic participation in quality improvement projects for undergraduate medical students might be met. The key barriers include lack of opportunities within the curriculum structure to allow sufficient time for authentic quality improvement projects and a lack of confidence amongst placement tutors to support medical students with quality improvement projects.

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