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This Ganger was a clone created from the Flesh in the image of the Time Lord known as the Doctor. When a bolt of solar energy struck the vat the Flesh was contained in, it was able to form a copy of the Doctor from a tiny measure of his genetic material, gained when he touched the Flesh. When the humans and the real Doctor fled from the other Gangers into the church, this Ganger confronted them and told them to trust him. (DW: The Rebel Flesh)
At first, the Ganger had some trouble adapting to the Doctor's DNA due to the residual traces of his previous incarnations present in his body, causing him to briefly act in the manner of his first, third, fourth, and tenth incarnations. He eventually stabilised into a form and manner virtually identical to the Doctor's; the only way to distinguish them was their difference in shoes, as the original Doctor had changed his after the initial scan. The two Doctors subsequently swapped shoes while their companions were distracted in order to prove that Gangers were no different from their originals.
The Ganger Doctor subsequently sacrificed himself and Ganger Miranda to stop Ganger Jennifer, setting the sonic screwdriver to a frequency that would cause the Flesh to collapse, in full knowledge that this would destroy him too, so that the others would be encouraged to negotiate better conditions for the Gangers. (DW: The Almost People)