For the first time in 30 years, medical schools in the United States are expanding their enrollments in response to projected shortages in the country’s physician workforce. The development of nine new allopathic medical schools is already underway with at least five more in planning stages. In October 2008 the Josiah Macy Jr. Foundation convened a conference to address complex issues concerning the Medical School Educational Mission. The papers and discussion included in this monograph provide the rationale for the conclusions and recommendations from the conference.