The first expansion of medical schools in this country in more than 20 years represents an important moment for medical education nationally. The Josiah Macy, Jr. Foundation took advantage of this moment to sponsor a conference in October 2008 entitled, “Revisiting the Medical School Education Mission at a Time of Expansion.” A conclusion of the conference, directed at the new schools as well as all existing schools, was: “This period of expansion in enrollment must not result in ‘more of the same.’ Failing to take full advantage of the opportunity afforded by this natural experiment to advance the mission of medical education for the benefit of the public would be tragic.” A number of recommendations were made on ways to improve the educational programs of all medical schools to better align them with the needs of society. That conference was not designed to address the “how” and the “why” of each of the new schools or the expansion plans of existing schools. The case studies reported in this report explore the motivations, challenges, and responses of ten emerging new schools.