The 1910 Flexner report prompted a transformation of medical education in the US and beyond not only by highlighting inadequacies in quality and facilities, but also by making a convincing case for an approach to education that was informed by the health needs of society 
. One hundred years later, the need for medical education to keep pace with evolving epidemiology, patient demographics, and health systems remains pertinent everywhere 
, but is particularly pressing in low- and middle-income countries. In these settings, a major transformation is needed—one that associates academic excellence with the delivery of improvements in population health outcomes.
Medical universities must teach to the local disease burden, as well as train students to practice within the care delivery models that are likely to best serve the local population health needs. The current reality is that educational institutions are not sufficiently integrated with the relevant local, regional, and national health authorities to ensure an effective alignment between medical education, research, health service delivery, and population health needs.
The current association of excellence with specialist skills, and in some cases, with training oriented to the global market, has meant that family and community-oriented medicine and public health, usually better matched to the overall epidemiological burden and needs of low- and middle-income countries, are often afforded low status and are relatively poorly paid 
. Promoting curricula that equip graduates to address the specific epidemiology of the communities where they are deployed will be an essential part of the transformative scale-up of medical education. This includes the incorporation of community medicine and public health into curricula as compulsory rotations, with a focus on prevention and determinants of health. In addition, institutional and national funding bodies should promote research directed to national health needs and health systems.
Finally, there is increasing evidence that team-based practice with partial transfer of tasks (“taskshifting”) to non-physician providers may be the most effective means of care delivery, particularly for primary care services, in a variety of settings 
. The form and content of medical curricula must evolve to adequately prepare physicians to practice within this model, and will likely require the incorporation of progressive educational strategies, such as interdisciplinary and inter-professional training 
. While this article primarily addresses physician education, it emerges from the broader context of a World Health Organization initiative on medical, nursing, and midwifery education 
. The lack of other health care workers is integral to the workforce crisis, and the scale-up of other non-physician providers will be a crucial part of any plausible solution 
Further challenges relate to the need for faculty with appropriate skills and experience to teach a new generation of providers. More students will require more teachers, and yet there is an insufficient number of medical and nursing faculty to meet even current needs. Training and retaining faculty and staff is therefore of paramount importance, but a number of complex challenges must be overcome. Institutions must seek an appropriate balance between faculty teaching, service, research, and management duties to ensure that course content is relevant, that clinical skills are maintained and updated, and that career development opportunities such as research and publication are available. At the same time, institutions should develop incentive structures to ensure that teaching achievements are afforded comparable status to research and clinical work 
Institutions such as Walter Sisulu University in South Africa and Gezira University in Sudan have used creative approaches to faculty expansion, incorporating doctors and nurses working in district hospitals or in health clinics into the faculty body, or establishing joint appointments and affiliate positions with other institutions 
. Developing clinical preceptor programmes can also be an effective means of expanding a mentoring pool, and can serve to bring community practitioners' understanding of local health needs into the university 
. A number of institutions have also explored the potential of international and public–private partnerships to increase pedagogical capacity and provide opportunities for students and faculty at all partner sites.