In early 1996, the Ben Gurion University Faculty of Health Sciences (BGU), Beer-Sheva, Israel, in collaboration with Columbia University Medical Center (CUMC), New York City, United States, decided to found a second medical school within BGU, the Medical School for International Health (MSIH), to prepare students to work both in medicine and in cross-cultural and international health and medicine (IHM). Methods used to establish and jointly run MSIH include (1) defining clearly the tasks of each university according to how it can best contribute to the new school; (2) establishing an organizational structure in each university for accomplishing these tasks; (3) establishing clear communication between the two organizational structures; (4) defining outcomes to measure success; and (5) developing methods for addressing management problems. CUMC's functions were admission, public relations, and the fourth-year elective program. BGU's functions were developing and running an innovative curriculum, including a four-year required track in IHM, evaluating students, taking the lead in helping students' with their personal problems, and managing financial aid. The first students were admitted in 1998. Variables reflecting MSIH's success include scores on the United States Medical Licensing Examination, residency placement, the attrition rate, and success in preparing students in IHM (e.g., success in learning cross-cultural medicine and the percentage of students who work in IHM). MSIH is running well and has solved its inter-university management problems. Its 85 graduates matched at very good to excellent U.S. hospitals and have learned and maintained enthusiasm for the IHM curriculum.