A guide for educators seeking to reform programs and teaching methods at established medical schools is presented. Focused on practical problems, attention is directed to an innovative curricular track and the ideas, experiences, and discussions presented during a conference attended by educators at eight institutions that have used the track approach. The institutions, which are located in China, Mexico, the Philippines, Thailand, and the United States, have used the track approach to reform medical education to be more relevant to the health needs of given populations by using either problem-based or community-based learning in the educational process. Of concern are 23 strategies for using the track approach to implement change, with consideration of start-up, building support and overcoming resistance, evaluation, networking, and options for the future of the track. Features and experiences of the innovative track schools on seven points are compared, including motivation for seeking change, curriculum content, and policies governing admissions. Comparative information is summarized in an extensive table that illustrates common trends and differences in approaches, circumstances, or outcomes. Detailed case studies of the eight schools are also presented. (SW)