Rural and remote communities have long been challenging health care settings that rely on distant metropolises to supply their health workforce. The Northern Ontario School of Medicine, a pioneering faculty of medicine founded in 2005, was established to realise the potential of the rich learning environments found in such communities. This is the story of the establishment of a school of medicine that is part of a growing trend toward providing medical education that responds to the needs of remote populations and produces resourceful physicians capable of meeting those needs. Twelve contributors highlight the various aspects of the school's development and the unique opportunities it offers. The first new medical school in Canada in over thirty years, the Northern Ontario School of Medicine provides a blueprint for those interested in an innovative approach to medical education. This collection provides a fascinating and detailed account of the challenges and rewards faced by those who insisted on creating a patient-centred, community-based, and culturally sensitive learning environment for the physicians of tomorrow.