Universiti Sains Malaysia established it's medical school in 1979, the third medical school in Malaysia after Universiti Malaya and Universiti Kebangsaan Malaysia. During the time of its establishment, the university was fortunate to witness a revolution in the world of medical education. PBL-based education was one of the most talked about approach in medical education. The University was fortunate to have experienced medical educators with sufficient foresight to start a medical school that has in its philosophy a community-based integrated curriculum utilizing problem-based learning, one of it's main modes of curricular implementation. Over the last 20 years, the medical curriculum has been revised and fine-tuned twice. The first major curriculum review was undertaken in 1995. One major outcome of this review was a firm commitment to continue with it's original philosophy in medical education at the same time introducing several key strategies to enhance the teaching of medical ethics, attitude formation and reaffirming the need for a lean, integrated curriculum which addresses core knowledge, attitude and skills. A more recent review in 2001 took several approaches including getting the input of students to enhance the original philosophy.