This volume examines education and decision-making in the health professions across diverse implementation contexts, exploring the negotiation between biomedical Western medicine and local traditions, practices, or constraints. Theoretical approaches such as collective competence, socioecology, and heterarchy provide lenses to understand how systems adapt and evolve. The result is a comparative exploration of how medical education reflects broader social, cultural, and political forces. Combining both theory and case studies, the volume identifies factors that have contributed to the success and failure of medical innovations around the world. Drawing on cases from Canada, Nepal, Ukraine, Sub-Saharan Africa, India, Brazil, Guatemala, and East Asia, the chapters explore how history, culture, and crises shape the development and delivery of medical education. Multiple chapters examine the continuing influence of colonial legacies, whether through the marginalization of Indigenous peoples in Canada and Guatemala, the influence of caste hierarchies in India, or structural inequalities in Sub-Saharan Africa. Others focus on curricular innovations, from the integration of medical humanities in Nepal to ethics training in Canadian neonatal care, and from traditional medicine in Brazil and East Asia to adaptive learning in contexts of war and displacement. It is essential reading for academics, clinicians and administrators in medical education as well as students in psychological and cognitive sciences.