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The University of Botswana (UB) started the only medical school in the country in 2009 in order to meet the increasing need for Batswana doctors who could deliver excellent health care anywhere in the country. Since then, the Faculty of Medicine has graduated four cohorts of locally trained medical doctors. Prior to its start, there were a series of events that played a pivotal role in the realisation of this momentous project. The nation’s health care system had long been facing a systemic problem with its medical doctor cadre. By the mid-1980s the nation’s health care system was characterized as having less than 14% of physicians who were citizens mostly working almost exclusively at the two national referral hospitals –Princess Marina in Gaborone and Nyangabgwe in Francistown respectively. No citizen doctors were employed in district clinics and primary hospitals, hence the decision in 1998 by the government to establish its own medical school. This paper chronicles the events leading to the establishment of the Medial School and its operation.