Approaches to evaluation of medical student teaching programs have historically incorporated a range of methods and have had variable effectiveness. Such approaches are rarely comprehensive, typically evaluating only a component rather than the whole program, and are often episodic rather than continuous. There are growing pressures for significant improvement in academic program evaluation. The authors describe an initiative that arose after a radical reorganization of the undergraduate medical education program at the University of New South Wales in part in response to feedback from the accrediting authority. The aim was to design a comprehensive, multicomponent, program-wide evaluation and improvement system. The framework envisages the quality of the program as comprising four main aspects: curriculum and resources; staff and teaching; student experience; and student and graduate outcomes. Key principles of the adopted approach include the views that both student and staff experiences provide valuable information; that measurement of student and graduate outcomes are needed; that an emphasis on action after evaluation is critical (closing the loop); that the strategies and processes need to be continual rather than episodic; and that evaluation should be used to recognize, report on, and reward excellence in teaching. In addition, an important philosophy adopted was that teachers, course coordinators, and administrators should undertake evaluation and improvement activities as an inherent part of teaching, rather than viewing evaluation as something that is externally managed. Examples of the strategy in action, which provide initial evidence of validation for this approach, are described.