This chapter traces the evolution of medical education from the traditional Flexner model to community-oriented medical education (COME) and, ultimately, to social accountability. The Flexner model, focused on hospital-based education and curative medicine, often overlooked preventive and promotive care and the social determinants of health. COME emerged as a response, aiming to make medical education relevant to community health needs by incorporating community-based education (CBE). However, challenges such as lack of clear goals, high costs, and faculty resistance hindered its implementation. The concept of social accountability, introduced by the WHO in 1995, redefined the role of medical schools, emphasizing their responsibility to address current and future health challenges through education, research, and service. This chapter explores the transition from COME to social accountability, outlining frameworks, challenges, and case studies that highlight best practices.