Background: Monitoring and evaluation (M&E) of large-scale government and donor investments is essential for tracking quality improvement, documenting lessons learned, and measuring returns on investment. M&E becomes particularly salient when interventions are also large in scale and unproven, as is the case with the Medical Education Partnership Initiative (MEPI). Through the Principal Investigators' Council, MEPI institutions observed that many schools faced similar challenges in M&E and that there was a need for more collaboration across programs. In response, an M&E Technical Working Group (TWG) was established in 2012, more than two years after the onset of MEPI, to facilitate interaction across the 13 MEPI institutions. The TWG was composed of M&E leads from each school, with technical support from the MEPI Coordinating Center (George Washington University and the African Center for Global Health and Social Transformation), the University of Nairobi, and the University of Washington.