Basic quality requirements for medical education have existed since the early 1900’s in the form of accreditation standards (Davis & Ringsted, 2006). As medical education has evolved so have the COCA standards. From standards focused on: process, to incorporating outcomes, to incorporating change based on outcomes, to more recently continuous quality improvement (CQI) with an emphasis on more objective measures of compliance to provide consistency, transparency, and accountability in osteopathic medical education. Incorporating best practices from the field CQI, one COM’s strategy will be shared for targeting areas for improvement utilizing both internal and external markers. The result being a framework that supports CQI efforts that can be shared with other COMs and a dashboard used to monitor progress that can be shared with accreditors.