Medical education serves as a cornerstone for the development of healthcare systems. Since its establishment in 1921, Peking Union Medical College Hospital (PUMCH) has pioneered the first-generation medical education reform, establishing a comprehensive teaching system characterized by residency training, bedside teaching, teaching ward rounds, and clinical pathological conferences. Through generations of dedicated mentorship, the spirit of medical humanism has been deeply embedded in its educational tradition. In the context of the third-generation, competency-based medical education reform, PUMCH has taken the lead in founding the China Consortium of Elite Teaching Hospitals for Residency Education, successively issuing the Consensus on Core Competency Framework for Residency Education Among China Consortium of Elite Teaching Hospitals for Residency Education and the China Consortium of Elite Teaching Hospitals Consensus on the Competency Framework for Clinician Educators. These initiatives have facilitated the full integration ofcompetency-based concepts into curriculum design, assessment systems, and faculty development. Furthermore, PUMCH has systematically explored pathways for cultivating high-level, compound medical talents through its Clinical Postdoctoral Program. Looking ahead to the fourth-generation medical education transformation, PUMCH remains committed to its founding ethos of "clinical excellence at its core and humanism at its heart", while further advancing evidence-based teaching and artificial intelligence-enhanced medical education practices. This dual commitment not only carries forward a century-old educational legacy but also represents a timely response to the evolving landscape of global medical education reform.