Background: The bilateral institutional partnership between the National Capital Consortium Family Medicine Residency at Fort Belvoir Community Hospital (FBCH) in Virginia, USA, and the Hospital Militar Central (HMC) in San Salvador, El Salvador, is a model longitudinal global health engagement--a mutually-beneficial, ethical global health initiative by the DoD. Methods/Results: Trust has been built over three exchanges at HMC and one at FBCH, assessing mutual needs and sharing expertise in patient safety, non-punitive responses to error, and optimal learning environments. Adverse event tracking was developed, systematic analysis and process improvement were integrated into morbidity and mortality conferences, and resident and faculty development was introduced. Conclusions: The FBCH-HMC relationship is an operationalized paradigm shift from traditional, isolated provision of care activities to sustainable, partner nation-driven, bidirectional engagements, in which US military Family Medicine physicians serve as trusted advisors over multiple trips, and develop competence in global health through immersive experience.#AAFPFamilyMedicineGlobalHealthWorkshop #2016 #GME #ElSalvador #FortBelvoirCommunityHospital #military