Background/Aims The new Peninsula Medical School (PMS) admitted its first undergraduate cohort in September 2002. Development of a new school has given rise to opportunities for critical appraisal of best practice in selecting students for medical school and development of new ways forward. Methods The authors developed a selection strategy and principles grounded in the objectives of the PMS programme and drawing extensively on best practice in assessment. Critical appraisal of custom and practice amongst other UK medical schools led to the rejection of hitherto commonly used instruments and procedures and the development of new ones. Common assumptions about ways to ensure quality were also challenged. Results A process for development of an evidence-based selection strategy is described. In addition, selection instruments and criteria to be used in a new medical school are discussed. Quality performance policies informed by psychometric and qualitative assessment performance measures are recommended. Discussion and Conclusion Critical appraisal of custom and practice and the development of new strategies, criteria and selection instruments go only part way to informing best practice. As with other UK medical schools grappling with these issues, the test of these selection processes lies in their product.