The management of medical schools has never been so difficult, but can be facilitated by using a well-developed, broadly accepted strategic plan. While the concept of strategic planning has been reasonably well accepted by both faculty and leaders at most medical schools, using the strategic plan to allocate resources has proved to be a challenge. Achieving "buy-in" by all parties involved can help meet this challenge and can be critical to the success of strategic planning and management. The authors describe the collaborative planning process that the University of Wisconsin Medical School used to develop its 1998-2000 strategic plan. This unique effort culminated in using a peer-review process--similar to that used by the National Institutes of Health (NIH)--and developing criteria to select a limited number of program priorities. This selection occurred after a school-wide process to solicit strategic program proposals had taken place. Over 130 faculty from most departments throughout the school helped develop and revise the strategic plan. There was frequent communication and engagement with faculty at all levels, which was important in gaining the faculty's acceptance and, indeed, endorsement of the process and its outcomes. Because the process was effective in achieving consensus about the school's strategic priorities, it enabled the school to reach a firmer end-point and implementation plan than had been possible with the previous strategic plan. It also identified important weaknesses in some areas of the medical school; the resulting attention to those areas will help strengthen the school. Finally, the process moved much more swiftly than the previous effort. The authors recommend that such an approach be used by other medical schools, and be carried out before a school implements mission-aligned budgeting and management of its fiscal resources.