Introduction. In higher medical education, deficits and gaps continue to exist between the training goals and the confirmed competencies of graduates, despite the increased expectations of the industry and society. In this context, the development of an operational model of a progressive structure for higher medical education is relevant as a reference point for the implementation of educational policies in Russian universities. Objective. To present a conceptual vision of a progressive model for the structure of higher medical education, to characterize its essential structural elements and transformation pathways, and to propose a methodology for evaluating its implementation. Materials and methods. The study employed publications by domestic and foreign researchers with a time depth of 7 years, materials from project seminars of the past 3 years (in particular, those held at Samara State Medical University jointly with the Moscow School of Management SKOLKOVO), expert assessments of participants in specialized conferences and congresses, data from student questionnaires (in total, over 12 700 people according to the student agenda), analysis of regulatory documentation, university websites, and regional ministries. The design is qualitatively descriptive; the analysis is narrative synthesis. Results and discussion. In the target model, education is positioned as a basic integrating process of the university and a driver of the development of an open ecosystem of knowledge and technologies. The common features and variability of the problem field in the training of medical personnel according to the types of universities and resources are demonstrated, and appropriate transformation pathways and efficiency criteria at the levels of process and outcome are proposed. The curriculum is described through integrated modules/domains: at the core of professional training lies the understanding of the organism as a whole, based on etiopathogenesis; the identification of three vectors of interdisciplinary content connectivity - clinical, socio-humanitarian and digital (which form the graduate’s competence profile). The significance of productive pedagogical technologies, the educational and methodological capabilities of the hybrid educational environment, the functionalization of teachers’ roles, the involvement of employers, and objectified assessment procedures is substantiated. Conclusion. Presented is the methodology of directed transformation and a list of indicators for progress towards the target state of education are presented. These elements are aligned with the curriculum architecture, pedagogical technologies, and assessment practices.