Strategies for establishing and developing overseas teaching hospitals

China is an important base for international medical education and attracts a large number of Bachelor of Medicine/Bachelor of Surgery international students, who often face language barriers, cultural differences, and mismatches in disease spectrum during clinical internships. To address these challenges, Nanjing Medical University (NMU) explored establishing overseas teaching hospitals guided by cultural adaptation theory. This mixed-methods study combined expert interviews (medical education, hospital management, clinical medicine, and cross-cultural communication) to develop selection criteria and an evaluation indicator system for overseas teaching hospitals, and a questionnaire survey to assess internship effectiveness after implementation at Royal Prima Hospital (Indonesia). NMU developed a trial selection method and evaluation indicators and implemented them at Royal Prima Hospital. Student evaluations improved after implementation, with notable gains in teaching and training activities (e.g., lectures, case discussions, and skills-center use). NMU has successfully established China’s first teaching hospital in overseas by formulating detailed selection criteria and an evaluation system, thus improving the teaching quality and meeting the needs of international students. This study indicates that the evaluation system and internship program developed through expert interviews have effectively enhanced students’ clinical skills and career adaptability. This approach offers a practical reference for medical schools planning overseas clinical training sites.