By the late 1940s, Florida faced a physician shortage particularly in the state’s large rural areas. Until 1952, the state lacked a medical school and young Floridians intent on pursuing medical careers were forced to go out of state for their education, many never returning to Florida to practice. Between 1946 and 1955, a pitched battle took place among Florida’s legislators, physicians, the Greater Miami Chamber of Commerce, the Florida Farm Bureau, and university officials over where the state’s first medical school—and the recipient of significant state funds—should be located: at the state’s land-grant University of Florida in the north central city of Gainesville or in the southern city of Miami at the private University of Miami. For Miami and its Chamber of Commerce, a medical school meant the opportunity to build trade, educational, political, and tourist links with Florida’s Latin American and Caribbean neighbors. For the Farm Bureau, whose priority was increasing agricultural workers’ access to health care services, Gainesville was the preferred location situated just 150 miles from two-thirds of the state’s rural population. This paper examines the debates over where to locate Florida’s first medical school, highlighting the multiple and often conflicting priorities of city, county, and state government officials in health care politics: while the state as a whole wanted a medical school to prepare physicians for the state’s residents; city and county officials were also interested in the economic and political gains of being home to a medical school and its teaching hospitals. These debates also reveal the potential economic benefits provided by a new medical school to city and state boosters: a new school promised local and regional economic development by way of jobs and commerce and offered the host city as a medical destination for neighboring cities, states, and countries.