The establishment of medical facilities and a proactive care system for expatriates in a foreign country should be approached in stepwise fashion. In advance of a new company operation, considerable information must be gathered about the company's plan. Risk assessment includes consideration of both occupational and country-related medical issues. Resource assessment generally requires an on-site visit. Establishing the medical plan for a site generally requires the selection of a company doctor and the best available hospitals and local specialists, and upgrading local facilities and site-specific plans. Comparable occupational health programs must be developed for the nationals employed in the country. These and other considerations will prepare the occupational physician to assist for each new company operation, for each new expatriate assignment.