Abstract:  Medical education reform is the key to improving the quality of medical services. Currently, there is a common dilemma of "high investment, low transformation" in medical education reform projects in China. This article analyzes the above difficulties and proposes four major challenges in the management of medical education reform projects, namely, the quality of declared projects varies greatly, there is a lack of procedural supervision mechanisms, the evaluation of project quality is singular, and the path for application and promotion of results is unclear. In response to the above difficulties, a systematic optimization plan is proposed in the article, which includes strict project application review, establishment of multi-dimensional quality standards, implementation of dynamic process management, strengthening mid-term assessment, innovation of medical evaluation system, focusing on student competency cultivation, clarification of transformation responsibilities, establishment of relevant supporting mechanisms, and the use of digital technology to empower medical education reform project management. These strategies will help improve the application quality and implementation effectiveness of medical education reform projects, and promote the innovative development of medical education through institutional innovation and technological empowerment.