National science and medical academies across the world serve a range of roles and functions. In particular, the benefits of an independent academy tasked with the provision of formal advice are compelling. For nearly half a century, the Institute of Medicine (IOM) has served the USA and the world by providing independent, authoritative advice on issues related to health and medicine. Its influence reaches deep into the health and policy worlds. This paper provides insight into the principles, processes, and governance that confer unique credibility to IOM advice. The IOM can serve as a useful model for other academies to consider for strengthening their work or when other countries contemplate the creation of a new academy.