Artificial intelligence promises to revolutionize medical education; yet, most institutions struggle to transition beyond pilot projects to meaningful implementation. This talk bridges the gap between AI's potential and current reality by showcasing real-world applications from across the medical education landscape. Participants will learn to navigate the "Alignment Paradox"—ensuring AI tools serve educational goals rather than undermine them—through an evidence-based decision framework. This practical approach, grounded in principles of AI performance patterns, helps educators determine when to trust AI autonomously, when human oversight is essential, and when to avoid AI entirely.