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Introduction Global health originated from colonial and tropical medicine, which served the interests of colonial powers. Despite efforts to address this legacy, the field still faces challenges in unequal partnerships between high-income (HICs) and low-income and middle-income (LMICs) countries. Activists push for paradigm shifts emphasising health equity, decolonisation and partnerships based on solidarity and justice. The Geisel School of Medicine at Dartmouth aligns with these movements, focusing its global health programmes on equity.Methods This study, employing ethnographic methods to centre the perspectives of learners at one of its partner institutions, the University Teaching Hospital of Kigali, identified key themes to enhance equity in global health medical education.Results These themes yielded concrete actions at the student, curricular and institutional levels that should be undertaken to promote equity and justice in academic global health partnerships.Conclusion The findings offer a tailored framework for fostering equitable and justice-oriented practices in future exchanges with potential applications to academic global health exchanges between HICs and LMICs more broadly.