The increase in global health opportunities in medical education has been accompanied by calls for ethical and reciprocal institutional partnerships. The Working Group on Ethics Guidelines in Global Health Training (WEIGHT) guidelines were developed in 2010 and are widely accepted by the global health community. We reviewed 43 articles on international partnerships from 1970 to 2010 for eight principles of reciprocity derived from the WEIGHT guidelines. The results showed that, while few articles reflected all principles, there was a trend to increasing consideration of the international partner’s local needs, pre-departure cultural training, and collaborative authorship. However, learner supervision and consideration of local cost/benefit ratios decreased over the same time period. Partnerships with only one international partner or with institutional partners in Africa had lower reciprocity scores than those with two or more partners and institutional partners in Asia and South America. We recommend that a new focus on ethics in global health partnerships leads to the inclusion of the principles of reciprocity in model program descriptions in order to enable and encourage ethical, sustainable, and mutually beneficial institutional partnerships.