In 2001, senior administrators in Emory University's Woodruff Health Sciences Center (WHSC) designated leadership as the central element of a new strategic plan, believing that an academic health center (AHC) requires excellence in leadership at all organizational levels to carry out the tripartite mission of teaching, research, and patient care. Leadership development in academic medicine presents unique challenges, however, including a wide range of professional roles and diverse operational centers that may be obstacles to unifying a leadership team in the pursuit of a central mission. Many administrators within academic medicine, although highly competent in their areas of expertise, possess limited leadership skills. In 2003, the WHSC created the Woodruff Leadership Academy (WLA) with the goal of developing a cadre of leaders throughout the WHSC with leadership skills relevant to an AHC and, specifically, to the WHSC. The graduates, called Woodruff Fellows, would work with senior leadership to create a shared vision of excellence and to pursue the goal of advancing all WHSC programs into the top rank of AHCs. After the first three years of the WLA, an informal assessment and a formal survey of the 70 fellows who had completed the program indicated that program graduates had embraced enhanced roles and responsibilities, undertaken new cross-disciplinary collaborative relationships, and acquired a renewed enthusiasm and respect for the shared vision of the WHSC.