Development of an effective, functional leadership structure is critical to the success of any large-scale organization. The department of medicine includes over 1,800 full and part-time faculty, 900 nurses, 881 trainees, and more than 1,000 employees in non-clinical roles. Like many academic departments, faculty carry out our missions on two campuses—Johns Hopkins Hospital (JHH) and Johns Hopkins Bayview Medical Center (JHBMC). These campuses provide complementary strengths, different patient demographics, and serve as program development laboratories for our entire health system.