Our Cancer Center is currently part of a Comprehensive Academic Medical Center. The organisation is along traditional departmental lines. Therefore the Cancer Center has under its governance the following departments: Haematology, Medical Oncology, Radiation Oncology, and Oncology Nursing. It has cancer surgeons that belongs to the hospital surgical department and paediatric oncologist that belongs to the hospital paediatrics department. To evolve into the next phase and I feel necessary for academic excellence and optimisation of training and service provision, I want to organise the cancer center into tumor specific groups comprising of surgeons, medical oncologist, radiation oncologist, and nurses specialised in different area of the body e.g. breast, gastrointestinal tract, lung etc. This will require a change from traditional organization, incentivization and funding that is all based on departments. For the change, I will need the buy-in of affected departments e.g. surgery, O&G, Paediatrics who will need to be willing to relinquish their staff, we need to be able to account for case loads so that these department will not lose out but losing staff working in the more ‘glamourous’ field of cancer. What are the possible solutions in this transformation? Are there hybrid solutions? An important point is that we are not stand alone cancer centers such as MD Anderson or Memorial Sloan Catering but a Cancer Center within a comprehensive general Academic hospital set-up so maybe more like Mayo Clinic or Cleveland clinic.