The Health and Hospital Corporation (HHC) of New York City developed the Institute of Medical Simulation and Advanced Learning to challenge the way we conceptualize medical education. The vision was to use educational tools to help our providers deliver better care to the millions of New Yorkers depending on them. The Sim/Ed Fellowship offers a roadmap to empower Educational Leaders within HHC to use Simulation, Adult Learning Theory and Systems Management to foster culture change and meet the educational needs of thousands of healthcare providers.