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Evidence based medicine (EBM) requires a level of maturity in the processes, both clinical and non-clinical, which is gained typically over years through consistent deliberate efforts. It is argued that the role of clinical leadership is critical to this. The Tata Memorial Centre (TMC) is a pioneer in cancer care and research in India. Over several decades, they have developed an indigenous approach to development and implementation of Evidence based medicine, which has catapulted them into leading cancer hospitals in the world. Set in March 2016, this case study describes TMC's journey thus far with particular emphasis on changes in organizational design as key enablers. TMC's next frontier is to propagate this model of clinical excellence to other cancer hospitals in India through the formation of National Cancer Grid. The key challenge confronting Dr Rajendra Badwe, Director of TMC, is can these other hospitals accelerate their journey based on the learnings from TMC or whether they will have to customize their approach based on their own operating context. More broadly, which elements of TMC's clinical excellence model are replicable in other hospitals and what organizational changes would be required to implement them.