The Faculty of Medicine in Newcastle, Australia, established an integrated curriculum in medicine and an organizational matrix structure to support it in which academic departments as such did not exist. As the faculty expanded its responsibility to other health professional programmes and semi-independent academic centres the organizational structure has been diversified whilst still retaining the same principles. This article explores the experience of this transition. It is of particular relevance in Australia with three schools moving to integrated courses in medicine but retaining in many aspects their original structure.