From its inception approximately 15 years ago, the Hopkins International Medical Center (IMC)in Singapore was built on the premise that the practice of oncology nursing was essential to the program's success. From the beginning, a SKCCC nurse was responsible for establishing the nursing structure and guiding clinical practice and operations. Through weekly conference calls, scheduled visits in both directions for oncology nurse administrators and clinical experts, and the IMC Director of Nursing's direct reporting relationship to the SKCCC Director of Nursing, the level of professional nurse practice has been elevated and sustained. The IMC is physically located in the Tang Tauk Seng Hospital (TTS), and IMC nurses help staff their subsidized chemotherapy clinic. IMC nurse educators have instructed TTS nurses on chemotherapy administration, safe handling, symptom management, etc. The IMC Director of Nursing participates in the TTS nursing leadership meetings.