Recognizing the effectiveness of substance abuse treatment is made easier when there is a steady supply of newly trained medical professionals who are competent in this specialty. University-based substance abuse treatment facilities have a clear obligation to educate such professionals. This article shows how three different medical colleges were able to establish new clinical fellowships in substance abuse so that teaching activities could be fostered at preexisting treatment sites. Fellowship activities varied from one place to the next, but at all three schools important momentum was generated on behalf of substance abuse education. These experiences provide models for those academicians and administrators who face the task of integrating educational and serivce delivery missions in the substance abuse field.