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In 1998, the University of California San Diego (UCSD) was selected as one of four National Centers of Leadership in Academic Medicine (NCLAM) to develop a structured mentoring program for junior faculty.Participants were surveyed at the beginning and end of the seven-month program, and one-four years after. The institution provided financial information. Four primary outcomes associated with participation in NCLAM were assessed: whether participants stayed at UCSD, whether they stayed in academic medicine, improved confidence in skills, and cost-effectiveness.Among 67 participants, 85% remained at UCSD and 93% in academic medicine. Their confidence in skills needed for academic success improved: 53% personal leadership, 19% research, 33% teaching, and 76% administration. Given improved retention rates, savings in recruitment was greater than cost of the program.Structured mentoring can be a cost-effective way to improve skills needed for academic success and retention in academic medicine.