Objectives: Traditional library work is spiraling downward. Health sciences librarians are taking on new roles such as embedded librarians or research data informationists. Simultaneously, institutionally mandated budget cuts force the question, "How do we maintain mission-critical work within our budget?" Survival means rejecting old service models, rethinking our roles, redoing our professional identity, and rejuvenating ourselves and our libraries. Methods: The Library Fellows Program at the University of Massachusetts (UMass) Medical School is one response to the challenges we are facing. The fellows program, designed to foster the next generation of medical librarians, provides a two-year experience for newly graduated library science students, emphasizing hands-on learning and research into topics of information management and medical librarianship. This innovative curriculum incorporates training, professional development, mentorship, and research with the library as the learning laboratory. Curriculum components focus on medical librarianship foundations as well as rotations within core library functional areas. This paper serves as a project description and evaluation. It discusses organizational changes that necessitated and facilitated the structural changes surrounding this program and the resulting effect on staff and operations. The midpoint success of the program is determined and reported, with recommendations and future considerations. Results/Conclusions: In early 2013, management at Lamar Soutter Library (LSL) planned organizational changes necessary to meet strategic initiatives and continue supporting the medical school's mission in the face of severe budget constraints. The final plan resulted in discontinuation of many traditional library activities, elimination of staff that supported those activities, and, ultimately, the development of the FELLOWS PROGRAM. In September 2013, three task forces were created to develop an implementation plan. A search committee was formed to begin the process of hiring three fellows. The Curriculum Task Force was charged with structuring the two-year fellowship program. The curriculum developed includes rotations through library departments, in-depth reference experience, expert searching training, structured projects, and performing research. The Reference Services Task Force was charged with developing a new reference model to replace the current triage and pager model. The Research Task Force was charged with laying the groundwork for creating a research environment in the library. With outside consultation, LSL developed a detailed evaluation plan. The program is in its eighth month. Modifications and refinements are being made as the first cohort experiences the program. The program has led to a redefinition of librarianship and a new professional identity based on a culture of achievement, research, and reflection.