The Northeast Ohio Medical (NEOMED) University Writing Center was founded in the winter of 2022 to support its medical, pharmacy, and graduate students. Through trial, error, and creativity, the Writing Center Specialists developed a successful writing center offering collaborative synchronous and asynchronous sessions. Often, graduate education needs a different type of support than undergraduate students do: in-house editing combined with traditional theory. This initiative highlights the importance of writing and editing support in medical education, addressing diverse needs across NEOMED’s colleges and promoting effective writing practices. On February 21, 2022, in a small meeting space between two offices, Brian sat at a large, wooden, boardroom table staring out the large window into the Aneal Mohan Kohli Academic & Information Technology Center, the official name of the Northeast Ohio Medical University (NEOMED) Library, waiting for the first students to appear for in-person writing tutoring. One week prior, Brian had signed a part-time (20 hours a week) contract to lead a writing center pilot project that ended on June 30, 2024. Brian was the Writing Center Specialist and was tasked with creating a writing center to support the more than 1,000 medical, pharmacy, and graduate students at NEOMED and had less than 30-months to do it. NEOMED is a stand-alone medical university in the rural community of Rootstown in Northeast, Ohio. It is not connected via physical space to any hospital system. NEOMED does not confer any undergraduate degrees but does offer several master’s and PhD programs for its students within its College of Graduate Studies. There are over 600 medical students, 300 pharmacy students, and more than 100 graduate students attending NEOMED. The school is within 50 miles of several teaching hospitals that partner with the NEOMED students in Cleveland, Akron, Canton, and Youngstown areas. The closest clinical location is a 20-mile drive from NEOMED’s campus. Brian’s background was in English Composition and Rhetoric, having taught at several universities since 2010. He worked in a Writing Center as a graduate student and followed writing center theory closely. Now, he was creating a writing center, carte blanche. He was given a common room and two offices. He had a small budget for paper products, a laptop, a bulletin board, and access to various means of communication. He met with the leaders of the three different colleges and asked the same questions: how can a writing center help your students? The answers were all different and began to mold the theoretical approach. NEOMED was founded in 1973 to meet Northeast Ohio’s critical need for primary care physicians. Much of the writing support for the College of Medicine (COM) was provided by the Assistant Director of Student Affairs and the Assistant Dean of Student Affairs. In the College of Pharmacy (COP), the Assistant Dean of Student Success worked with students as they navigated writing assignments. In the College of Graduate Studies (COGS), individual professors were tasked with this writing support. While the individual colleges attempted to support their students in their writing, typically, only the high-stakes professional writing—resumes, curriculum vitae (CVs), personal statements, and letters of intent—were given priority. As an example, the Assistant Director of Student Affairs for the COM reviewed 150-160 CVs and personal statements between May and July each year. The group of third-year medical students submitted their applications for residency programs through the Electronic Residency Application Service (ERAS), the system used by medical graduates to apply for specialized training positions in hospitals. COGS, in which Brian had been an adjunct professor since 2018, needed academic writing support for its students. Many of the nine graduate programs had writing assignments throughout the semester. Some of the program’s students wrote master’s theses and others wrote doctoral dissertations. Many of these students utilized the Writing Center for support. Professors in COGS also asked Brian to create several writing specific videos which covered topics on grammar, punctuation, research writing, and formatting. COP had one goal in mind for the Writing Center, and that was supporting their second language learning (SLL) students. The SLL students struggled with plagiarism, understanding prompts, taking notes, research writing, and reaching out for help. In August 2023, 18 months after Brian was hired, funding was allocated to hire an SLL specialist, and Brook was hired to support the SLL students, specifically those in pharmacy. COM had a detailed list of needs for the Writing Center, much of which was high stakes writing. The number one need of the COM was to support the 600+ medical students as they create their professional CVs. Then, the Writing Center was asked to collaborate with the students as they create personal statements for residency applications and research opportunities. Medical students also created oral and poster presentations, journal articles, and many other writing projects. The University provided its students with 20 hours of writing support. Yet, after a week of being open, students did not come for the support they needed. Brian sent emails to cohorts. Announcements were made. It was clear that sitting at a table facing the window to the library and waiting for students to start coming in for in-person tutoring sessions was not happening. The typical, in-person consultation consisted of reading the paper out loud in the undergraduate writing center world that Brian was accustomed to. Undergraduate writing theory was not what the NEOMED students needed. Instead, it took trial and error, a lot of support, a little bit of money, and some creativity to establish the NEOMED Writing Center as a fully funded center of the University. Ultimately, the NEOMED Writing Center pilot program is a story that all graduate schools can use to create their own writing center. By promoting asynchronous sessions, screenshares, and collaboration, a graduate school writing center became successful.