Academic medical centers operate at the intersection of clinical care, medical education, and research — three distinct enterprises with competing priorities, separate governance structures, and vastly different technology needs. This panel brings together CIOs navigating the unique complexity of the AMC environment, from managing faculty physicians who demand best-of-breed tools to building research computing infrastructure that can't touch clinical data. Leaders share how they align IT strategy across all three missions, make trade-offs when resources are constrained, and build organizational trust with stakeholders who don't always speak the same language.