This paper describes a process evaluation of an opinion leader (OL) project for a geriatric medical education program in dementia. Structured interviews with OLs were conducted to understand their experience as formal OLs from their initial training to the project's completion. Thirteen of 15 physicians involved in an OL project were interviewed. The adoption of a formal educational OL role was not an easy transition for most identified OLs. Some physicians struggled with the role and would have preferred more specific guidance. For this subject some content expertise was felt to be essential. Strong project leadership and some measures of success are important to sustain the OL commitment to a project. More attention needs to be devoted to the appropriate selection and training of OLs for educational projects to ensure that they have the relevant clinical expertise and skills to be effective and feel comfortable adopting a formal OL role.