The leadership position of an academic departmental chair can be a positive and rewarding opportunity. These rewards principally stem from the success of the faculty, residents, other trainees, nurses, and everyone supporting the department. With health care reform and the constraints of the federal budget, increasing attention and time has become directed toward administrative management. There are multiple and often competing constituencies and agendas requiring thoughtful strategies to achieve departmental goals. The objectives of a chair are advancing patient care, education, and research. True excellence of a department is achieved by the innovation of its faculty. Cancer 2015;121:3795-3798. (c) 2015 American Cancer Society. The major goals of a Chair of a Clinical Department at an Academic Medical Center are advancing the care of patients as well as the educational and research missions of the Department. True excellence of a Department is achieved by the innovation of its Faculty.