Shortly after becoming a chair of medicine in 2002, I chanced upon an article by Barry S. Coller, MD, PhD, entitled “Reflections on Being a Chair of Medicine, 1993-2001” that was published in Association of Professors of Medicine (APM) Perspectives in The American Journal of Medicine. The article served as a lueprint for me as I shouldered the new responsibiliies of being a chair. After a decade as a chair, I am elinquishing my position to undertake new challenges. s I was cleaning out my desk I again found myself eading Coller’s thoughtful discourse. It caused me to eflect on my own tenure as chair. Clearly, academic edicine has changed over the past decade and so, too, as the role of the chair of medicine. Some critics have rgued that being a chair of medicine in the era of ealth care reform requires greatly different skill sets han were required even a decade ago. I would posit hat while many of the challenges are new, most of the enets put forward by Coller are just as important today; lthough the order of priorities may be different and ew skill sets are required. To provide new chairs of edicine with the same type of information that Coller rovided a decade ago, I put forth what I think are the 0 most important concepts that a new chair should eep in mind when undertaking the challenge of leadng a department of medicine in 2012.