Reflections on leadership as chair of a department of psychiatry.

The chair of a department of psychiatry has a complex role, balancing leadership of the department with the broader role as an institutional leader. The competencies and training opportunities for this role are ill-defined. Mentorship, strong administrative supports, and champions for psychiatry within the academic health center are key resources for the chair. The continued need to be a knowledgeable leader in the national trends of education, research, and clinical systems of care is a real challenge.