When an academician or clinician assumes the chair of department, multiple responsibilities dawn upon the chair that requires appropriate analysis and effective decision-making skills. Head of the department is uniquely poised to translate the organisational goals into the collective performance of the departmental members. Headship is an iterative process which necessitates providing a mechanism for sense-making among sub-ordinates depending upon the varying environments (1). Sense-making can be defined as the ability of the head to improve the capacity of the department by productively organizing the information / perspectives arising from the various stakeholders and develop the most optimal action plan (2). An effective sense making can be achieved by articulating the formulated vision, influencing the peers, emphasising the goals, adopting the right problem-solving approaches and honing a proactive relationship dynamics among departmental members. The ability of sense-making gains more importance in high stakes departments where it is crucial to strike the right balance between the teaching, research and patient service before opting for major changes in the administration of the department.