To be the 95th president of the Western Surgical Association is a great honor of which I and my family are tremendously appreciative. To be your first president who is a foreign medical graduate is a unique distinction that reflects the warm and tolerant spirit of this membership. To be the chairman of a major university department toward the end of a 22-year tenure with an opportunity to muse publicly on the changing contours of the chairmanship is a rare chance. Believing that too few surgeons, both in and out of academic life, have more than a vague knowledge of today's surgical chairmanship, my purpose is to reflect on a few selected facets of this often coveted but seldom comfortable position. I propose, like a cartographer, to delineate the changing boundaries and the rugged terrain of the chairman's territory. While there is some variation in climate over the land, the