Universities are in a highly competitive environment, needing strong academic leadership. Some heads of departments have been appointed into leadership positions in a healthcare faculty after having been mere academics for a few years. They are more likely to experience challenges. This study aimed to explore the views and understanding of heads of departments in a healthcare faculty on being appointed as academic leaders in a higher education context in South Africa. A qualitative design using 12 individual unstructured interviews was conducted with all the heads of departments in a health sciences faculty. Open coding was conducted and two themes emerged, focusing on the varied skills needed for academic leadership positions and developing leadership skills amongst senior academics. The findings indicated that development of senior academics in leadership should be undertaken by a knowledgeable professional in formal or informal settings, to encourage mentorship and more regular group meetings, while addressing the core role of a leader. Implications of these findings for a faculty of health sciences and suggestions for leadership succession in future are discussed.