Background: The Health Sector and the rendering of health services in South Africa have undergone substantial adjustment since the political change in 1994, filtering through to academic medicine. The managerial responsibilities of the Heads of Department at Medical Schools multiplied. In order to improve their management skills; decrease their frustration; and optimally utilize the highly skilled person-power available, this study endeavoured to establish a management model for use by experienced as well as new Heads of Department in a School of Medicine, measured against the background of good management practices.

Methods: A descriptive, explanatory survey comprising a literature review, a questionnaire survey and a Delphi process was performed. The literature study covered a few aspects, including assessing the possible needs of Heads of Department, exploring factors impacting on their environment, as well as the difference between management and leadership, and the difference between various management models that may be applicable to management in an academic setting such as a Medical School. The second part of the empirical study was the Delphi process, which involved six experts from the areas of management, health management, and education. A quantitative approach with open-ended questions was followed, focusing on measurement of experts' feelings about these areas.

Results: Heads of Department are appointed in the academic environment with the primary focus on their educational achievements. Throughout the process, it was demonstrated that this is still relevant and needs to be part of the appointment process of Heads of Department in a School of Medicine. It was also indicated throughout this study that there is an increasing expectation from Heads of Department to take on sole responsibility for the management of their departments. In view of these developments, it was important to consider assisting them through establishing a management model, thus empowering them to manage their departments in the future. The main findings from the questionnaire to Heads of Department, the Delphi technique, and information obtained via the literature study enabled the researcher to make a recommendation on a management model that is flexible, individualized, relevant, and adaptable for Heads of Department at the School of Medicine at the UFS.

Conclusion: Resources and services are spread thin by challenges from political changes and other challenges such as the AIDS pandemic and tuberculosis. Emphasis has shifted from hospital-based care to primary health care adding another dimension to the management strategy of academic institutions. A management model, the PRIME model, was developed that is simple, flexible, allows for individuality, integration and efficiency and should be easy to implement. It adds quality to management tasks but also to lives. It embraces multi-tasking and still focuses on the key position of the leader, while allowing growth and development of new talent. It is adjustable and should be the model of choice to address the ever changing environment of health management. It is recommended that a future study be conducted evaluating the possibility of utilising the principles of the PRIME model in other Medical Schools in South Africa in order to assist them with the managerial problems they might be experiencing.