Competency-oriented human resource management has become a fundamental issue in the human resource management of the public health field in China. Since there is no consensus on the post-competency dimensions of clinical department directors in class-A tertiary hospitals, this paper explored the determinants of this position’s competency to clarify the influence factors. In this qualitative study, we adopted in-depth interviews with 10 Chinese clinical department directors from class-A tertiary hospitals. In our research, professional skills, administrative ability, personal traits, and interpersonal relationships are the main categories for the competency of this position