Background: Exercising discretion is vital when making decisions. While decision-making implies having to choose between predefined alternatives, discretion requires sifting through several solutions and critically choosing the desired one that implies a choice between many alternatives without rigid guidelines pointing to one direction or the other. While previous studies have constantly investigated the nature and dynamics of creative insubordination or discretionary insubordination in primary and secondary education little is known as to how such a construct operates in higher education.

Purpose: This study was undertaken to address the central question: "What attributes define creative insubordination as a decision-making strategy among Philippine medical school deans?"

Design: Anchored on descriptive phenomenology, 21 medical deans who have been in the position for at least 4.5 years (range 4.5-26 years) were purposively selected for in-depth semi-structured interviews. Guided by the rules of cool and warm analyses, transcribed texts were phenomenologically reduced and interpreted, and validated via member checking procedure.

Findings: Five interesting elements that typify the modes of behavior in the practice of creative insubordination surfaced, namely: cognitional elasticity, emotional sensitivity, conational sincerity, relational mobility and axiological reflectivity.

Conclusion: This study provides eidetic images of the multidimensional facets of individual attributes necessary for the praxis of discretionary decision-making by a select group of Philippine medical deans in varied instances.