The author considers the training requirements of a general surgeon who will be the only surgical specialist in a small community. Apart from the usual heavy gastrointestinal content, the surgeon's training should include 1 year of fracture and trauma training, the care of head injuries and urologic injuries, and, the management of abdominal gynecologic problems and the technique of cesarean section. Attendance at smaller regional surgical meetings, participation in the Surgical Education and Self-assessment Program (SESAP) of the American College of Surgeons and other continuing education programs are also essential in maintaining standards.