In reviewing the major American and British surgical journals throughout a 15-year period (1983-1998) for the absolute number of articles and the proportion of national and international papers published, it has become apparent that internationalization has occurred. Asian and European manuscripts showed the most striking increase in all journals, with national papers down by 19% among American monthlies and by 28% in the British Journal of Surgery. The number of basic research papers declined by 15% in US surgical journals, with a simultaneous 2.4% decrease in government funding. Is this a result of multiple new specialty journals siphoning away our national output? Is it closely related to the national government funding reduction? Is it part and parcel of the pressures of managed care on many academic faculty members? Or is it an example of the globalization process we see all around us in other professionals and markets? Dr Tompkins and his group, representing American academia; Dr Bernard F. Ribeiro, a distinguished British surgeon; and Dr Leigh Delbridge of Sydney, Australia, present their analyses. Surely, after reviewing all of this, one can formulate his or her own opinion. Let us hear from you!