When the University of Iceland and its medical school were founded in 1911, a hospital owned by the Catholic Church (St Joseph's Hospital) became the teaching hospital (Figure 1). In 1930 the government built a hospital, Landspitali, which since then has been the main teaching hospital (Figure 2). In 1967 the City Hospital, owned by the city of Reykjavík, was opened and also became a teaching hospital affiliated with the University of Iceland (Figure 3). The City Hospital specialized in trauma from the start. By 2000, all of these hospitals had merged into 1 institution called Landspitali University Hospital, owned and run by the government. The merger provided an opportunity to coordinate the various services and departments. The 3 general surgery departments that once existed have now merged into 1, and the same is true for the orthopedic departments. Special departments exist for pediatric surgery, thoracic and cardiac surgery, urology, plastic and reconstructive surgery, ophthalmologic surgery, otolaryngology, neurosurgery, and vascular surgery. Most of these departments have existed for a long time. The youngest one, the department of vascular surgery, became a special service in January 2000. Within the section of general surgery, subspecialization exists in upper gastrointestinal surgery, colon and rectal surgery, and breast and endocrine surgery. Major operations on the esophagus, pancreas, liver, and rectum are rather uncommon in a small population such as Iceland. To maintain a high standard of care, these operations are performed by just a few surgeons. All hospitals in the country, such as Akureyri Hospital on the north coast, which is the largest outside of Reykjavík, Neskaupstadur Hospital on the east coast, and Isafjordur Hospital in the West Fjords, are owned and run by the government (Figure 4).