I have, therefore, addressed the issues of making surgery a more attractive prospect, never underestimating the value of an attractive and exciting clerkship. We have begun to address the issues of the surgical residency, making it both more realistic and more attractive, but we have yet to come to grips with the limitations on the junior faculty. Many of our junior faculty came into surgery with the thought that they could remain as a translational surgeon-scientist and find that exercise incredibly difficult. We must continue to promulgate time control and access to the translational aspects that make surgery such a rewarding career. We need to educate that as surgery becomes more complex and the time demands more comprehensive, if we are going to have creative, thoughtful innovators, then time must be provided for that intellectual cognitive exercise. It can be done! More and more examples are being identified of young people with the mind-set and drive. We should not fear that many will focus on outcomes research rather than on molecular diagnostics. One of the issues that have set us apart as surgeons is our ability to perceive and examine the patient in his or her entirety. Within a generation, we have lost track of that, but it can easily be redeemed. Where 3 decades ago the challenges were those of total parenteral nutrition, organ transplantation, control of shock and hemorrhage, we can see many of these problems having been solved on a macro level, and now we can come back to looking at what best serves the patient in terms of outcome, applying the end model of a comprehensive “the study of man is man” to allow an evaluation of both diagnostic and therapeutic endeavors as they translate into long-term outcome. This takes back our independence and belief that we can foster an entire field of science as we continue to try to manage the patient in his or her entirety. The ability to do this will change the way that the junior faculty expend their endeavors but preserve, in the end, a wonderfully attractive existence. Some of the senior faculty may not be able to be rescued having grown in an environment so different from the one they are expected to cope with at the present time. We can only hope that with utilization of institutional resources, we can protect our most productive surgeons from being hobbled with administrative restrictions that show little benefit other than in the minds of the compliance police. Leadership changes have to occur in terms of patient care delivery. Many of the advances will come not from the overall leader of a department but more from a division head, where the dimensions of the issues are small enough that they can be comprehensively encompassed and dealt with with diligence and attention to detail.