RT Journal A1 Givel JR, Harder FH T1 SUrgery in switzerland JF Archives of Surgery JO Archives of Surgery YR 1999 FD December 1 VO 134 IS 12 SP 1400 OP 1403 DO 10.1001/archsurg.134.12.1400 UL http://dx.doi.org/10.1001/archsurg.134.12.1400 AB Switzerland is a truly federal nation. This means that important sectors, such as health care, teaching, and the police, are controlled mainly at the level of the 26 cantons, independently and in their own specific fashions. These divisions make the development of very large centers extremely difficult, whereas they do offer an excellent basic surgical service within small communities. To appreciate this particular setup, one has to realize that Switzerland is characterized by its small size (population of 7 million), hosting 2 main cultural backgrounds, Germanic and Latin, and 4 national languages (German, French, Italian, and Romansch). Switzerland has only 5 faculties of medicine in the Universities of Basel, Bern, Geneva, Lausanne, and Zurich, still a large number for 7 million people. The public health sector (around 50% of the hospital bed capacity of the country) is divided into university, cantonal, and regional hospitals, respectively. In addition to providing basic health care, generally at a remarkably high standard, all physicians participate actively in undergraduate and postgraduate medical training.