The surgeon of the future will be required (expected) to engage in leading high performance teams that integrate surgical and nonsurgical skills; he or she will be integral to the evolving systems of health care. Practice will be based on evidence and measured by outcomes that will include some aspect of public reporting. Continuous professional development will be based upon recertification that is founded on practice and objective learning criteria. The processes and goals of CER are of the highest priority and remain in line with the surgeons' practice and professionalism. As we guide the evolution of the health care of the future, our professionalism will be increasingly focused upon accountability. We, as surgeons, must assume this challenge as our legacy, which includes a 100-year history that provides inspiring quality with development of higher standards and improved outcomes for the surgery patient. Copyright © 2011 by Lippincott Williams & Wilkins.