The ACS strives to exemplify our motto, “To Heal All with Skill and Trust.” Because access to surgical care remains uneven across the US, the ACS has developed programs, courses, and advocacy efforts to help surgical teams close gaps in care for underserved and rural communities.
Updated RTTDC
In 2003, the ACS launched the Rural Trauma Team Development Course (RTTDC), designed to help healthcare teams deliver high-quality care in US rural communities. Over the past 2 decades, the RTTDC has helped hundreds of teams improve their responses to low-volume, high-acuity trauma.
This month, we are launching the fifth edition, with an important update to the name: the Resource-Variable Trauma Team Development Course. The change signifies our understanding that the course’s frameworks and skills apply far beyond just rural areas and are appropriate for any resource-limited environment. Built on the expertise of ACS-affiliated surgeons, the course is now tailored for global and humanitarian health contexts, austere environments, military deployed settings, under-resourced institutions, and rural US hospitals.
Prehospital Blood Access
The ACS also advances clinical practice in underserved and rural areas by advocating for universal access to blood products for emergency medical services (EMS) nationwide.
Blood access in prehospital care has the potential to save more than 10,000 lives per year. Patients in underserved and rural areas, who often face longer transport times, are in greatest need.
With the leadership of Jeffrey D. Kerby, MD, PhD, FACS, immediate past Chair of the ACS Committee on Trauma (COT) and current ACS Medical Director, Trauma Education, the ACS has promoted broader access to blood products in patients with hemorrhagic shock.
This has included ACS participation in the Prehospital Blood Transfusion Coalition (PBTC), which has persuaded nearly all US states to permit paramedics to initiate transfusions in the field. With the PBTC’s encouragement, whole blood programs within ground EMS agencies now extend nationwide, from major urban centers to small, rural communities.
The ACS continues to engage. COT member Peter E. Fischer, MD, MS, NRP, FACS, represents the ACS on the PBTC board of directors. The ACS recently cosponsored a PBTC meeting that brought 125 leaders to our Washington, DC, office to discuss funding strategies for prehospital blood access, with a focus on addressing rural disparities.
EMS for Underserved and Rural Children
Ensuring high-quality care for children is another ACS priority.
At Clinical Congress 2025, Mary E. Fallat, MD, FACS, FAAP, a pediatric surgeon and past First Vice-President of the ACS, delivered a well-received Scudder Oration on Trauma on trauma and burn care for US children. She expressed that children, who are 22% of the US population, should receive care equal in quality to that of adults. Yet most children who need trauma or burn care are in underserved areas where hospitals may see fewer than 10 pediatric patients a day.
Because providing this care is a serious challenge, the ACS has advocated for advancing pediatric emergency care nationwide. In late 2024, we reached a milestone with the passage of the Emergency Medical Services for Children (EMSC) Reauthorization Act. The EMSC Program provides grants to states for improvements to pediatric emergency response and is the only federal program so engaged. The reauthorization extended program funding for 5 years.
While the EMSC Program faced potential elimination in the FY2026 federal budget proposal, Congress acted to save it. The ACS supported that decision and will continue to advocate for children, particularly those with limited access to high-quality care.
The ACS has also worked closely with the federally funded EMSC Innovation and Improvement Center to advance pediatric readiness in ACS-verified trauma centers.
Offerings for Rural Surgeons
The ACS also offers programs specifically tailored to rural surgery.
Newly released Commission on Cancer accreditation standards for rural hospitals are helping advance care. Additional grant-funded initiatives are redesigning quality measures to better reflect geographic, social, and biologic drivers of inequity in surgical oncology.
The COT is developing Level IV trauma center standards specific to rural hospitals. An additional Rural Trauma Program is in development; we will share further details later this year.
Finally, I recommend “The Rewards and Frustrations of a Rural Surgery Practice,” a webinar featuring Michael D. Sarap, MD, FACS, and Alisha D. Reiss, MD, FACS, a member of the ACS Board of Governors. Both offer valuable insights from their lived experiences.
Rural surgeons are strongly represented among ACS leaders. Our immediate Past President, Beth H. Sutton, MD, FACS, is a private practice general surgeon from Wichita Falls, Texas, and a strong advocate for rural surgeons. Our present leadership also includes Regent David J. Welsh, MD, MBA, FACS, a private practice general surgeon in Batesville, Indiana; Regent Gary L. Timmerman, MD, FACS, who is chair of surgery at the University of South Dakota in Sioux Falls; and Second Vice-President-Elect Robert P. Sticca, MD, FACS, an emeritus professor at the University of North Dakota in Grand Forks who helped establish and lead the only surgical residency program in that state. All these leaders have deep experience in rural surgery, and all are contributing to an effort to strategically align ACS rural surgery initiatives for maximal impact.
The ACS is committed to bringing higher-quality care to all surgical patients by supporting all surgeons, no matter their geographical setting or resource access. If there is more the ACS can do to help you, please let us know.
Join a Committee
We are committed to an open and inclusive application process to serve on ACS committees. Importantly, we welcome the voices of surgeons from all specialties, practice configurations, and locations. Learn more and apply by June 5 at facs.org/committees.
Register for Clinical Congress 2026
Clinical Congress is a great opportunity for all surgeons to learn and connect with colleagues and experts. Each year, we look forward to sessions on surgery across diverse environments and patient needs, plus events for surgeons across specialties, career stages, and practice settings. Register now at facs.org/clincon2026.
Educational Courses for Residents
Registration is also open for our popular ACS Residents as Teachers and Leaders course June 10–13 in Durham, North Carolina. Additionally, our Residency Readiness Course for medical school graduates entering internship will be held from June 15 to 17 at the ACS Headquarters in Chicago, Illinois. Please inform any future surgical residents you know about these opportunities. Information and registration are available on facs.org.
