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As general surgery trainees continue to enter specialty practice at a high rate, fewer and fewer are caring for emergency general surgery (EGS) patients. Thus EGS has become one of the cornerstones of the practice of acute care surgery. With the centralization of this area of surgical care in many areas of the country, a clear understanding of the issues associated with this becomes vital. Understanding the public health implications with respect to burden of care and cost will allow for appropriate planning and resource allocation in the future. In addition, the development of validated severity modeling will help with risk stratification in future study of these diseases.