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In the 1950s when surgical residents graduated from their programs, the pace of graduate surgical education was at a fevered pitch. These were the postwar years, when enormous strides in education and research were made almost daily. Research was well funded from almost all agencies, especially from the federal government. In those years, it seemed that all residents were turned out with excellent credentials to enter academia; however, soon there were not enough academic vacancies for the number of applicants.
Consequently, many of these residents (myself included) went into private practice (town) and soon helped to develop an academic environment within the confines of private health care institutions. The enthusiasm from the medical school environment spilled into the private practice arena. Here were great reservoirs of clinical material and, in many instances, encouragement and support from hospital administration. Some private institutions developed well-run basic research laboratories that were instrumental in
RAINER WG. Graduate Surgical Education From a 'Town' Perspective. Arch Surg. 1991;126(3):287-288. doi:10.1001/archsurg.1991.01410270027003