The International Cardiovascular Society was founded 18 years ago to bring together investigators, teachers, and practitioners from medical and surgical disciplines with a common interest in vascular disease. From a review of the membership roster and the contributions to this and previous programs, it is apparent that our North American chapter has become increasingly surgically oriented. In these exciting years we have, in fact, participated in the birth of two surgical specialties, vascular surgery and cardiac surgery. We are now being asked by the government to propose means for strengthening the delivery of the products of these specialties. Many of you began service last year as professional consultants in a nationwide, federally sponsored and financed study which is to provide guidelines for the future conduct of these disciplines. Your responsibility is to design and to develop programs for the care of patients with cardiovascular disease that would assure the availability