Acute Care Surgery (ACS) is an evolving specialty with three essential components- trauma, critical care and emergency surgery.  Following a survey of the surgical critical care program directors and of the major trauma organizations it was clear that trauma and critical care surgeons were increasingly responsible for emergency surgical care. This increasing responsibility was a result of increasing need for trauma and emergency surgical coverage in both academic and community hospitals. There was an educational gap identified as Trauma and Acute Care Surgical specialty emerged. Leaders in Trauma and Acute Care Surgery have developed educational goals and encouraged a more formalized curriculum for training programs to meet this educational gap. The AAST has taken the lead in reviewing programs who have decided to pursue this more formalized curriculum. These approved programs undergo a rigorous review to ensure that each trainee meets the goals of the Acute Care Surgery program.