<p>In light of the growing threat posed by terrorist attacks and the increasing likelihood of alliance or national defense operations, not only the armed forces but also civilian hospitals must be prepared to manage potentially large numbers of severely injured patients. This necessitates the development of comprehensive stand-by concepts that extend beyond the traditional boundaries of surgical specialties. At the same time, there is a noticeable decline in broadly trained general surgeons, largely driven by increasing specialization and subspecialization. As a result, current training structures tend to promote earlier specialization in order to meet the complex demands of modern medicine and to keep pace with rapid technological advancements. To address these opposing developments, innovative and adaptive training concepts are required. This article examines the current surgical training structures in Germany and presents contemporary approaches to the acquisition of competence in emergency surgery.</p>