Healthcare in the 21st century will be characterized by an aging population, increased costs, and scientific and technological advances. It will be characterized by a physician shortage, especially of specialists. Healthcare will be increasingly provided by caregivers with a spectrum of diverse educational backgrounds other than M.D. graduates of United States medical schools, such as international medical graduates, Doctors of Osteopathy, and Non-Physicians Clinicians. General surgery and other specialties are attempting to clarify the roles and services that their specialties will provide. Designing modern undergraduate and graduate educational programs is key to planning for healthcare in the 21st century.