The Canadian Association of General Surgeons distributed a questionnaire to members located in communities of 40 000 population or less. The objective was to establish a minimal referral base of general surgeons, to identify the scope of procedures performed and the adequacy of training for serving smaller communities and to gain knowledge of the need for other specialists and the activity of the general practitioner-surgeons in smaller centres. A review of 92 replies indicated that, in general, these surgeons are very satisfied with the hospital and laboratory facilities, and perform a broad range of operative procedures for which there is abundant operating time. In communities of 10 000 to 20 000 there appears to be a need for extra training in obstetric, gynecologic and orthopedic procedures. Most of the larger communities have an adequate number of other surgical specialists with the exception of neurosurgeons. Of the respondents, 80% practised on a referral basis only with an average of 10 referring general practitioners; 24% were in competition with general practitioner-surgeons, but most indicated that this is a diminishing problem. It appears that practice in small communities provides a very rewarding and professionally challenging surgical career.