One hundred years ago, a group of surgeons from the United States and Canada founded the American College of Surgeons (ACS). Its origin lies in its journal, which was started 8 years earlier. Annual clinical congresses designed to promote the journal attracted so many surgeons from North America that the need for a permanent organization to promote the practice of surgery was apparent. Franklin H. Martin, the pioneer of all these initiatives, should be remembered on this centenary as the hero of continuing medical education (CME) and advocacy in surgery. The ACS has remained true to his vision. It is the premier advocate of surgery and surgical patients in the United States and is the world’s principal source of CME materials. Martin’s clinical congress, which continues as the annual scientific meeting of the ACS, remains the most important meeting of surgeons. For Canada, the founding of the ACS was a milestone. Instead of turning to Britain for advanced surgical education, Canada would collaborate with its neighbour to develop all aspects of surgery at home. Anesthesia and asepsis had permitted the growth of surgery so that almost every operation performed today was attempted, if not perfected, by the end of the 19th century. Surgeons, however, were only distinguished from the general medical community by a presumed ability and a willingness to restrict their practices. Wealthy surgeons sought additional education in Europe, and a few came home with fellowships from a Royal College of Surgeons in Britain or Ireland. Canadian surgeons, often working in competitive solo practices, were hungry for CME and collegial support. When Martin solicited the attendees of the first 2 clinical congresses to join a new college of surgeons, 68 Canadians agreed and became founding members of the ACS