Data complied by The National Center for Health Statistics show that surgical utilization has increased dramatically, particularly during 1971-1977 (+34 per cent). Increases were greater among females than males, primarily because of an increase in gynecologic surgery. The 15-year-and-younger cohort was the only age group that did not show an increase, while surgical patients per 1,000 increased consistently with advancing age. Many factors probably have contributed to the increase in surgical utilization, yet the one factor which as been suggested more frequently than any other is surgical manpower (there may be too many doctors performing surgery for the needs of the population and this situation may lead to excessive surgery). This issue of how many physicians there should be in surgical training is widely disputed and politically volatile, however. The problems inherent in estimating future manpower requirements are many, making it hard to derive "optimal" distribution patterns.