The staffing on trauma service can vary widely. In US teaching hospitals, a senior resident will typically be present 24/7, but an attending surgeon may or may not be present. At Parkland Hospital in Dallas during the late 1970s to early 1980s, there was a chief resident in-house who often performed surgeries due to the high volume of trauma cases. Attending surgeons were not required then, but that changed in the 1980s. When the writer was a resident at Yale New Haven from 1980 to 1985, a third-year surgical resident was the senior person on night duty, with the chief resident on-call for OR cases. Nowadays, attending surgeons are required to be present for surgeries, even during the night, but big trauma centers may have full teams in-house to handle the high volume of cases. In contrast, small hospitals may not have trauma surgeons and rely on general surgeons, orthopedists, ENTs, neurosurgeons, plastic surgeons, urologists, cardiothoracic surgeons, or vascular surgeons who are on-call from home, provided they have those specialties on staff.