[University trauma surgery and orthopedics: where is the journey going to?]

In the field of tension between generalists and specialists, in modern university trauma and orthopedic surgery the question arises as to which expertise has the greatest importance for the future of clinical care. University medicine consists of three large pillars: Research, teaching and treatment of patients. Each of these pillars is faced with the challenge of increasing specialization; however, generalists are extremely important for the future of university trauma surgery and orthopedics. Generalists promote interdisciplinary collaboration through their broad training and are versatile in acute care situations. Specialists are characterized by in-depth specialist knowledge and technological expertise in specific areas of surgery. This article analyses the changing requirements in trauma surgical and orthopedic care in the context of innovation, technologization, digitalization and increasing specialization. It also examines how structural reforms, such as the Hospital Structure Act and the new licensing regulations, are influencing the role of generalists and specialists in university training and clinical practice. The article provides a differentiated view of which specialist skills will be necessary in hospitals in the coming years and discusses whether a balance between generalism and specialization is the solution for high-quality patient-centered care.