This EAST Careercast brings back Dr. L.D. Britt for a discussion about "Acute Care Surgery." In a follow-up to one of the first Careercasts (Careercast #3) recorded in 2014, Dr. Leichtle interviews Dr. Britt about the current state of our specialty, its most important challenges, and future directions. Among many other things, listeners will learn why the Journal of Trauma and Acute Care Surgery should consider a name change, how surgical rescue might become a new pillar of Acute Care Surgery, and what the future holds for training and board certification.