given the relative small sample size of doctors surveyed, one cannot generalize this knowledge gap to our country as a whole, yet it raises the question of whether our doctors receive some basic fundamental knowledge and skills training to provide the initial stabilization of trauma patients. In conclusion, the current study suggests that Turkey still requires a well-organized trauma system. We strongly believe that one of the most critical step to improve the system is to show that everything is not okay. This survey is one of the few steps to initiate efforts for a unified trauma system. We suggest implementing changes to the Turkish emergency medical system that should include didactic and hands-on training trauma courses, with emphasis on triage training. Additionally, the implementation of triage scenarios done at least twice each year at the hospitals more likely to receive mass casualty victims may be beneficial in decreasing the early mortality of trauma victims. The implementation of a comprehensive national trauma database with mandatory reporting by the designated trauma centers may provide the additional information needed to develop an ideal country-wide trauma system. Our study has the following limitations: (1) the number of completed survey was low at 75%, therefore some of our conclusions may not be generalizable; (2) the sample size was too small to analyze the different geographic locations of the country, including the type and locations of the institutions and specifically doctors working in more urban versus rural hospitals, hence, we cannot know whether the knowledge and skills gaps identified are a country-wide issue or a local or regional issue. Additionally, while we have offered some possible solutions with respect to how to correct some of the perceived deficiencies highlighted by our survey, we must caution the reader that these are merely suggestions and not strong recommendations. With this article, we sincerely hope to establish the first step to create a unified trauma system and trauma research in Turkey. REFERENCES 1. ACS Committee on ATLS. Trauma evaluations and management: early care of the injured patient. 2nd ed. Chicago, IL: American College of Surgeons; 2005. 2. Annan K. Secretary-general of the united nations. United nations road safety collaboration: a handbook of partner profiles. Version 1. Geneva, Switzerland: World Health Organization; 2005. 3. Turkey’s Statistical Yearbook. Turkish Statistical Institute, Printing Division, Ankara, Turkey; 2013. 4. Ünlü A, Cetinkaya RA, Ege T, Ozmen P, Hurmeric V, Ozer MT, Petrone P. Role military hospitals: results of a new trauma concept on 170 casualties. Eur J Trauma Emerg Surg 2015 Apr;41(2):149-155. 5. Squyer E, Robert C, Eric L, Yanturali S, Kilicaslan I, Oktay C, Holliman CJ. Comparison of trauma mortality between two hospitals in Turkey to one trauma center in the US. Eur J Emerg Med 2008 Aug;15(4):209-213. 6. Arslan ED, Kaya E, Sonmez M, Kavalci C, Solakoglu A, Yilmaz F, Durdu T, Karakilic E. Assessment of traumatic deaths in a level one trauma center in Ankara, Turkey. Eur J Trauma Emerg Surg 2015 Jun;41(3):319-323. 7. American Trauma Societ y. Trauma center levels explained. Available from: http://www.amtrauma. org/?page=traumalevels (accessed September 21, 2015). 8. Field Trauma Triage, Guide for Leveling Hospitals. Izmir Trauma Group, September, 2013. 9. Cryer HM. The future of trauma care: at the crossroads. J Trauma 2005 Mar;58(3):425-436. 10 The Roy E. Campbell Trauma Act of 1990 established the specific steps for an individual general acute care hospital in Florida to follow when seeking to provide trauma care services. Included in these steps are the requirements that the hospital provide a written application to the Department of Health Division of Emergency Medical Operations, Office of Trauma, for review and approval and that the hospital accept an on-site survey by department staff and contracted out-of-state surveyors with expertise in trauma patient care. This pamphlet, “Trauma center Standards,” details the standards a hospital shall meet to successfully complete the trauma center application process. The hospital shall also maintain these standards to operate as a trauma center. The contents of this pamphlet are based in part on the standards published in the 1998 version of this pamphlet, in part on the guidelines published in the American College of Surgeons’ Resources for Optimal Care of the Injured Patient: (2006), and in part on the experience gained during site surveys conducted at Florida trauma center applicant hospitals since 1990. This latest edition of the standards pamphlet contains many changes. Most notable is that this document now contains four chapters: a definitions chapter and a chapter that describes the minimum approval standards for each of the three options available for a hospital seeking to operate as a trauma center. Chapter One consists of definitions of words, phrases, and acronyms used throughout the document to meet the unique requirements of the Florida program. Some definitions, for example, "trauma team," may not necessarily match definitions in documents published by other organizations or by other states. In Chapters Two through Four, several individual standards begin with an introduction contained within a shaded box. Also, several standards have general