People are still dying in the ditches. Avoidable problems deprive one in five accident victims a chance for survival before ever reaching the hospital. Many injuries are even worsened by their pre-emergency room lack of management. The Yale-New Haven Medical Center serves a population of 800,000 including inner city, suburbia and rural areas. Emergency services, in a totally discoordinated fashion, are provided by volunteer and commercial ambulance companies, community rescue teams, fire departments, police departments and even ski-patrols. Lacking the organized support of local government, with only the passive acquiescence of local medicine, and with miniscule financial backing, the surgical house staff planned, organized, and conducted a program for the training of emergency medical technicians. Using the American College of Surgeons curriculum, 132 ambulance attendants have completed the 72 hour course. This report documents the experience of a hospital-based, resident-inspired and conducted solution to providing our community with our new man in town - The Emergency Medical Technician.