The Veteran’s Affairs Puget Sound Health Care System is the major tertiary referral center of the VA Health Care System for one of the largest geographic areas in the United States, including Washington, Alaska, Idaho, and parts of Oregon. The Surgical Service at VA Puget Sound is thoroughly integrated with the Department of Surgery at all levels – faculty, residents, and students. Residents and students gain experience from rotations at the Seattle VA at all stages of their training.