Following the dissolution of Austria-Hungary and the establishment of Czechoslovakia, Slovak society was struggling from a severe lack of professional elites. A considerable portion of civil servants, academics and pedagogues rejected the new regime and left Slovakia. By examining the cases of two significant figures of medical science (surgery), S. Kostlivý and K. Čársky, this study introduces some key difficulties affecting the establishment of this discipline during inter-war Czechoslovakia. S. Kostlivý was among the founders of Slovak surgery, K.