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. Čársky was a member of the first generation of Slovak surgeons. Political censorship and a profound lack of professionals enabled the rapid career growth of S. Kostlivý at the time Czechoslovakia was founded. K. Čársky experienced similar conditions at the beginning of wartime Slovak Republic as the change of regime in 1938 forced the completion of activities for a majority of Czech intellectuals in Slovakia. As the career of S. Kostlivý shows, neither great competence nor strong social capital within the medical community was sufficient enough to withstand the politically and ideologically motivated purges. However, after a short time, the founding generation of Czech doctors and pedagogues managed to create a solid collection of medical specialists who mitigated, to a certain extent, the effects of personnel disruption due to regime changes.