In the years immediately following World War II the urge for international exchange, particularly in the medical profession, had been constrained by the lack of both finance and time. However, by the late 1950’s Europe and America were recovering from the effects of war, and the improved economic conditions together with the development of air travel eased both these constraints. Old friendships, many arising from shared experiences in the war years, were rekindled. Large organisations, such as the American College of Surgeons, scheduled meetings in the British Isles and on the continent of Europe. The International Society of Surgery was starting its reorganisation and modernisation. The founders of the I.S.G. were convinced that there was a need for the closer personal relationships that could develop most satisfactorily, not in such large meetings, but in a small group of surgeons meeting to share their ideas, successes and failures. Surgical clubs of this sort had existed prior to the war in Great Britain, but the concept of a transatlantic group was new, and it was appreciated that the members of this group should be selected not only on the basis of their reputation as academic and clinical surgeons, but also on their willingness, because of their belief in the validity of the concept, to travel at regular intervals to the meetings.
In 1955 Ian Aird of London and Erling Dahl-Iverson of Copenhagen, while crossing the Atlantic to New York on board the liner Queen Elizabeth talked much about surgery and lamented the fact that the large size of most surgical congresses made them impersonal and inhibited close contacts between participants. They conceived the idea of founding a group of 30 to 50 leading surgeons from the English-speaking countries bordering the North Atlantic and, after reaching the USA, discussed their plan with Alexander Brunschwig, who agreed with them whole-heartedly. Together the three made a list of prospective members and decided to approach those in their own regions, namely the USA and Canada (Brunschwig), Great Britain (Aird), and the Scandinavian countries (Dahl-Iverson). In April 1956, together with John Hellstrom of Stockholm and Carl Semb of Oslo, they wrote a letter to selected surgeons, inviting them to join an “International Surgical Club”. The response was enthusiastic and nearly all whom they invited agreed to join.