For a long time, the date of the Military Medical Academy foundation remains debatable, thus the origins of the first departments and earlier disciplines or professorships also have differences. This study analyzes the jubilee academic publications of 1898, 1998, and 2008 series of dissertations, reports on research works, and essays on the history of departments that were systematically and separately prepared in the 1890s, 1940s, and 1990s for the anniversaries of departments. The documents were studied based on the Complete Collection of laws of the Russian Empire, several archival documents, and records in the historical form of the Academy and literary sources. The origins of the formation and transformation of the oldest surgical departments are traced to the example of departments of general, faculty, hospital, and military field surgery. Over time, views on the history of departments have changed in publications of different years; however, the continuity passes or, conversely, does not pass from one department to another without clear reasons. Based on the analysis, the proposed view of the historiography of departments in the context of Academy continuity with hospital schools at the General St. Petersburg Land and Admiralty hospitals and the Main Medical School is considered justified. Thus, the oldest surgical department of the Academy may be the successor of the first professorial position of the surgical department of the Main Medical School that was established on 07.15.1786. The second oldest in the modern department was allocated on 01.29.1829 from the department of I.F. Bush in the form of a surgical clinic department. Created at the suggestion of N. I. Pirogov, the Department of Hospital Surgery was established by a personal decree of 03.11.1841 by N. N. Elansky, and then by I. M. Talman on 06.10.1937. A new surgical department was created, which was twice created anew in the whirlwind of reforms in 1930.