In the light of the recent Calman Report and the Royal College of Anaesthetists document 'Specialist training in anaesthesia, supervision and assessment', there is currently much debate concerning the future of anaesthesia training in the UK. We present a description of anaesthesia training in the US for discussion and comparison. US residency training is short and seamless. It is highly structured, but retains a capacity for specialisation. It may offer ideas for the future direction of training in the UK.