Summary Self-regulation by a profession or specialty group, which is basically no more than Standard setting, tends to evolve into true regulation which some legal authority legitimizes. Specialty training in anaesthesia can be regulated by specifying either the quantity of training (minimum duration or number of procedures performed) or by assessing the quality of the output (by examinations). Inspection of training centres is of the same kind, since it works on the assumption that high quality training centres will produce high-quality trainees. Both the quantity and quality approaches can be combined. Regulation can be quite sophisticated within nation States but only crude measures are possible at the international level. Although the European Community is the most sophisticated supra-national political body yet in existence, its decision-making still depends on consensus between sovereign member States. They have agreed on the minimum length of training but the reality is that almost all States insist on a much longer period. None of its official organs has yet been developed in a way that could regulate specialist training in a realistic way. Specialty Boards, the latest initiative of the UEMS, may find it difficult to evade the consequences of their genesis predominantly from national societies. The European Society will find comparable difficulties in trying to influence the EC. Only a professional, charitable body of leading practitioners, such as The European Academy of Anaesthesiology, can hope to have their advice followed, and even then only when it can clearly be seen to be in the interests of patients rather than practitioners.