The professional carrier of 356 residents, the 1960-2007 graduates of the Saint Petersburg Medical Academy of Postgraduate Education, was studied to specify approaches to professional selection of anesthesiologists. Thirty (8.4%) graduates did not work as anesthesiologists at all. It should be noted that most (n = 24) of the 30 graduates had successfully completed the residency. The anesthetic activities were generally altered under the influence of factors that are not related to successful education, namely financial, social, familial, etc. In this connection, long-term forecasting underlying professional selection appears to be of doubtful feasibility. The selection made within the first year of training (a follow-up by teachers) is valid. However, it is impossible to consider each residency graduate to be a well-trained anesthesiologist. An intermediate decision to solve this problem is to establish the new nationally accepted order: a graduate may start his/her professional career only at a university clinic or other large hospital especially licensed for this purpose, by being supervised by senior colleagues. Permission for fully independent practice should be given not earlier than after 2-3-year work at the above mentioned clinics.