A lifelong learning process is necessarily the basis for the specialization and expertise in the field of anesthesiology. Thus competency as a physician is a complex, multidimensional construction of knowledge, skills and attitudes to be able to solve and persist the complex daily work challenges in a flexible and responsible way. Experts therefore showflexible and intuitive capabilities in pursuing their profession. Accordingly modern competency based learning objectives are very helpful. The DGAI Commission for “Further Education” already thought ahead in defining a competencybased curriculum for the specialization in the field of anesthesiology and could be integrated into the frameworks of the German Medical Association. In addition to the curricular framework elements of assessment are necessary. A single oral exam is consequently not representative for different levels of competencies. However, there is beside the responsibility of the learners for their learning processalso a high obligation of the clinical teachers to attend the learning process and to ensure a positive learning atmosphere with scope for feedback. Some competencies potentially could be better learned in a “sheltered” room based on simulation outside the OR, for example to train rare incidents or emergency procedures. In general there should be ongoing effort to enhance the process of expertise development, also in context of patient safety and quality management.