Abstract
Technology advancements provide several surgical approaches including thoracoscopic and robotic-assisted thoracic surgery. That adds more challenges for the thoracic anesthesiologists with the required high-level of skills and competencies in the anesthetic, airway management, lung isolation and separation, ventilation, and perioperative analgesic techniques. Thoracic anesthesia has gained the attraction of many anesthesiologists to being specialized in that subspecialty. That raise the concerns about the requirements and structure of formal training into thoracic anesthesia in the United States and Europe regarding. This narrative review aims to analyze the lessons learned from the European Association of Cardiothoracic Anaesthesiology (EACTA) in terms of the current situation, requirements, limitations, competencies, teaching techniques, assessment, and certification.