Background and objective: The study evaluated the manpower requirements in anaesthesia in Belgium until 2020. The basic intent was to estimate the need for anaesthesiologists in different hospitals because the number of medical students will be reduced to 700 in 2004 and to 600 in 2007 (numerus clausus), and the number of trainees in anaesthesia from 110 to 42 (best scenario) or to 21 (worst scenario). Simultaneous anaesthesia (more than one patient at the same time) is not allowed by our professional safety rules or by the Belgian Ministry of Public Health. The questions are: will we have enough anaesthesiologists in the next 20 years, and is there a need for nurses to administer anaesthesia? This professional title of nurse anaesthetist does not presently exist in Belgium.

Methods: Every registered anaesthesiologist in Belgium received a questionnaire about the manpower requirements in his or her institution expected over the next 20 years. The workload in the specialty was also considered.

Results: We received 154 replies from 186 different hospitals. The workload is definitely high: 10 h per day was devoted to clinical work and 4.6 h per week to administration. Belgium will need 51 anaesthesiologists each year after 2004, and 58 each year from 2010 to 2020.

Conclusions: Will anaesthesiologists accept their present high workload for the next 20 years? If not, the consequences will be serious. Three-quarters (75.4%) of the replies identified a need for more anaesthesiologists and considered that an anaesthesiologist supervising anaesthesia nurses for a number of patients simultaneously was a possible solution.