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Purpose of review The purpose of this review is to describe recent developments and current trends in training anesthesiologists in out-of-operating room anesthesia (OORA). Recent findings In the United States, the Accreditation Council for Graduate Medical Education recently updated its training requirements to include a mandatory 2-week rotation in OORA for anesthesiology residents. This likely reflects the continuing expansion of anesthesia services in the out-of-operating room (OOR) environment as well as the increasing complexity of OOR procedures and medical acuity of patients in these settings. In the United Kingdom, the Royal College of Anaesthetists has rigorous and progressively complex requirements for trainees in 'non-theater' anesthesia experience as they move through the four stages of training. A variety of educational strategies and a well-validated six-step process for curriculum development are described in this review. Summary This review will provide useful models for training directors needing to design and implement OOR rotations for their trainees.