Anaesthesiology changed since last 30 years, from open drop ether to newer intravenous and safely calibrated vaporizers for inhalational agents which have contributed to a patient outcome. There was an increasing awareness of pre and postoperative period, pain relief services by nerve blocks. The anesthesiologist is dealing with resuscitation in shock, cardiac arrest and toxaemia and multiorgan dysfunction. The monitoring modes and experience with multi organ failures lead to his involvement in Intensive Care Units.. With this speed of development of technology the corporate sector took the lead in the technology but medical college and district hospitals lagged behind to cop up with the newer advances or computer and fully utilize its advantage. The teaching of postgraduates except for some institutions has also suffered as the senior teachers still teach stages of ether anaesthesia, which is not in use since long.. Even the questions asked in the postgraduate courses are still of the same old mode as were asked 20 years ago. The P.G. teaching also suffers because a graduate joining specialty has no concept of anesthesiology and its relevance to medical therapeutics in surgery and medicine. This leads to the conflicts between surgeon and anaesthesiologist. There is a need for anaesthesiologists to get trained in the pre operative care and optimizing of their patients rather than depending on the physician whose approach about the patients is on an OPD basis. This book tries to fill all the gaps, seen in the postgraduate training. Further, there is a gap between the present training and the recent advances. Most of the super specialty training for students remains on papers in their textbooks. All this results in a medical postgraduate getting only a degree on paper without any proper training. The fresh graduate is raw, hesitant. He wants to join a corporate hospital where he starts again as a trainee till he gets proficiency, thus getting exploited in the process. The available existing books in anaesthesiology are from western countries. We are updating ourselves quite well to them. However, the practical training and theory is not correlated well, especially when most of the students are left to fend for themselves in the postgraduate tenure.. The target is this group which can be imparted a knowledge relevant to present circumstances and the need to improve.. The contradiction of old and new exists. This has to be tackled by relevant postgraduate and undergraduate training and knowledge according to our own needs. An effort is made so as to stimulate others to carry on this idea and start writing more and more books relevant for the postgraduates of our country.