Why do we need Royal Colleges?

Today's Royal Colleges can be traced to the guilds that arose during the 13 th and 14th centuries. They fulfil similar roles: to maintain the highest s tandards of practice, professional integrity and self-regulation. This pape r traces the development of the Royal Colleges, together with the emergence of specialisation within medicine, with particular reference to anaesthesi a as a modern specialty. It considers whether these functions are still app ropriate for the rapidly changing practice of medicine today. The colleges have unique strengths, but they also have weaknesses and must be prepared t o counter threats to their professional function.