The incorporation of coloproctology as a part of the surgical training and further education of assistant and specialist physicians shows great differences between Germany, Austria and Switzerland. In this article the international and national possibilities before and after specialist medical training are described in detail. In Austria, an optional coloproctology module can already be chosen in the third year of surgical training. Coloproctology is a compulsory component during the complete surgical training in Germany but a lower number of operations are required. In the basic module in Switzerland coloproctology is compulsory but contained in the operation catalogue to a lesser extent, although it has to be explicitly chosen in the further specialist training. The mandatory training in coloproctology in Germany enables all surgical assistants to undergo training, even if it is less intensive. As a result of partially compulsory and partially optional modules in Switzerland, a lower proportion of trainees receive specific training but it is more detailed. The number of trainees who are trained in coloproctology is even smaller in Austria due to the coloproctological training being optional. In the German-speaking regions a variety of specialized courses and further education are available for assistants and surgeons to further deepen their knowledge, no matter which form of training they had. At the international level the European Board of Surgical Qualification (EBSQ) for coloproctology has been available since 1998 and for many European specialists is the only possibility for formal specialization. The quality of a coloproctology training and further education curriculum may vary with national and international factors; however, it is a parameter for high standards in coloproctology in routine daily work, for the numbers of young coloproctology surgeons and is associated with a sufficient research performance in this discipline.