Most surgeons acquire their foundation of surgical skills during residency or fellowship training. However, surgical techniques and technology are constantly evolving and it is challenging for practicing surgeons to keep up with the state-of-the-art.  While the model of residency training is very effective, it is unrealistic for surgeons to leave their practice to spend time learning new techniques.  This hinders the advancement of surgical innovation.  While surgeons often attend courses and practice on simulation models in order to learn new techniques or skills, this is probably not enough for true skill acquisition. The ideal model for postgraduate skill acquisition may involve a stepwise process  of interactions between the experienced mentor and the less experienced mentee.  Although it is likely necessary for the trainee to initially spend time in the operating room with the expert, and vice versa, it is unrealistic for this to continue for a prolonged period of time. That is why, we believe, that the key component to postgraduate skill acquisition involves the use of Tele-collaboration.