SUMMARY All doctors need a core of basic surgical skills, whether or not they eventually specialize as surgeons. Mastering any skill requires sustained deliberate practice, usually over several years. Ideally this should start early in undergraduate training and be reinforced at intervals. Simulation is well established in medical education and is ideal for learning surgical techniques. Realistic simulated tissue models allow initial training to be detached from the stresses of clinical practice. Small-group workshops run by experienced tutors provide learner-centred teaching. Computer-aided learning encourages regular practice, in preparation for supervised clinical experience when the basics have been mastered. This article describes a five-stage approach to learning surgical procedures using the author's multimedia CD-ROM in combination with simulated tissue: (1) watching an animated graphic; (2) watching a clinical video; (3) watching a demonstration on a simulated tissue model; (4) doing the procedure on a model; (5) doing the procedure on a patient, under supervision.