Extended reality (virtual reality, augmented reality, metaverse and spatial computing) will have an increasingly important role in delivering surgical training for future workforce planning. Virtual Reality in Medicine and Surgery (vrims.net) has live streamed surgical cadaveric training to over 6000 participants in 101 countries in 6 one-week courses demonstrating a scaleable approach for XR training. vrims.net has created the largest immersive surgical training resource in the world with over 400 surgical cadaveric training videos from all of the surgical specialties. Our stepwise approach in adoption of immersive training resources using 360video, 360video with virtual studio overlay, interactive 360video with virtual studio overlay, virtual reality with 6 degrees of freedom and ultimately generative AI will enable surgeons to build XR resources for surgeons with low or no code. This is the vrims.net vision for the universal adoption of XR in surgical training and global surgery.