PrecisionOS is a Vancouver, BC based software company founded by an orthopedic surgeon and two veteran game developers. We are on the brink of changing the way surgeons worldwide can access, learn, teach and enhance their skill set to positively impact the outcome of patients. The potential worldwide impact of this technology, started with an innocent lunch between three relatively quiet and unassuming Vancouver residents. Our software is intended for surgical trainees and surgeons who want to perform all the steps of surgery in case-based scenarios with real time feedback to achieve competency. This is done in virtual reality in a high fidelity, fully immersive environment which truly simulates the real operating room. Our technology is novel as it uniquely combines decision making, with technical skills training to improve expertise amongst surgeons.