Endoscopic training within any particular country generally provides a solid foundation of basic endoscopic skills; however, subsequent development of advanced skills may be limited due to regional and national adoption of specific techniques, available accessories, and exposure to certain pathology. In this chapter, the authors aim to share their reasons for pursuing potential training opportunities outside the United States and solutions to some of the challenges that trainees typically face. When considering endoscopic training abroad, there are several clear benefits and drawbacks that must be weighed. Training with an internationally recognized expert has many other advantages. It allows the trainee to be exposed to other experts and colleagues who come to visit the primary endoscopist. Japan has a great history in endoscopic education. The authors focus on the personal experience of one of the coauthors during his time receiving training for endoscopic submucosal dissection procedure.