We established five clinical skills laboratories that deliver simulation bronchoscopy training. We also set up a group of regional experienced bronchoscopists responsible for the development of simulation bronchoscopy training. We have run 15 courses and trained >60 candidates. Although initially we used different formats for the courses, the trainees’ overall experience of simulation-based bronchoscopy was extremely positive. Based on our initial experience, we established that the optimal design for delivering simulation-based bronchoscopy courses should incorporate a blend of short lectures, e-learning, and hands-on experience using simulation. To be successful, simulation-based bronchoscopy requires a high trainer-to-trainee ratio (ideally 1:2), and, therefore, we established a faculty of experienced bronchoscopists with a special interest in procedural training. Our results confirmed significant improvement, for both novices and more experienced trainees, in the technical ability of handling bronchoscopes, their understanding of anatomy and identification of bronchial segments, and their knowledge of the procedure; the improvements were in the range of 20% and 30% when using high fidelity alone and in combination with low-fidelity bronchoscopy simulation, respectively.2 We observed that the best outcomes were achieved by combining sessions on a virtual reality bronchoscopy simulator with low-fidelity manikin and real scope modules. Our real-life experience showed that it is possible to set up a large and successful regional simulation bronchoscopy training program, which is now offered to all of our trainees (before exposure to patients).