Interventional pulmonary (IP) and advanced bronchoscopy training occurs in various stages of a physician career. Competency had traditionally been developed in formal fellowship training with mastery developing over the entire career. With the rapid rate of new procedures, knowledge and procedures learned in fellowship may become obsolete requiring competency developed as a part of continuing medical education. New strategies of learning and teaching are being utilized in IP and advanced bronchoscopy in the face of an evolving subspecialty such as simulation, educational regulatory policies, and assessments.