The EASIE-R5 Simulator is the newest model of the EASIE-R series. It is completely redesigned to facilitate an improved specimen installation and allows the simulation of more procedures to be performed in the same model. The EASIE-R5 simulator features a new torso-shaped tray with mannequin head to simulate esophageal intubation. The shape of the EASIE-R5 allows the specimens to be fully submerged in water. Our new ERCP module can facilitate the simulation of fluoroscopy without the use of X-ray. The new EUS-guided direct biliary access model allows the use of ultrasound to access an artificial dilated common bile duct.