PROJECT SUMMARY TOP-TIER (Training OPportunities in Translational Imaging Education and Research) is a clinician scientist post-doctoral training program at Washington University (WU) in St. Louis designed with the purpose of providing trainees with instruction in the performance of rigorous translational imaging research. The goal is to prepare resident and fellow trainees for careers as successful independent investigators and to ultimately become leaders in their field, developing imaging techniques and applications that translate into human subjects and impact healthcare. Precision Medicine is an approach to disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. Development of methods of patient-specific biomarker imaging to guide and monitor patient-specific therapies will be needed to advance Precision Medicine. Moreover, a trained workforce is key to taking advantage of new developments in machine learning and artificial intelligence which can be applied across disciplines, to include targeted molecular imaging, photoacoustics, and magnetic resonance imaging (MRI) in terms of data acquisition, image processing, and diagnosis. Such imaging advances are interdisciplinary with technology innovations crossing the physical, biological, and data sciences. These studies start with preclinical mechanistic inquiries using targeted pathology-based imaging in animal disease models, and then expand into human subjects. Human studies include safety testing and the Food and Drug Administration’s (FDA) Investigational New Drug (IND) and Device Exemption (IDE) process. The ultimate goal is to make research innovations widely available to the public and the entire practicing medical community. Although this “bench-to-bedside” process has been widely acclaimed, there remains a knowledge gap in the medical imaging research community as to how to take preclinical research into humans, and how to then take these innovations to the public. Moreover, clinical scientists – residents and fellows – often lack the understanding to navigate research regulatory requirements as well as the knowledge base to understand or perform preclinical research that will inform the mechanism of innovation. In this T32 renewal, we have optimized training to provide supportive Mentoring Teams and cover technical advances, research rigor, and the practical aspects of grant submission to better prepare future imaging scientists for the challenges of performing science which impacts healthcare.