PROJECT SUMMARY This competitive renewal Stanford T32 Training Grant Proposal combines pediatric and adult pulmonary programs in order to select the most promising Trainees and provide an optimally diverse interdisciplinary training experience centered on pulmonary biology. Dr. David Cornfield, the pediatric chief, Dr. Mark Nicolls, the adult chief share Program Director responsibilities; each bringing unique and complementary skills to the leadership position. In the first few years of this new T32 funded in 2016, we have accomplished our goal of creating a more integrated and cohesive academic culture. We describe the excellent progress of our first nine trainees. We have developed 38 Mentors from the Stanford biomedical community with a strong track record of training and academic productivity and 2 Junior Mentors. Based on the expertise of our Mentors, we have identified nine domains of excellence from which trainees can choose a primary focus for an individualized development plan. These research areas include: 1) Vascular Disease, 2) Stem Cells & Lung Development, 3) Genetics & Genomics, 4) Lung Injury & Repair, 5) Lung Immunology, 6) Lung Microbiome, 7) Lung Cancer and 8) Outcomes Research, and 9) Imaging. The grant proposal describes a process by which fellows are recruited to Stanford, exposed to research areas, introduced to Mentors, and move through a selective process designed to identify Trainees with the best chance of success in academic medicine for T32 support. We describe a well-supported and carefully constructed system of oversight to promote recruitment of underrepresented minorities. All T32 trainees will have an individualized development plan that includes a core curriculum and electives appropriate to their research domain. Through a longitudinal monthly T32 meeting lead by the PDs and quarterly informal meetings with T32 trainees, Mentors and PDs, Trainees will be immersed in a microculture of academic pulmonary medicine. A Scientific Oversight Committee identifies appropriate coursework and ensures ongoing and timely Trainee progress. We have assembled an experienced Internal Advisory Committee at Stanford and an acclaimed group of national leaders in pulmonary medicine for the External Advisory Committee. We will utilize regular feedback from these groups, the Mentors and Trainees to identify programmatic strengths and weaknesses and reassess our processes to adjust, adapt and improve the T32 fellowship. As a world university embedded in a vibrant local economy, Stanford is particularly well situated to develop and inspire the next generation of physician-scientists and clinical researchers.