This proposal requests support for the Medical Scientist Training Program (MSTP) at the Vanderbilt University School of Medicine. The program's primary goal is to identify, recruit, train, and mentor a talented workforce of compassionate and dedicated future physician-scientists. These Vanderbilt-trained physician-scientists will serve critical needs in all aspects of medicine, science, industry, and government to improve human health and improve society through leadership in biomedical research and clinical practice. Our joint MD-PhD program is based on rigorous training in clinical medicine and scientific inquiry. Core program elements explicitly developed for dual-degree students include a foundational biomedical course, a literature-based seminar series, the Clinical Preceptorship Program, Seminar Series, leadership workshops, the Physician- Scientist Speaker Series, extensive near-peer mentoring, a host of student-led institutional and community outreach activities to give back to the community, and an annual retreat to reinforce connections, hear about great science, and learn together. Students receive formal instruction in quantitative reasoning, responsible conduct of research, and rigor and reproducibility threaded and reinforced throughout the curriculum. An innovative advising college program offers opportunities for vertical integration of faculty members and both physician-scientists in residency and MSTP trainees. Current students play key roles in student recruitment and curriculum development. Our alumni are exceptionally accomplished which include the founding president of the Gladstone Institute, three deans, three department chairs, 26 full professors, and 18 industry leaders. More recent graduates still in training are in superb residencies and fellowships. The 109 current trainees come from 74 colleges and universities distributed across North America. The increase in applicants from across the country is due to our dedicated recruitment campaigns, which emphasize attracting students whose personal experiences uniquely qualify them to provide care for others. In the current year, 595 applications have been received, from which 15 students will be selected to enter the incoming class. The educational environment for physician-scientists at Vanderbilt University ranked #12 in NIH funding, is outstanding and built on established strengths in biomedical informatics, cancer biology, cell biology, clinical pharmacology, diabetes, neurosciences, toxicology, drug discovery, genetics, chemical and physical biology, imaging sciences, microbial pathogenesis, pharmacogenomics, and vaccine science. Newer areas of research emphasize immunobiology, inflammation and cancer, precision medicine, quantitative systems biology, and structural biology. Based on the commitment of our leadership team, the strength of our applicant pool, enhanced opportunities for physician-scientist training, a longstanding institutional commitment to the education...