ABSTRACT / PROJECT SUMMARY In response to a 30-year decline in the number of physician-scientists, attributed to prolonged clinical training, doubling or tripling of education debt, uncertain grant funding prospects, unclear career trajectories, and a lack of mentored research opportunities during early clinical training, the NIH started the Mentored ResearchPathway in Residency R38 program. Residency training, a critical step in physician training, is often carried out by training programs that do not support physician-scientist development. Significant gaps exist for protected research time, structured trainingand mentoring, and support to continue researchafter returningto the clinic. The primary goal of the multidisciplinary Duke NHLBI Scientist-Clinician-Investigator Stimulating access to Research during Residency (Duke SCI-StARR) program is to train a diverse cadre of physician-scientists who will lead the development, implementation, and evaluation of new clinical modalities to prevent, diagnose, and treat disease states affecting the heart, lungs, and blood throughout the life-course. Duke NHLBI SCI-StARR trainS residents across 3 departments: Pediatrics, Medicine, and Surgery in areas along the full biomedical research continuum (basic/translational, early phase clinical trials and pharmacokinetics, and late phase clinical trials and outcomes) with a theme of improving health over the life course. The program will consist of four training aims: 1) comprehensive didactics covering basic, translational, and clinical research and professional development; 2) development and completion of a research project and an individualized career development plan; 3) establishment of a track record of scholarly activity; and 4) eligibility for board certification and continuation to subspecialty training. Duke NHLBI SCI-StARR will be led by an Executive Committee (EC) of MPIs Mai K. ElMallah, MD (Pediatrics), Scott Palmer, MD, MHS (Medicine), and David Harpole, Jr., MD (Surgery), and an Expanded EC of Residency Program Directors and Program Coordinators, capitalizing on a team of 33 multi-departmental, multi-disciplinary, well-funded, and experienced faculty preceptors. This application requests support for three Resident-Investigators each year with each trainee to be supported for 18- 24 months of research. Upon completion of the program, these individuals will be capable of transitioning to research-intense fellowship training, successfully competing for extramural funding to support a path to independence as physician-scientists, and becoming the next generation of physicians leading and mentoring trainees in clinically-oriented research of disease states affecting the heart, lungs, and blood. Achievement of the program's objectives will fulfill urgent medical needs for: 1) more full-time academic physician-researchers and mentors in medical schools throughout the country and 2) innovations and clinical translation of novel strategies to improve th...