Project summary In this application for the renewal of the UM-01 NHLBI Cardiac Surgery Trial Network (CTSN) grant, PENN will continue to build upon our success in participating and developing cutting edge surgical trials in cardiac surgery and cardiovascular disease, develop a center of excellence for the training of a new generation of leaders in clinical research within in the field of cardiovascular surgery and mentor our designated partner and mentor the Catholic Health Initiative (CHI) St. Vincent Infirmary in Hot Springs, Arkansas, a large cardiac program in the Mississippi Delta. Specific AIM #1: In this renewal we will continue to develop, enroll and execute multi-centered, randomized cardiac surgical prospective trials as well as other novel and unique clinical research tools sponsored by the NHLBI CTSN. Specific AIM #2: We plan to collaborate closely with the Perelman School of Medicine, the Office of Clinical of Research and the Department of Translational Research and Science to develop a strong comprehensive mentoring and management plan for the affiliate site, CHI St. Vincent Infirmary. Our goal of the mentoring plan is to provide strong leadership, direction, collaboration, synergy and extensive skill development to support the development of a research experience and capacity at the St. Vincent Infirmary. SPECIFIC AIM #3: We will develop a Clinical Implementation Research Skills Program (CERP) at PENN. This program at the University of Pennsylvania will be designed to foster and train future cardiovascular specialists, surgeons, trialists and implementation scientists. We propose a two tier approach which will include the establishment of the PENN CERP Fellow Program which is aimed at mid and senior level trainees in surgery or junior faculty to achieve over two years to obtain a Masters of Health Science and Policy (MHSP degree at the University of Pennsylvania Perelman School of Medicine). The program will also include the PENN CERP scholar program which is designed for junior trainees such as medical students and junior residents. The scholars will receive a Clinical Research Certificate offered to the University of Pennsylvania through the Clinical Center of Epidemiology and Biostatistics (CCEB). The scholar program will be available to augment the overall mentoring program at the CHI St. Vincent Infirmary for interested students, MDs and nurses.