PROJECT SUMMARY/ABSTRACT We propose to continue our Training Program in Surgical Innovation (TPSI) to provide pre-doctoral engineering students the knowledge, skills and experience necessary for becoming leaders in surgical innovation. During the current funding period, we established a pipeline of quality applicants, implemented an effective review and selection process, developed new courses, and trained 10 predoctoral students (2 of whom are new trainees). Program evaluations (performed independently by Dartmouth’s Center for Program Design and Evaluation, CPDE) found our innovation curriculum was praised, mentor-mentee relationships were strong, and merging of training in biomedical engineering, surgical translation and innovation & entrepreneurship was valued highly by trainees and mentors, alike. Outcomes to date are also strong: graduates hold industry positions in innovative biomedical technology companies (two in medical start-ups), patents were filed and papers published in peer- reviewed journals. Current trainees are also exceling: 2 were selected among 6 finalists (from more 50+ appli- cants as far away as Canada) in a regional pitch competition; two are interning at biomedical start-ups. TPSI links the Thayer School of Engineering (TSE) PhD Innovation Program (PhD-I) with a state-of-the-art NIH- sponsored surgical research facility, the Center for Surgical Innovation (CSI). PhD-I provides trainees with na- tional recognition, a well-developed curriculum, experienced faculty, approved advanced degree requirements and a proven track record of success. CSI provides trainees access to experienced clinician-scientists and state-of-the-art operating rooms equipped with advanced intraoperative imaging, designed for human and ani- mal use. The funding request will cover tuition and stipends for 6 pre-doctoral positions per year. We will retain TPSI’s administrative structure of three Program Directors (now Multi-PIs) with expertise in Biomedical Engi- neering, Surgical Translation, and Innovation & Entrepreneurship, respectively. Participating mentors will con- tinue to be organized similarly into Biomedical Engineering (BE), Surgical Translation (ST) and Innovation & Entrepreneurship (IE) groups, and each trainee is assigned to a trio for guidance through the program. Train- ees satisfy all of the elements of PhD-I – technical proficiency, technical breadth, specialization, professional competence, original research and innovation skills development – tailored to the surgical setting, including specialized courses in surgical innovation and commercialization. Methods for trainee recruitment and reten- tion, diversity enhancement, program evaluation, instruction in responsible conduct of research and methods for enhancing reproducibility are in place, and will continue to be monitored by CPDE.