Project Summary / Abstract This application will support and renew the Medical Scientist Training Program (MSTP) at Stanford University School of Medicine. In over 50 years of continuous NIH funding, over 350 trainees have graduated from this program, many of whom have become leaders in their fields of academic medicine and biomedical research. Our program provides a superb environment and unique advantages for fulfilling our mission “to train a diverse cohort of pioneering physician scientist (PS) leaders dedicated to a lifetime of biomedical discovery that improves human health through innovation.” Dual degree pre-doctoral training in the Stanford MSTP has durably produced successful outcomes in our trainees, based on several metrics used to compare MD/PhD programs nationally, including low attrition and time to degree conferral, publication record, and high retention of graduates in biomedical research careers. This proposal describes important changes in the Stanford MSTP. Program enhancements include a significantly increased level of institutional support, reflected in increased staffing and faculty effort to direct the MSTP; increased financial support for student training by the School of Medicine; integrated training in rigorous, reproducible, responsible and safe research conduct throughout the curriculum; improved mentoring and monitoring mechanisms for students throughout their training; enhanced career development training and physician scientist community building; new physician scientist training tracks for MD-only students and recruitment for internal admission to the MSTP; enhanced integration of MD-only trainees in MSTP activities; and substantial new initiatives to ensure diversity, equity and inclusion at all levels of the Program. Together, the increased institutional support, increased effort by School of Medicine faculty and leadership, dedicated program enhancements, and integration of clinical and graduate training have changed, expanded and improved the Stanford MSTP. Support through this proposal, heavily leveraged with School of Medicine and University resources, will support continuing innovation in training physician scientists at Stanford.