The current rapid pace of scientific discovery offers unprecedented opportunities for direct application of basic and clinical scientific findings to the problem of gastrointestinal disease. This progress will be optimized by providing rigorous training in research thought and technique to a group of surgical residents who have expressed a strong interest in pursuing careers as gastrointestinal (GI) surgical investigators. The Specific Aim of this program, currently in its twenty fourth year of funding, is to provide formal training in either clinical, laboratory or biomedical engineering research to this select group of surgical residents as an integral component of their postgraduate clinical training. One trainee per year is competitively selected from those in the general surgery training program at Johns Hopkins University (JHU) as well as accomplished surgical residents from other institutions. In this renewal, we have significantly modified the research training plan in direct response to the needs of our trainees. Trainees will enter one of three tracks: Basic/Translational, Clinical and a newly added Biomedical Engineering and Device Design Track. Each trainee will be guided to choose a senior preceptor/mentor from our list of participating faculty, all of whom have demonstrated an outstanding record of achievement, significant NIH funding, and an established record of mentorship. The formal scientific training period begins after the third clinical year, and lasts for two or three consecutive years. Many of the T32 trainees complete Masters or Doctoral degrees in the JHU Bloomberg School of Public Health. All trainees are assigned an Individual Progress Committee charged with critiquing the trainee's research, monitoring long-term progress towards an independent investigative career, and aiding in the selection of appropriate course work. Additional oversight and guidance is provided by both Internal and External Advisory Boards. This T32 training includes formal training in research ethics and mandatory course work directly relevant to the research topics. All our trainees are immersed in an outstanding educational environment, which includes the McKusick-Nathans Department of Genetic Medicine, the NIDDK-funded Johns Hopkins Digestive Diseases Research Core Center, and the NCI funded Sidney Kimmel Comprehensive Cancer Center, the top-ranked JHU Department of Biomedical Engineering and the School of Public Health. Since inception in 1996, 24 trainees have completed their combined clinical and research training. All have achieved full-time academic faculty positions in prominent institutions, where many hold senior leadership roles and the majority have achieved extramural research funding. In this manner, the program is designed to generate a superbly trained group of GI surgeon-scientists who will provide academic leadership for the 21st century.