The University of Utah MD-PhD Program is rapidly growing with a highly successful history of training physician- scientists. It enjoys robust institutional support, a large and diverse body of 135 outstanding and well-funded research mentors, and an integrated health science campus with adjacent clinical and research facilities. Utah’s MD-PhD program recruits from across the country, but is uniquely attractive to students from the vast Intermountain West region, with no other MSTP within 500 miles, making it a potential new regional hub for students pursuing physician-scientist training. The accelerating momentum of the Program is evident in the tripling of applications and doubling of class size since 2017. The high quality of trainees and the training environment are evidenced by the excellent F30 success rate over the past 5 years (67%). Trainee outcomes are strong, with an 84% MD-PhD completion rate (100% receiving at least an MD or PhD), high research productivity (average of 6.9 publications per trainee, with 2.7 as first/co-first author), and 96% of MD-PhD graduates pursuing residency training. In the past 3 years, 40% of incoming students are from NIH-defined underrepresented groups. The proposed MSTP would further optimize the training program with increased integration between the MD and PhD phases, an improved governance structure with extensive trainee participation, enhanced diversity recruiting, rigorous day-one lab safety training, enhanced mentor training, and detailed program evaluation. A key focus will be smoothing the transitions between research and clinical training via Program activities and curriculum, including a practice clerkship, longitudinal clinical experience during the PhD years, and a proposal preparation course that readies trainees for departmental preliminary exams. The proposed program plan will also emphasize rigor and reproducibility, as well as the responsible conduct of research with formal training and integration into community events (monthly meetings, annual retreat). An extensive array of community and wellness resources ensure that trainees are well-supported during this intense, but highly rewarding training. Four trainee slots are requested in year 1, and 8 slots are requested in years 2-5. Each trainee will be supported for their first two years, but will follow the proposed Program Plan for the entirety of their MD-PhD training.