Project Summary There is a great need to increase academic physician scientists in Newborn Medicine who will perform high level laboratory, clinical, translational, and health services research to improve our understanding of the pathobiology of developmental diseases, health disparities, and long-term morbidities. The main objective of our training program is to train postdoctoral physician scientists by providing a structured, mentored, intensive research experience to advance our knowledge of developmental diseases and improve short and long-term health outcomes of children. Equally important, this renewal application requests the resources to continue our record of training physician scientists to become future national leaders and mentors. The unique fetal and early postnatal periods of rapid organ growth represent a critical window in which environmental exposures can result in epigenetic changes that underlie the pathogenesis of a multitude of diseases including psychiatric disorders, cancer, obesity, and cardiovascular diseases. There is no other time in the life of a human when even minor medical interventions can have such a profound impact on long term health, underscoring the need to train neonatology physician-scientists who can focus on diseases of this critical developmental stage. The Harvard Neonatal-Perinatal Medicine Training Program has a ~ 50-year history of training physician scientists who now lead national programs in academic neonatology. Historically, most of our graduates (>80%) continue in academic careers whereas the national average has remained ~35%. We have a large pool of outstanding eligible applicants combined with a highly accomplished mentoring faculty in the rich scientific community of Harvard Medical School which allows us to train top candidates in our field. Our 3-year research and career training program broadly focuses in four areas: 1) The study of molecular, cellular, and epigenetic mechanisms of normal development and perinatal injury; 2) Investigation in neonatal genomics to uncover the genetic basis of complex disorders and develop precision medicine-based therapeutic strategies; 3) Clinical studies using bioinformatic approaches, biomarkers science, clinical trials and health outcomes research; and 4) Innovative imaging of the fetus and newborn, including placental function and hemodynamics. A mentoring program and scholarship oversight committee is assembled for each trainee to provide mentoring in scientific and career development. Didactic courses are required for both basic and clinical research training and supplemented with relevant seminars, a course in the responsible conduct of research, a DEI curriculum on anti-racism and community advocacy as well as an annual research symposium. Advisory committees of national experts advise on candidate and mentor selection, scholarly progress, and overall success. We have a strong history of advancing the career of URiM trainees and multiple strategi...