ABSTRACT This renewal application seeks support for our well-established T32 postdoctoral research training program in basic, translational and clinical investigations of rheumatic and autoimmune diseases and the significant health disparities associated with these diseases. The Research Training Program in Inflammatory and Fibrosing Diseases is centered in the Rheumatology Division at the Medical University of South Carolina. The program's ultimate goal is to improve the healthcare and outcomes for individuals with rheumatic diseases in the southeastern United States. Our training program emphasizes the interrelationship between inflammation and fibrosis and how these biologic processes impact end organ function such as renal disease in lupus and lung disease in scleroderma. The participating faculty members have particular strengths and existing collaborations in areas of health outcomes and community-based research, epidemiology of rheumatic diseases, health disparities, gene/environment interactions, innate immunity and adoptive immunotherapy, lupus nephritis, signaling pathways leading to fibrosis, matrix proteins, scleroderma lung disease, and disease biomarkers. Trainees matriculate to 1 of 3 research tracks: Bench Research Track for Clinicians, Clinical Investigator Track including a Master of Science in Clinical Research degree, and Translational Research Track for Non-Clinicians. The program's structure helps trainees gain critical skills for sustained careers in academic medicine in a flexible framework that accommodates a diverse range of prior education/experience and multiple modes of investigation focused on the programmatic theme. Established in 2005, with NIAMS T32 support for 3 cycles (2005-2021), this program has graduated 21 postdoctoral fellows to date: 19 females, 2 males including 4 underrepresented minority (URM) fellows; 9 MD, 2 MD/PhD, 10 PhD. Collectively, they published 135 peer-reviewed publications (89 first authored) based on their research training. Currently, 13 remain in academic research, 3 in clinical practice, 3 in industry research, and 1 in the nonprofit sector. We propose 16 Primary Mentors and 6 Emerging Mentors of which 3 are URMs. For the coming year, 3 fellows will be appointed: 1 female PhD and two female rheumatology fellows (1 Med/Peds fellow). The current application requests continued support for 3 fellowship positions. Fellows will be on the research training grant for 2 years with an option for a 3rd year if justified based on productivity and potential. Application numbers for our fellowship program have doubled over the last 5 years due to increased interest in rheumatology as well as national recognition of our program's excellence. The Program Steering Committee will review and approve the selection and annual re-appointment based on specific criteria, evaluation data and slot availability with input from the External Advisory Committee. In this renewal, our research areas have expanded into ...