ABSTRACT The overarching goal of this proposal is to create a four-state Mid-South REACH Hub to accelerate real-world impact of biomedical innovations through education, mentorship, and financial support for aspiring entrepreneurs. This Hub is critically needed, as much of the region is not supported by any REACH Hub, and our consortium dramatically extends REACH, both geographically and demographically, to a network of hundreds of community colleges and minority-serving institutions who currently encounter disproportionate challenges in accessing federal support for innovation and entrepreneurship. The significance of this endeavor is twofold: we will turn many more academic discoveries into real-world products that save lives and improve human health, and we will catalyze a medical innovation economy in states that have a robust innovation pipeline but limited resources to translate these discoveries into a knowledge- based biomedical technology industry. Leveraging more than $2M per year in committed state and institutional matching funds, Mid-South REACH will exponentially expand the impact of the REACH program. Innovation in our Hub comes from a radically democratic approach to ensure equitable decision making, the ability to reach a large network of underrepresented/underserved institutions across four states, and the new flexible, scalable, and sustainable Hub model we propose in which many states and universities contribute matching funds that are then used to fund innovators within their own constituencies. This model makes it easy to add new partners; each can be confident that their money will stay in their local area, enhancing sustainability. Our approach is to extend excellent education, proactive mentoring, and financial support throughout a diverse coalition of states and universities across the Mid-South, combining Vanderbilt’s expertise in entrepreneurial education with the collective experience of our partner institutions in supporting biomedical innovation. Our Hub will be led by a diverse and experienced Multi-PI leadership team with PIs in each state who bring unique perspectives, extensive networks, and outstanding experience in innovation, entrepreneurship, and medical research to the team. Together, we will recruit an exceptional and diverse External Review Board, with funding decisions made democratically by the board and the PIs. We will experientially educate our teams via proactive mentoring that begins from the earliest moment of the pre-proposal stage and continues throughout their projects, encouraging them to focus on product-market fit and to “fail fast” by identifying and working toward the critical six-month technical and educational milestones that would justify subsequent funding tranches. Ultimately, the payoff of this process in terms of startups founded, job creation, and economic impact will motivate institutions and state governments to continue providing funding and in-kind administrative support, makin...