This proposal is a competitive renewal application for a National Research Service Award Institutional Research Training Grant (T32) to further support a Multidisciplinary Rheumatology Training Program at Johns Hopkins. Over the past 4 years, the program has demonstrated outstanding trainee achievement, in the areas of publications, appointment to faculty positions after training, and a very high rate of acquisition f independent, peer-reviewed funding. We demonstrate that the overall trajectory of this program remains steeply positive, with outstanding divisional and institutional resources available to postdoctoral fellows in rheumatology, continued growth and enhancement of the program faculty, and a pool of highly competitive applicants (including women and under-represented minorities). The program has very engaged and highly expert internal and external advisory committees, who provide real-time advice about the program's priorities, systems and directions. Members of the program faculty have a breadth of interests and expertise, and are proven mentors in the rheumatic diseases, immunology, molecular biology and genetics, cell biology, epidemiology and biostatistics. The overall goal of this program remains the development of 2 postdoctoral fellows each year (4 trainee slots total) into outstanding academic investigators in rheumatic disease, through rigorous instruction in research methodology and immersion in outstanding quality mentored research projects. Our training environment is focused on providing a productive clinical and translational research training program. The following specific aims will be pursued:  Provide rigorous training in investigational methods to rheumatology postdoctoral fellows, applicable to the conduct of both clinical and basic research; Utilize clinical centers of excellence to provide access to well-defined rheumatic disease patient populations, enabling fellow projects to be efficiently conducted on established patient cohorts; Engage postdoctoral fellows in high caliber research projects addressing important questions under the supervision of nationally renowned faculty; Integrate multi-layered mentorship for each postdoctoral fellow to accomplish productive research, independence, and development of a successful academic career;and  Assess, and modify as needed (through incorporating feedback from trainees, training program faculty, and internal and external advisory committees), the outcomes of this training environment through assessing benchmarks of academic and programmatic achievement, including peer-reviewed publications, external research funding, post-training academic position, and recruitment of underrepresented minorities.
In aggregate, the Rheumatic diseases pose a major challenge to US health, due to their frequency, morbidity and resulting disability. Improving diagnosis, monitoring therapy and prevention of these diseases requires a highly expert group of investigators. Training such investigators is the major focus of this program.
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