This T32 training grant proposal will provide post-doctoral training in the field of trauma and peri-operative injury. Traumatic injury is one of the major causes for the loss of life, loss of productivity and loss of years of life. Compared to other processes such as cancer or cardiovascular disease, trauma frequently occurs in a younger age group with corresponding increased years of life lost. Trauma also disproportionately affects underserved and minority populations making trauma a health disparities issue. Currently, traumatic injury represents an unmet medical need. Against this background we intend to train physicians and scientists in basic methods of research so that they may be applied to study of traumatic injury. We will request support for 3 fellows per year, and each fellow will spend 2 years working closely with a research mentor. It is useful to consider the grant in terms of 2 groups: One group consists of the training faculty who will provide the education and the second group is composed of the fellows who will be trained. We are fortunate to have a strong cadre of currently funded, active and senior mentors who will participate in this grant. There are a total of 18 investigators and labs that have collectively trained more than 200 fellows over the past 10 years. The strength of the faculty must be considered un-paralleled. The trainees will come from both the clinical programs and also the direct application to individual labs. An emphasis will be placed on recruiting physicians in the current residency programs since Boston University has a strong track record in recruiting a diverse group of physicians and placing our fellows in academic positions. Based on institutional information there are currently several physicians in training who wish to participate in basic science training. Boston University School of Medicine has a rich tradition of serving the underserved which attracts a significant number of minority physicians to our clinical training programs. They will be a significant source of potential trainees. The training program will recruit from several clinical departments above and beyond the Department of Surgery. The training program is specifically designed to minimize formal coursework and maximize the interactions with the mentors. Potential trainees will be exposed on a frequent basis during their clinical rotations to the training opportunities provided by this program. The concept is that bright young, energetic minds directly observing clinical problems will be stimulated to closely examine the mechanisms which directly cause morbidity and mortality in the trauma patients. Patients who have suffered a traumatic injury and survive the initial insult have increased loss of life over the next several years. Substantial morbidity occurs over the remainder of the patients'lives. The impact of the initial traumatic injury extends far beyond the first event. This grant will train physicians and scientists in the study of how traumatic injury causes this increase in loss of life and loss of function.
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