Medical Scientist Training Program at the University of Nebraska - The MD-PhD program at the University of Nebraska Medical Center (UNMC) trains physician scientists to improve health through scientific advances and evidence-based approaches. Through doubling the program size since 2007, increasing NIH-funded F30/F31 fellowship awards from 2 to 19, maintaining time-to-degree that is better than the national average, improving anatomy test scores over 20 percentage points, and holding attrition below 10%, we have documented training success. Over a third of our trainees earn extramural fellowships (42%) and most hold student leadership roles. UNMC is ranked in the top 10 nationally for primary care training and rural practice and has research strengths in cancer biology, infection and inflammation, neuroscience, cardiovascular disease, and aging. The program curriculum provides career development that fosters critical thinking, adult learning, challenging paradigms, and using data to inform research and care. We foster a positive culture of training for students and focus on trainee well-being and professional activities. The program objectives are: (1) Recruit trainees committed to advance biomedical research; (2) Integrate medical and research training; (3) Promote productivity of students in advanced research areas; (4) Develop a cohort of mentors who promote student development; (5) Support service learning, community care, and development of clinical skills; (6) Develop student transferable and leadership skills through principles and practice; (7) Maintain appropriate time-to-degree for student success; and (8) Foster retention by preparing students for research and career setbacks. UNMC and our partner institutions have infrastructure for clinical and translational research through the Great Plains IDeA CTR and the Nebraska Pediatric Clinical Trials Unit. In this proposal, we propose the Nebraska Medical Scientist Training Program (MSTP) to support physician scientist training and request two funded training slots in the first year and four per year after that. Our program would be among the few MSTP programs based in an IDeA state. In this funding period, we will increase assessment sophistication, enhance alumni engagement, build our mentorship training, and provide leadership skills to all trainees. We will leverage the requested T32 funding to advance our program and change medicine.