The need to develop children's environmental health (CEH) clinician-scientists focused on the translation of pediatric and reproductive environmental health is critical. In parallel to the rise of developmental origins of health and disease (DOHaD) principles, precision medicine (PM) has emerged as the new approach in healthcare. PM seeks to transform medical care and disease prevention by identifying factors that more reliably predict individual risk for disease but has focused almost solely on genetics, even though environment is clearly a very large piece of the puzzle. With DOHaD principles suggesting that early life environment is at the root of most chronic diseases, a life course perspective to PM and pediatrics is needed to understand how human health is shaped by fetal and early childhood environments. Adverse health outcomes result from a multitude of environmental, social and microbial toxin-induced shifts in molecular, cellular, and physiological states and their interacting systems. Elucidating and translating the role of environment in health and development requires specific expert training. Mount training Institute (PEHSU) ecosystem Sinai has long been at the forefront of CEH clinical through the longest running pediatric environmental health fellowship program in the country, an for Exposomic Research, a P30 Core Center, a Pediatric Environmental Health Specialty Unit and a state run CEH clinical center. We are uniquely poised to leverage this well-established to continue to build national capacity in translational CEH through this exciting K12 program.Our program strives to advance a systematic plan to integrate environmental health into reproductive and pediatric PM initiatives to better address the root causes of disease. Many things are needed to realize this vision, but one of the most pressing is building the pediatric/perinatal translational workforce needed to lead this paradigm shift. Translation to better health outcomes will require developing broadly trained child health practitioners able to engage in transdisciplinary (TD) teams that extend beyond discipline-specific concepts, approaches, and methods. We seek to establish the Mount Sinai program for Scholars in Environmental Pediatrics, Reproductive Health, and Life Course Science embedded in a mature TD team science learning culture grounded in the principle that the major proportion of the variability in health outcomes is environmentally driven. This program will be led by environmental health physician-scientists and leverages Mount Sinai's longstanding commitment to CEH, our Region 2 PEHSU, our NY state children's environmental health centers, our established pipeline programs and regional networks to identify potential scholars, our infrastructure in pediatric/perinatal environmental health research and workforce development, and our institutional investments in exposomics. Our K12 program will develop healthcare professionals poised to integrate environmental science with established PM and pediatric care efforts and develop the next generation of versatile children's environmental health leaders.

Human health and disease are shaped by a range of life-long exposures, and our biological response to them, underscoring the need for a systematic plan to integrate environmental health/exposomics into precision medicine initiatives. Clinician-scientists are a critical bridge for translating basic and clinical research into new paradigms of clinical care. The Mount Sinai K12 program will develop healthcare professionals poised to integrate environmental science with evolving precision medicine and clinical care efforts and catalyze the development of the next generation of versatile children's environmental health leaders to address emerging complexities of pediatric and reproductive environmental health.