This is a first competitive renewal application for a thriving T32 Research Training Program in Cardiovascular Surgery. Cardiovascular diseases and their complications are leading causes of death and disability in the United States. The health implications of surgical cardiovascular disease create a strong need to ensure sustained research by training future investigators in the field. Unfortunately, graduates of cardiac and vascular surgery training programs face steep challenges to establishing research careers. Taking advantage of our position in the Texas Medical Center, the largest medical complex in the world, our postdoctoral training program in cardi- ovascular surgical research is designed to: (1) increase the pool of MDs and PhDs who enter cardiovascular surgical research careers, and (2) provide our trainees with the skills necessary to be successful and productive in cardiovascular research. We accept two trainees per year (MD surgery residents, other clinicians, or PhDs) into three training tracks, each two years in duration: bioengineering and biodesign, basic and translational re- search, and data science and health services research. Trainees can pursue diverse research career training opportunities, yet in all cases the focus is on addressing a clinical problem relevant to cardiovascular surgeons. To provide a range of training opportunities and mentorship, we have recruited 22 mentors from Baylor College of Medicine (BCM), Rice University, and the University of Houston. Within the three training tracks, the 22 men- tors are grouped into specific themes, such as “aortic disease,” based on their expertise and existing collabora- tive relationships. Each track allows trainees the option of completing a degree, such as a Master’s Degree in Bioinformatics; [all tracks include a mandatory Grant Writing course.] Our Program Director is Todd Rosengart, MD, Chair of the Michael E. DeBakey Department of Surgery at BCM; Co-Directors are Scott LeMaire, MD, Vice Chair for Research, and Barbara Trautner, MD, PhD, Director of Clinical and Health Services Research. Our leadership is supported by an Executive Steering Committee, a diverse panel of 11 local experts in research education and mentoring. Program leadership is also guided by an External Advisory Committee composed of five scientists who have all directed and/or served as a mentor in T32 training programs. Over the past five application years, we received 91 inquiries about the program from across the United States, leading to 10 trainees entering the program, three of whom were from surgical residency programs outside Houston. Our outreach through national professional organizations that support groups underrepresented in the scientific work- force has been fruitful; [36% of our accepted applicants are from a group underrepresented in biomedical sci- ences. Our three PhD graduates all secured an academic research position; our three MD graduates returned to clinical training. Collectively our trainees have published 64 manuscripts with their mentors, and three trainees secured external funding.] We look forward to the opportunity for our program to continue to grow the pool of highly qualified MDs and PhDs contributing to the high-impact arena of research in cardiovascular surgery.

NARRATIVE Cardiovascular diseases include some of the major causes of death in the United States population: heart attacks, heart failure, strokes, and aneurysms. Many of these illnesses can be prevented or managed with surgery. Training investigators in surgical cardiovascular research is essential to ensure that people receive the best possible care for these conditions.