This is a renewal application for The Pittsburgh Pediatric Rheumatology Training Grant. Pediatric rheumatology focuses on musculoskeletal and autoimmune diseases of childhood. Serving this population of children are 237 board-certified pediatric rheumatologists in the United States (as of 2008). All but a handful of these are clinicians who do not engage in research. As a result, few pediatric rheumatologists have had research mentorship and they lack the skills to perform cutting edge research. The Division of Pediatric Rheumatology at the Children's Hospital of Pittsburgh, with substantial and sustained institutional support, has endeavored to create a national center of excellence offering comprehensive, state-of-the-art clinical care, educational programs, and competitive research involving clinical, translational, and basic sciences. Our Training Program is one of only two NIH-funded training programs dedicated to pediatric rheumatology. One of our central missions is to educate a new generation of academic pediatric rheumatologists who can play a leading role in the specialty as physician scientists. The goal is to provide a prime source of well- trained M.D. academic pediatric rheumatologists and Ph.D. scientists to serve the national need for cutting- edge research in the pediatric rheumatic diseases. To achieve this mission, we seek to provide, within a single center, the research role models, mentorship, and rich environment necessary for nurturing such individuals and ensuring their success. Support is requested to continue the current number of trainees in our program, currently four trainees per year, in order to provide two new trainees per year and two years of support for each trainee. The trainees will consist of two types of individuals. At least 75% will be pediatric rheumatology M.D. fellows who have completed a first year of clinical training. Following a first year of intensive clinical training, they will select a mentor from among the program faculty in order to gain exceptional research experience that will be used as the basis of an independent academic career. Up to 25% will be Ph.D. trainees who desire to focus their research careers in pediatric rheumatology. They will select a mentor from among the faculty who study the pediatric rheumatic diseases.