The University of California San Francisco (UCSF) Integrated Training Program in Diabetes, Endocrinology and Metabolism (DEM) founded in 1980 has the broad goals of supporting research training in Endocrinology and Metabolism along 3 distinct pathways. Track 1 is the predoctoral training path, now accomplished through the UCSF Biomedical Sciences Training (BMS) Program. The BMS Program is a graduate training program that prepares students for research careers that address the basic mechanisms of human physiology and disease states. Integration of predoctoral training in Endocrinology-Metabolism into this larger multidisciplinary program has dramatically strengthened the opportunities for graduate students interested in research fields related to DEM. Track 2 provides training support for postdoctoral research including formal educational opportunities (seminars, lectures, journal clubs) and mentored research training. Track 3 is a combined clinical and research training program for physicians. Postdoctoral trainees in Track 2 or 3 may train in the Basic Investigator or Clinical Investigator Pathways. Both pathways provide a combination of didactic and individually-mentored training, geared to the needs of the fellow. Training for Clinical Investigators includes courses in Epidemiology, Biostatistics, and Clinical Study Design. All predoctoral and postdoctoral DEM trainees participate in seminars on the Ethics and the Responsible Conduct of Science. The DEM faculty is large (~75 members), accomplished, and diverse, drawn from 15 academic departments and several training sites at UCSF. The DEM Program's track record is excellent. The current levels of accomplishment of predoctoral and postdoctoral trainees are high. The majority of Track 1 students who received their PhDs (83%) are actively engaged in postdoctoral fellowships at academic institutions. Of the Track 2 postdoctoral trainees who completed their fellowships during this funding period, 88% are in predominantly research positions. Of the Track 3 postdoctoral fellows, 50% have advanced to research careers, and most have secured extramural funding. The development of a new basic science campus at UCSF Mission Bay and the opening of a new UCSF Diabetes Center -- both since the last renewal -- in combination with a strong DEM Training Program, will enhance future opportunities in DEM for both predoctoral and postdoctoral trainees at UCSF.