ABSTRACT Women living in the developing world face an unacceptably high risk of disability and death, often from preventable causes. Obstetrician-gynecologists (Ob-Gyns) are needed to reduce this disease burden worldwide, but there are few established pathways to prepare investigators in global women?s health research. To address this gap, we launched the UNC Global Women?s Health Fellowship in 2012. Our program is research-focused, with the explicit goal of training the next generation of independent NIH investigators. We offer an immersive training experience, through which fellows typically spend two years overseas, working at established international research sites. Our trainees are intensively mentored by an experienced and highly accomplished faculty representing diverse disciplines and backgrounds. Fellows take part in structured enrichment activities to guide their scientific and professional development, including graduate-level coursework, conferences and seminars, and professional networking. To date, our program has supported 13 postdoctoral trainees, including eight appointed to our current T32 award. UNC Global Women?s Health fellows have implemented cutting-edge research and published policy-relevant papers; most have transitioned to academic positions after graduation. Importantly, all have learned how to design and implement studies in developing world settings. In this renewal application, we request another five years of support for our fellowship. Building upon the foundation of our current program, we propose several key improvements. These changes have been informed by a systematic evaluation of the fellowship, including structured feedback from mentors, trainees, and advisors. First, we will reorganize our fellowship curriculum so that each new trainee chooses one of three distinct research tracks (pregnancy outcomes, reproductive health, women?s cancers) and one of three methodological concentrations (clinical trials, epidemiology, implementation science). This framework will permit a more individualized approach to assigned coursework, mentor pairing, and research projects, so that fellows gain deeper topical and methodologic expertise as they complete the program. Second, we will expand our program eligibility by introducing novel combined fellowships with the established Ob-Gyn subspecialties of maternal fetal medicine, family planning, and gynecologic oncology. Third, we will extend our geographic coverage beyond our current sites in Zambia (Lusaka) and Malawi (Lilongwe) to offer training placements in South Africa (Johannesburg). By the end of the fellowship, graduates will obtain the necessary skills and experience to become independently-funded NIH investigators in the field of global women?s health.