The Harvard Medical School Department of Dermatology training grant (now administered by Brigham and Women's Hospital) has a long and distinguished history of preparing individuals for careers in biomedical research relevant to the skin. Historically, one of its major roles has been to support the development of dermatologist physician scientists interested in a career in biomedical research. It also supports the development of PhD scientists who are seeking a biomedical research career relevant to skin biology, skin diseases, and skin cancers. During the last funding cycle, the training grant has achieved its goals, training both dermatologist physician scientists and PhD scientists, the vast majority of whom are employed at academic institutions or in the biotechnology sector. Looking back over a longer timeline, we are able to demonstrate that trainees on our training grant have generated over 120 publications in peer reviewed journals, including some of the highest impact journals in the biomedical sciences. In addition, ex-trainees have been funded by RO1 grants, K awards, other NIH grants, and multiple awards from the Dermatology Foundation and other private funding agencies. Since 2008, the Harvard Medical School Department of Dermatology has been decentralized into three affiliated Harvard Departments based at the key affiliated hospital-the Beth Israel Deaconess Medical Center, the Brigham and Women's Hospital, and the Massachusetts General Hospitals. The Chairs of these hospitals are represented on an Executive Committee, currently chaired by Dr. Kupper. Given this decentralization, the Harvard Dermatology training grant assumes an even greater significance as the "glue" that helps hold these departments together, along with the shared residency program. The training grant goals over the next five years are unchanged: to identify, support, and train the best and most promising dermatologist physician scientists, and PhD (non-MD) scientists, as a means of preparing them for careers in biomedical research. It appears that pay line percentiles in most NIH institutes will remain in the low-teens for the foreseeable future. This means, quite simply, that training grant support for young biomedical scientists interested in skin disease research has never been more critical to the success of their careers, and by extension, to the survival of our specialty.