ABIM Research Pathway -Applying for Residency Ajit Janardhan   Washington University in St. Louis Internal Medicine Reside...
Today’s topics <ul><li>The ABIM Research Pathway </li></ul><ul><ul><li>Traditional Pathway vs. Research Pathway </li></ul>...
The ABIM Research Pathway <ul><li>Designed by the American Board of Internal Medicine (ABIM) for physicians who are devote...
“ Traditional” Pathway: Internal Medicine Residency-Subspecialty Fellowship <ul><li>Internal Medicine Residency – 3 years ...
Fellowship Training Time Requirements 12 24 Rheumatology 12 24 Pulmonary Disease 12 24 Nephrology 12 24 Medical Oncology 1...
“ Traditional” Pathway: Internal Medicine Residency-Subspecialty Fellowship <ul><li>Internal Medicine Residency – 3 years ...
The ABIM Research Pathway <ul><li>AKA the “short-track” / Physician-Scientist Pathway / Medical-Scientist Pathway </li></u...
Sample comparison - Cardiology <ul><li>Traditional pathway </li></ul>1 2 3 4 5 6 7 8 Medicine Resident Cardiology Fellowsh...
Advantages of the Research Pathway <ul><li>Shortened length of general Internal Medicine clinical training </li></ul><ul><...
Disadvantages of the Research Pathway <ul><li>Loss of 1 year of IM clinical training </li></ul><ul><li>Must choose subspec...
Things you will hear <ul><li>Some say  –   </li></ul><ul><ul><li>Residency is the ONLY time to get real training to be a p...
Why do institutions participate in these programs? <ul><li>Nationally recognized need for physician-scientists </li></ul><...
Major categories of programs <ul><li>Match, then apply to Research Pathway in year 1 of IM Residency </li></ul><ul><ul><li...
Major categories of programs <ul><li>Match, then apply to Research Pathway in year 1 of IM Residency </li></ul><ul><ul><li...
Major differences between institutions <ul><li>Number of positions earmarked for ABIM Research Pathway </li></ul><ul><ul><...
Other important points <ul><li>Who offers it?  </li></ul><ul><ul><li>University-Based Teaching Hospitals that draw large a...
What’s the Bottom line? <ul><li>This program is designed with MD/PhD’s in mind to facilitate their entry into academic med...
How do you know if this is right for you? <ul><li>Determine your goals and priorities </li></ul><ul><ul><li>Are you intere...
What to do if you’re interested <ul><li>Incorporate your interest in research into your personal statement </li></ul><ul><...
Applying for residency
What to think about if you’re in… <ul><li>1 st /2 nd  year medical school </li></ul><ul><ul><li>Two most important things ...
What to think about if you’re in… <ul><li>3 rd /4 th  year medical school </li></ul><ul><ul><li>3 rd  year scheduling </li...
Letters of recommendation <ul><li>Minimum of 4 needed for residency application </li></ul><ul><ul><li>One from your PI </l...
Applying for residency <ul><li>Selecting programs to consider for residency </li></ul><ul><ul><li>University hospitals </l...
Last few tidbits of advice <ul><li>“ Dean’s letter” – Medical Student Performance Evaluation </li></ul><ul><ul><li>You wri...
Web Resources <ul><li>ABIM website – research pathway </li></ul><ul><ul><li>http://www.abim.org/cert/respath.shtm </li></u...
Web Resources <ul><li>ABIM website – research pathway </li></ul><ul><ul><li>http://www.abim.org/cert/respath.shtm </li></u...
 
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ABIM Research Pathway -Applying for Residency

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ABIM Research Pathway -Applying for Residency

  1. 1. ABIM Research Pathway -Applying for Residency Ajit Janardhan Washington University in St. Louis Internal Medicine Residency – Cardiology Fellowship Edward Kim University of Michigan Internal Medicine Residency – Medical Oncology Fellowship
  2. 2. Today’s topics <ul><li>The ABIM Research Pathway </li></ul><ul><ul><li>Traditional Pathway vs. Research Pathway </li></ul></ul><ul><ul><li>Differences in structure and application to the Research Pathway at different institutions </li></ul></ul><ul><ul><li>Advantages and Disadvantages </li></ul></ul><ul><li>Residency application advice </li></ul><ul><ul><li>Timeline: what you should do and when to do it </li></ul></ul><ul><ul><li>Selecting programs and who to ask for advice </li></ul></ul><ul><ul><li>Miscellaneous tidbits of advice </li></ul></ul><ul><li>Open forum </li></ul>
  3. 3. The ABIM Research Pathway <ul><li>Designed by the American Board of Internal Medicine (ABIM) for physicians who are devoted to a career in clinical/basic research </li></ul><ul><li>Who is this designed for? </li></ul><ul><ul><li>MD/PhD’s or those with significant research experience </li></ul></ul><ul><li>Major features: </li></ul><ul><ul><li>Shortened length of clinical training </li></ul></ul><ul><ul><li>Protected research time with guaranteed salary </li></ul></ul><ul><ul><ul><li>Designed to allow physicians to develop research interests & eventually apply for independent funding </li></ul></ul></ul>
  4. 4. “ Traditional” Pathway: Internal Medicine Residency-Subspecialty Fellowship <ul><li>Internal Medicine Residency – 3 years </li></ul><ul><ul><li>Apply for fellowship in 2 nd year of residency </li></ul></ul><ul><ul><li>Ph.D definitely helps competitiveness for fellowships– </li></ul></ul><ul><ul><ul><li>fellowship programs need fellows to do research (like your PI) </li></ul></ul></ul><ul><li>Subspecialty Fellowships - 2-3 years </li></ul><ul><ul><li>1-2 years of clinical training </li></ul></ul><ul><ul><li>6-12 months of research time </li></ul></ul><ul><ul><li>Variable degree of protection of research time </li></ul></ul>
  5. 5. Fellowship Training Time Requirements 12 24 Rheumatology 12 24 Pulmonary Disease 12 24 Nephrology 12 24 Medical Oncology 12 24 Infectious Disease 12 24 Hematology 18 36 Gastroenterology 12 24 Endocrinology, Diabetes, and Metabolism 24 36 Cardiovascular Disease Clinical Months Required Minimum Months of Training Area of Discipline
  6. 6. “ Traditional” Pathway: Internal Medicine Residency-Subspecialty Fellowship <ul><li>Internal Medicine Residency – 3 years </li></ul><ul><ul><li>Apply for fellowship in 2 nd year of residency </li></ul></ul><ul><ul><li>Ph.D definitely helps competitiveness – </li></ul></ul><ul><ul><ul><li>fellowship programs need fellows to do research (like your PI) </li></ul></ul></ul><ul><li>Subspecialty Fellowships - 2-3 years </li></ul><ul><ul><li>1-2 years of clinical training </li></ul></ul><ul><ul><li>6-12 months of research time </li></ul></ul><ul><ul><li>Variable degree of protection of research time </li></ul></ul><ul><li>Additional years of research time generally required to develop studies that will be independently funded </li></ul><ul><ul><li>NIH K type awards, R01 awards </li></ul></ul>
  7. 7. The ABIM Research Pathway <ul><li>AKA the “short-track” / Physician-Scientist Pathway / Medical-Scientist Pathway </li></ul><ul><li>The Basics </li></ul><ul><ul><li>Internal Medicine Residency shortened to 2 years </li></ul></ul><ul><ul><li>Fellowship training split: </li></ul></ul><ul><ul><ul><li>Spend minimum time allowable in formal clinical training </li></ul></ul></ul><ul><ul><ul><li>Research time extended: </li></ul></ul></ul><ul><ul><ul><ul><li>3 years mandatory research time (protected from clinical duties) </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Normal research time is 6-12 mo, not always protected </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>80% Research, 20% Clinical (to stay current) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Clinical time is outpatient subspecialty clinic – NOT Floors, O/N Call </li></ul></ul></ul></ul><ul><li>These features apply to every program – guidelines are set by the American Board of Internal Medicine </li></ul>
  8. 8. Sample comparison - Cardiology <ul><li>Traditional pathway </li></ul>1 2 3 4 5 6 7 8 Medicine Resident Cardiology Fellowship 1 2 3 4 5 6 7 8 Medicine Resident Clinical fellow Research <ul><li>ABIM Research pathway </li></ul>1 2 3 4 5 6 7 8 Medicine Resident Clinical fellow Research <ul><li>Alternate ABIM Research pathway </li></ul>Research (& Clinical…) Research (& Clinical…)
  9. 9. Advantages of the Research Pathway <ul><li>Shortened length of general Internal Medicine clinical training </li></ul><ul><li>Still do entire length of required CLINICAL fellowship training </li></ul><ul><li>Begin research sooner </li></ul><ul><ul><li>Increased time to set up research projects, produce publishable data, write grants </li></ul></ul><ul><li>Truly protected research time </li></ul><ul><ul><li>No overnight call, no backup, no consults </li></ul></ul><ul><ul><ul><li>Big deal if you’re trying to do experiments to know you won’t be disturbed </li></ul></ul></ul><ul><ul><li>20% clinical / 80% research split allows you to stay current clinically </li></ul></ul><ul><li>Fellowship secured earlier </li></ul><ul><ul><li>Stability allows better planning of personal life </li></ul></ul><ul><li>Inside track to faculty positions </li></ul><ul><ul><li>Most institutions view this program as a means to develop faculty </li></ul></ul>
  10. 10. Disadvantages of the Research Pathway <ul><li>Loss of 1 year of IM clinical training </li></ul><ul><li>Must choose subspecialty 1 year early </li></ul><ul><li>Waste of time if you ultimately choose a purely clinical position </li></ul><ul><li>“ Another long *!&*!&%* program!!” </li></ul>
  11. 11. Things you will hear <ul><li>Some say – </li></ul><ul><ul><li>Residency is the ONLY time to get real training to be a physician – </li></ul></ul><ul><ul><ul><li>Therefore you should not shortchange any of the residency because you never know what you may ultimately do </li></ul></ul></ul><ul><li>Counter arguments - </li></ul><ul><ul><li>How much of your time will be spent doing pure Internal Medicine? </li></ul></ul><ul><ul><li>What is the educational yield of third year of residency </li></ul></ul><ul><ul><li>No difference in duration of clinical training during fellowship </li></ul></ul><ul><ul><li>Trying to develop research projects after fellowship, when burdened with clinical responsibilities (your salary depends on it) is very difficult </li></ul></ul>
  12. 12. Why do institutions participate in these programs? <ul><li>Nationally recognized need for physician-scientists </li></ul><ul><ul><li>Same justification as NIH-funded MSTPs </li></ul></ul><ul><li>Much cheaper to hire future faculty from within than from other institutions </li></ul><ul><ul><li>Average cost of recruiting faculty is greater than $1,000,000 </li></ul></ul><ul><li>Fellowship programs get an early crack at people who have a proven ability to carry out research </li></ul><ul><li>Prestige </li></ul><ul><ul><li>looks good for the residency and fellowship programs </li></ul></ul>
  13. 13. Major categories of programs <ul><li>Match, then apply to Research Pathway in year 1 of IM Residency </li></ul><ul><ul><li>No guarantees of acceptance to Research Pathway (limited slots) </li></ul></ul><ul><ul><li>No guarantees of acceptance to particular fellowship </li></ul></ul><ul><ul><li>If accepted to Research Pathway, one can generally get a fellowship at same institution </li></ul></ul><ul><ul><ul><li>Allergy/Cards/GI vs. Oncology vs. ID/Rheum/Endo </li></ul></ul></ul><ul><li>Match directly to Research Pathway </li></ul><ul><ul><li>Program guarantees Research Pathway upfront </li></ul></ul><ul><ul><li>Must apply for specific fellowship in year 1 of IM residency </li></ul></ul><ul><li>Match directly to Research Pathway - Fellowship </li></ul><ul><ul><li>Program guarantees Research Pathway AND Fellowship upfront </li></ul></ul>
  14. 14. Major categories of programs <ul><li>Match, then apply to Research Pathway in year 1 of IM Residency </li></ul><ul><ul><li>No guarantees of acceptance to Research Pathway (limited slots) </li></ul></ul><ul><ul><li>No guarantees of acceptance to particular fellowship </li></ul></ul><ul><ul><li>If accepted to Research Pathway, one can generally get a fellowship at same institution </li></ul></ul><ul><ul><ul><li>Allergy/Cards/GI vs. Oncology vs. ID/Rheum/Endo </li></ul></ul></ul><ul><li>Match directly to Research Pathway </li></ul><ul><ul><li>Program guarantees Research Pathway upfront </li></ul></ul><ul><ul><li>Must apply for specific fellowship in year 1 of IM residency </li></ul></ul><ul><li>Match directly to Research Pathway - Fellowship </li></ul><ul><ul><li>Program guarantees Research Pathway AND Fellowship upfront </li></ul></ul>
  15. 15. Major differences between institutions <ul><li>Number of positions earmarked for ABIM Research Pathway </li></ul><ul><ul><li>Accepting a (ABIM Research Pathway) Participant means sacrificing one 3 rd yr IM Resident in the residency program </li></ul></ul><ul><ul><ul><li>Participants only do 2 yrs IM residency </li></ul></ul></ul><ul><ul><li>Participants spend less time overall in fellowship training </li></ul></ul><ul><ul><ul><li>This means fellowship must hire more fellows to account for your absence from clinical service </li></ul></ul></ul><ul><ul><li>Each Participant is guaranteed a salary for 3 yrs of funded research </li></ul></ul><ul><ul><li>Thus, it is advantageous to go to a well-funded Dept. of Medicine </li></ul></ul><ul><li>Talking the talk vs. Walking the walk </li></ul><ul><ul><li>Actual number of people who do join the Research Pathway each year? </li></ul></ul><ul><li>Incentives </li></ul><ul><ul><li>Money for supplies and salary supplement </li></ul></ul><ul><ul><li>Costs of attending meetings & conferences </li></ul></ul>
  16. 16. Other important points <ul><li>Who offers it? </li></ul><ul><ul><li>University-Based Teaching Hospitals that draw large amounts of research funding </li></ul></ul><ul><li>Organization and Funding </li></ul><ul><ul><li>Some are well organized, formal programs with budgets, others are put together on an ad-hoc basis (less desirable) </li></ul></ul><ul><ul><li>Some have a program director & committee that guide your career </li></ul></ul><ul><li>Support </li></ul><ul><ul><li>Research-committed vs Research-supportive vs Research-permissive </li></ul></ul><ul><ul><li>Some programs have the support of the chair & faculty </li></ul></ul>
  17. 17. What’s the Bottom line? <ul><li>This program is designed with MD/PhD’s in mind to facilitate their entry into academic medicine </li></ul><ul><li>If you are considering an academic medical career – you WILL need to do substantive research beyond the Ph.D. </li></ul><ul><li>The ABIM research pathway gets you into the lab more quickly and protects & funds your research time </li></ul>
  18. 18. How do you know if this is right for you? <ul><li>Determine your goals and priorities </li></ul><ul><ul><li>Are you interested in a career consisting of Research only, Research & Patient Care, or Patient Care only? </li></ul></ul><ul><ul><li>Do you have an interest in a particular field of medicine? </li></ul></ul><ul><ul><ul><li>Your thesis topic need not relate to your fellowship field </li></ul></ul></ul><ul><ul><ul><li>Perfectly acceptable to not know your field of interest </li></ul></ul></ul><ul><ul><li>Do you want the guarantee of the Research Track or Research Track - Fellowhip? </li></ul></ul><ul><ul><li>Would you prefer the stability of knowing where you’ll be located for residency and fellowship? </li></ul></ul>
  19. 19. What to do if you’re interested <ul><li>Incorporate your interest in research into your personal statement </li></ul><ul><ul><li>Be as specific as possible: disease, areas of investigation, etc. </li></ul></ul><ul><li>Letter writers should know you’re interested in academic medicine </li></ul><ul><ul><li>Especially true for your PI </li></ul></ul><ul><li>Contact Research Pathway directors – let them know you’re INTERESTED! </li></ul><ul><ul><li>Email addresses are usually listed on websites – end of 3 rd year </li></ul></ul><ul><ul><ul><li>Do this before you complete your application (ERAS) </li></ul></ul></ul><ul><ul><li>IM Residency director and Research Pathway director are rarely the same </li></ul></ul><ul><ul><ul><li>Don’t assume that they communicate with each other </li></ul></ul></ul><ul><ul><ul><li>When you get interview invitations - make sure they know you’re also applying for Research Track – some have supplemental interview days </li></ul></ul></ul><ul><ul><ul><li>Confirm that your interview is for the Research Pathway </li></ul></ul></ul><ul><li>Do your homework </li></ul><ul><ul><li>Look up faculty and ongoing research (PubMed) </li></ul></ul><ul><ul><li>Determine strengths of institutions based on research being conducted, number and funding of researchers </li></ul></ul><ul><ul><li>Ask as many people as many questions as possible! </li></ul></ul>
  20. 20. Applying for residency
  21. 21. What to think about if you’re in… <ul><li>1 st /2 nd year medical school </li></ul><ul><ul><li>Two most important things </li></ul></ul><ul><ul><ul><li>Find a good lab with a good PI </li></ul></ul></ul><ul><ul><ul><li>Step 1 score </li></ul></ul></ul><ul><ul><li>Don’t slack off just because you’re MD/PhD </li></ul></ul><ul><ul><li>Document your activities – (esp. leadership roles) </li></ul></ul><ul><li>Graduate school </li></ul><ul><ul><li>Form a thesis committee and defend your thesis proposal early </li></ul></ul><ul><ul><ul><li>meet frequently – ideally every 6 months </li></ul></ul></ul><ul><ul><li>Let Dr. Frohman how things are going on a routine basis – especially if they are going poorly or are stagnating </li></ul></ul><ul><ul><ul><li>He is your biggest advocate and supporter </li></ul></ul></ul><ul><ul><li>Inform Carron and Dr. Frohman of your plans to return to medical school as soon as you are seriously considering defending </li></ul></ul>
  22. 22. What to think about if you’re in… <ul><li>3 rd /4 th year medical school </li></ul><ul><ul><li>3 rd year scheduling </li></ul></ul><ul><ul><ul><li>Your first rotation will be your worst </li></ul></ul></ul><ul><ul><ul><li>Complete the rotation in field of interest before September of application year </li></ul></ul></ul><ul><ul><ul><li>All rotation sites are not created equal </li></ul></ul></ul><ul><ul><ul><ul><li>Expect to work longer and have less time to study at SBUH </li></ul></ul></ul></ul><ul><ul><li>Learn what you can on the wards but focus on finding time to study for the shelf </li></ul></ul><ul><ul><li>4 th year scheduling </li></ul></ul><ul><ul><ul><li>Completion of a subinternship (sub-I) is a major part of your candidacy </li></ul></ul></ul><ul><ul><ul><li>Complete your sub-I before November of application year </li></ul></ul></ul><ul><ul><ul><ul><li>If you did not do your clerkship at SBUH, you should do sub-I at SBUH </li></ul></ul></ul></ul><ul><ul><ul><li>Schedule “away” electives if you have the time </li></ul></ul></ul>
  23. 23. Letters of recommendation <ul><li>Minimum of 4 needed for residency application </li></ul><ul><ul><li>One from your PI </li></ul></ul><ul><ul><li>One departmental letter </li></ul></ul><ul><ul><li>Two from attendings </li></ul></ul><ul><ul><ul><li>Preferably from established faculty </li></ul></ul></ul><ul><ul><ul><li>One from sub-I attending </li></ul></ul></ul><ul><ul><ul><li>Remaining should be from clerkship attendings </li></ul></ul></ul><ul><ul><ul><ul><li>Ask anyone you worked with regardless of duration of contact </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Ask for letters during/immediately after contact </li></ul></ul></ul></ul><ul><ul><li>Be safe and ask early for more letters than you will need </li></ul></ul><ul><ul><ul><li>No upper limit to number you can keep on file </li></ul></ul></ul><ul><ul><ul><li>You choose which letters to use for application </li></ul></ul></ul><ul><ul><li>Research Track </li></ul></ul><ul><ul><ul><li>Additional supplemental letters from PI’s familiar with your research </li></ul></ul></ul><ul><ul><ul><ul><li>Committee members are ideal </li></ul></ul></ul></ul>
  24. 24. Applying for residency <ul><li>Selecting programs to consider for residency </li></ul><ul><ul><li>University hospitals </li></ul></ul><ul><ul><ul><li>vs. university-affiliated vs. community </li></ul></ul></ul><ul><ul><li>Research opportunities </li></ul></ul><ul><ul><li>Reputation </li></ul></ul><ul><ul><li>Location </li></ul></ul><ul><li>Whom to ask for advice? </li></ul><ul><ul><li>MSTP alumni </li></ul></ul><ul><ul><ul><li>Eager to help and best suited to understand your situation </li></ul></ul></ul><ul><ul><li>Clerkship directors / SB Residency directors </li></ul></ul><ul><ul><li>Mentors </li></ul></ul><ul><ul><li>Residents </li></ul></ul>
  25. 25. Last few tidbits of advice <ul><li>“ Dean’s letter” – Medical Student Performance Evaluation </li></ul><ul><ul><li>You write it, Dean Schiavone edits it, and Dr. Frohman embellishes it </li></ul></ul><ul><li>What to look for and expect on interviews </li></ul><ul><ul><li>Be prepared to talk about your research and ANYTHING in your personal statement and application </li></ul></ul><ul><ul><li>Fellowship matching success: a good indicator of how program is perceived </li></ul></ul><ul><ul><li>Attending Teaching vs. Private Attendings (& private patients) </li></ul></ul><ul><ul><li>Resident satisfaction – take the time to talk to them </li></ul></ul><ul><ul><li>Get a feel for the residency program director </li></ul></ul><ul><ul><ul><li>They play a major role in your daily residency experience and fellowship hunt </li></ul></ul></ul><ul><li>Thank you letters </li></ul><ul><ul><li>Get business cards from your interviewers AND program directors </li></ul></ul><ul><ul><li>Send a thank you letter immediately after your interview </li></ul></ul><ul><ul><ul><li>Make them personal and avoid form letters </li></ul></ul></ul><ul><ul><li>Near the end of interview season, send a second letter to directors of your top programs to show your interest </li></ul></ul><ul><ul><ul><li>Let your number one program know that they are your number one! </li></ul></ul></ul>
  26. 26. Web Resources <ul><li>ABIM website – research pathway </li></ul><ul><ul><li>http://www.abim.org/cert/respath.shtm </li></ul></ul><ul><li>Sample program websites </li></ul><ul><ul><li>Wash U. http:// meded.im.wustl.edu/application/PSTPFlier.html </li></ul></ul><ul><ul><li>Vanderbilt http://medicine.mc.vanderbilt.edu/harrison/q4paharrison.cfm </li></ul></ul><ul><ul><li>UCSD http://pstp.ucsd.edu/ </li></ul></ul><ul><ul><li>Stanford http://medicine.stanford.edu/education/scip.html </li></ul></ul><ul><ul><li>Columbia http:// www.cumc.columbia.edu/dept/medicine/residency/tracks.htm </li></ul></ul><ul><ul><li>Einstein http://www.medicine-residency.org/special_programs/msp/index.html </li></ul></ul><ul><li>Residency database </li></ul><ul><ul><li>www.ama-assn.org/go/ freida </li></ul></ul><ul><li>Ajit Janardhan [email_address] </li></ul><ul><li>Edward Kim [email_address] </li></ul>
  27. 27. Web Resources <ul><li>ABIM website – research pathway </li></ul><ul><ul><li>http://www.abim.org/cert/respath.shtm </li></ul></ul><ul><li>Sample program websites </li></ul><ul><ul><li>Wash U. http:// meded.im.wustl.edu/application/PSTPFlier.html </li></ul></ul><ul><ul><li>Vanderbilt http://medicine.mc.vanderbilt.edu/harrison/q4paharrison.cfm </li></ul></ul><ul><ul><li>UCSD http://pstp.ucsd.edu/ </li></ul></ul><ul><ul><li>Stanford http://medicine.stanford.edu/education/scip.html </li></ul></ul><ul><ul><li>Columbia http:// www.cumc.columbia.edu/dept/medicine/residency/tracks.htm </li></ul></ul><ul><ul><li>Einstein http://www.medicine-residency.org/special_programs/msp/index.html </li></ul></ul><ul><li>Residency database </li></ul><ul><ul><li>www.ama-assn.org/go/ freida </li></ul></ul><ul><li>Ajit Janardhan [email_address] </li></ul><ul><li>Edward Kim [email_address] </li></ul>

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