Carib Grads working in Canada??

[docmira]

Hi all..
I know this topic has been discussed many times, but i just received the application package from SGU and there is a letter included from a graduate. He was from Canada, and graduated at SGU and is now working in Toronto. I was always under the impression that once you go to the caribbean, there is little chance of being able to practice in Canada......
He graduated in '88 or something like that. Is this why? or is there a chance to get back into canada?
I've been seriously thinking about SGU lately..but i don't want to leave canada

thanks!

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[Badkarma25]

Hey there,
i think the situatoin with carib grads isn't hopeless but it's very difficult...there are most definitely carribean grads workign in canada, just not many of them...saba has a few grads scattered around, in particular manitoba, saskatchewan, and nova scotia...you aren't necessarily saying bye to canada permanently but you might have to get licensed in the u.s. first...i know ontario's foreign grad repatriation program sucks...in a word...it is really difficult to get into and really doesn't guarantee you anything

 

[Bevo]

Im not canadian, but I know there are a few canadians here at Ross who I believe are working to graduate and practice in Canada once they are done.

 

[Renovar]

One simple word, and the only word you need to keep in mind when you are considering a carib school and your chance to return to Canada.

The word is impossible.

There MAY have been one or two lucky individuals who, with heaven's willing, slipped through the cracks, but otherwise it is generally considered impossible. It's so bad that SGU and Ross' generally-loudmouthed websites dont even dare to mention it out loud to save their face and business from Canadian customers (it says something like "contact our office regarding this matter.")

There are multiple website created by unsatisfied Canadian SGU/Ross customers all over the web, who will attest and define the word impossible to its every letter.

Enjoy. If you need a couple links, I'll be happy to provide them.

 

[DocRuth]

docmira,

You may choose to accept this idea that it is impossible for international medical graduates to practice in Canada, but before you do, there is one rather revealing link that merits your attention.

Check out the Romanow Report:

http://www.hc-sc.gc.ca/english/pdf/romanow/pdfs/HCC_Final_Report.pdf

Scroll down to Table 4.2

According to Romanow, 22.7% of practicing physicians in Canada graduated from medical schools outside of Canada. So clearly, it is FAR from impossible to study abroad and then come back to Canada.

This table also gives the percentages of IMGs (international medical graduates) for each province. It's worth a look.

Best of luck with your decision making.

 

[The Pill Counter]

If you write MCCEE, MCCQE Part 1 and 2, do an ACGME residency in the States, write the corresponding FRCPSC or CCFP exam, then there really is no reason why you can't get licensed in Canada (except Ontario, they want one year of Canadian experience before you can register, and probably Quebec).
Just don't expect to be able to do a residency in Canada.

 

[poly]

Table 4.2 does not say anything about the current situation for IMG's in Canada. The majority of these IMG's could have been licensed in the 60s, 70s and 80s.

Currently, most of the provinces for licensing require an IMG to do at least 1 year of residency -- and this residency is hard to obtain as an IMG in Canada.

Though, there appears to be ways for IMGs from certain countries to get licensed (probably temporary ones)?

 

[Badkarma25]

the majority of foreign MD's in canada were licensed years ago...i know in my hometown that's the case....they are all in their 40's or 50's now, and came from either england, ireland, or south africa. i think the pill counter's post was bang on...just don't plan on getting a residency in ontario....the trouble with this topic is that most people who wnat to practice in canada mean ontario, and ontario is the hardest province to crack

 

[DocRuth]

poly and Badkarma25 --

you both make a really good point, and your posts got me wondering how many new IMGs are licenced in Canada each year. So I did some quick searches to find some numbers, and here's what I found:



College of Physicians and Surgeons of Alberta:

http://www.cpsa.ab.ca/physicianregistration/physician_statistics.asp
Of 378 new registrants in 2002, 131 did not go to med school in Canada or the US.
Has numbers since 1998.

College of Physicians and Surgeons of BC:

http://www.cpsbc.ca/physician/documents/2002_Annual_Report.pdf
Between 80 and 100 IMGs are licensed each year.
No tables, just a registrar's report.

College of Physicians and Surgeons of Manitoba:

http://www.umanitoba.ca/colleges/cps/Reports/REGREPORT2002.pdf
Table 1 has a breakdown of the past 10 years complete with country of qualification. Of 139 new registrants in 2002, 80 graduated outside of Canada or the US.

I also tried to get info on New Brunswick, Nova Scotia, and Ontario, but didn't find anything on their sites. Of course, I didn't look very hard.

Obviously, this isn't very comprehensive or anything, but it does show that at least in the western provinces, IMGs are a substantial part of the new workforce.

Now if we can just get some info on where they all graduated...

 

[Badkarma25]

hey there,
i know a few provinces USED to have measures in place with certain foreign countries to guarantee a smoother path for the acceptance and equivalence of foreign medical qualifications...saskatchewan is one of them, not sure about alberta, and i think b.c. was one also...they used to have measures in place to accept foreign grads almost readily from ireland, england, and south africa...not sure about aussie grads...again, this used to be in place, not sure if it still is....and i know nova scotia and newfoundland had similar measures...most docs in nfld are irish-educated as i understand it...nice work on digging up those numbers doc ruth!

 

[Renovar]

Let's just say that even as a US medical grad to be, I find the path to be tortuous and ridiculously complicated if I think about the prospect of working in Canada/doing a residency in Canada after I am done. Even as a US medical grad. Considering how much bull**** restrictions and handicapped the whole process is to me, I am going to put the whole practicing in Canada issue on the backburner until they fix the regulations.

PS: There is no question that by far the majority of the FMGs practicing in Canada is from the 70's or prior, when the need for physicians in Canada lowered the governmental restrictions. My family doc in Canada is a med school grad from HK, he got licensed in Canada in like 1970. (Even though he is like 70 years old now, that little lucky bastard has been taking up a practicing spot and is refusing to retire, still trying to milk what he can out of the already-impoverished system.) And unlike in the US, FMG's in Canada gets absolutely NO disrespect or discrimination, so there is not an FMG lobby group within the CAFP or Royal Canadian College of Physicians community. In fact, many of the FMG's actually wants to burn the bridge after their own paths and close doors to all OTHER FMG's to avoid mass influx of people just like them for their own job security. Some currently practicing FMG's actually favor the authorities in putting a more definitive "NO RESIDENCY TRAINING FOR ANYONE OTHER THAN CMG's" rule, as they think the wording of the current rule is too ambiguous and they felt this ambiguity threatens their job security. I have heard that from at least 4 FMG FPs in my area, and 2 of them are active members of the BC college of physicians. What an injust world, isn't it?

 

[docmira]

wow
thanks for all the research..it's a lot to consider.
I have lived in Ontario my whole life, but I think I would like to live in BC if i have the chance to practice in Canada.
Hopefully the system will undergo some changes in the next 5 years or so..by the time i'm ready to practice..

cheers

 

[roo]

This is an authoritative answer.

Yes, you can do residency in Canada after medical school abroad.

For all of them, you need to write a MCCEE (evaluating exam). You can write the MCCEE in your final year of school before graduating, so that you can go straight from school graduation to starting residency the next month. Percentage of candidates that pass the MCCEE is ~97%. Alberta wants the part one of MCC done too. Some provinces have restrictions that you were from there (Quebec, BC notably). Ontario is not worthwhile at all at present, but is supposed to reform its useless 9-month unpaid slave program in 2003-2004, as no strong candidates will go to that province at present. For Canada, do your MCCEE in Nov of final year, apply in the 2nd round CaRMS match, do your phone interviews, rank programs, await results.

Your primary information is here:

http://www.CARMS.CA/stats/pgy-1_2003/page22_table21-22-23.htm

and here:

http://www.CARMS.CA/stats/pgy-1_2003/page17_table14-15.htm#top

Unfortunately, there is no breakdown of country of origin. Off the record, UK/Ireland/Aus/NZ are looked at more closely as candidates (with UK/Ireland even more so in Maritimes), but strong candidates are strong candidates regardless of the country of their origin.

Quite frankly, if a program director has a view that the candidates are picked based primarily on their nationality, etc, instead of their merits, then it is a program that is neither going to have the strongest teammembers, nor the most positive work environment for you to work in.

You can also go to the USA, for that you need:
-MCCEE
-USMLE Step I
-USMLE Step II
-CSA (Clinical Skills Assessment)

You go in first round match in USA. If your desired field is in a discipline for which there are not many available places in Canada, but is in USA (like int. med, or anesth), then best advised to train in USA.

 

[Winged Scapula]

In response to the post above, Canadians who have trained abroad and wish to do a US residency do not need to take the MCCEE to start a US residency but rather the TOEFL and get ECFMG certification (after having taken USMLE Step 1 and 2 and the CSA).

 

[poly]

The IMG match in the second round of CARMS gives you an idea of how difficult it is to get a residency spot in Canada. Note only 67 IMGs matched in 2003. And these IMGs are not necessary from Caribbean schools; these are IMGs from worldwide. Are graduates from USA considered IMGs by CARMS?


I have this impression that if you are graduates from certain countries, there is a better chance of getting permanently licensed by doing the temporary licensing route. Anybody disagree (and why)?

 

[Renovar]

IMG is used by americans in describing people who trained at a school that's not LCME accredited. So to Americans, Canadian med school grads are not considered IMG, and are generally treated the same as AMG's.

In Canada, on the other hand IMG just means anyone who did things out of the country, INCLUDING the US. That figure 67 probably is made up exclusively from AMG's or other 1st world med schools from the common wealth like England or Australia. In some provinces, AMG's can only match in the 2nd iteration.

 

[The Pill Counter]

Correction Kim: If the said Canadian is starting a US residency on a J-1 visa, then MCCEE is a must (Ministry of Health won't sign the letter of need without it). It can only be skipped if they are sponsored on an H-1 or have a green card.
Also Renovar: An AMG with Canadian permanant residency or citizenship can enter the first iteration of the match for some provinces.

 

[Winged Scapula]

Originally posted by The Pill Counter
Correction Kim: If the said Canadian is starting a US residency on a J-1 visa, then MCCEE is a must (Ministry of Health won't sign the letter of need without it). It can only be skipped if they are sponsored on an H-1 or have a green card.
Also Renovar: An AMG with Canadian permanant residency or citizenship can enter the first iteration of the match for some provinces.

Ahh...thanks for the clarification.

 

[silenthunder]

Hey all,

Pill Counter, I was a bit surprised when you said that AMG's with canadian permanent/citizenship can apply to 1st iteration of match in some provinces. Which provinces?

Do these provinces also give the same priviledge to Canadian citizens who have trained elsewhere? (I'm guessing no, since everything I've heard is to that effect......)

Cheers,

Silenthunder

 

[Renovar]

No, only to American medical school grads. You can find out which provinces on the CaRMS webpage it's not something I have commited to memory.

 

[Thewonderer]

I don't believe that CaRMS tells you which provinces exactly. It has always been on a school-by-school basis (i.e you should contact each residency program director to find out if american med grads are eligible to enter the 1st iteration).

Of notes, some residency programs in the US are shorter than those in Canada (for example, general medicine and peds residencies are 3 years in the US while it is 4 years in Canada. If you want to do fellowship in Canada, you only need 3 years of, say, medicine or peds before applying. However, in the US, some programs allow you to "fast-track"; in other words you can do only 2 years of medicine and then enter your cardiology or endocrine fellowships right away). However, some programs (cardiac surgery) are shorter in Canada than in the US.

 

[Apollyon]

Originally posted by Thewonderer
However, in the US, some programs allow you to "fast-track"; in other words you can do only 2 years of medicine and then enter your cardiology or endocrine fellowships right away.

Every accredited fellowship for IM requires you to be IM BC/BE, which you can't be after only 2 years. Which programs are you thinking of?

 

[moo]

Originally posted by silenthunder
Hey all,

Pill Counter, I was a bit surprised when you said that AMG's with canadian permanent/citizenship can apply to 1st iteration of match in some provinces. Which provinces?

Do these provinces also give the same priviledge to Canadian citizens who have trained elsewhere? (I'm guessing no, since everything I've heard is to that effect......)

Cheers,

Silenthunder

I think BC is one of them. Check out carms.ca. This does not apply to non-LCME accredited schools. Generally Canadians who did med schools in the US are in a gray area... they don't have to take the qualifying exams but are somewhat handicappped in the process. However, matching to Canadian programs as a US grad is a lot easier than as a foreign grad (including UK, Australia, Ireland, etc.)

 

[Renovar]

Originally posted by moo
I think BC is one of them. Check out carms.ca. This does not apply to non-LCME accredited schools. Generally Canadians who did med schools in the US are in a gray area... they don't have to take the qualifying exams but are somewhat handicappped in the process. However, matching to Canadian programs as a US grad is a lot easier than as a foreign grad (including UK, Australia, Ireland, etc.)

How many Canadians who did their med school in the US is attempting to match in Canada in a year, you think?

 

[mkmgal]

I recently saw the topic of discussion and thought I'd drop a quick question about the residency issue. I'm currently a 2nd year DO student and I'm thinking of practicing in Canada some time in the future. I was born in Alberta but only lived there until I was 1. My wife, however, was born and raised in Alberta. I plan on doing a residency in family practice in the states, but is it recommended that I do an ACGME residency over an AOA residency? Does it really matter? Would Alberta still approve an AOA residency? Anway, any thoughts would help. Thanks!

 

[Renovar]

Originally posted by mkmgal
I recently saw the topic of discussion and thought I'd drop a quick question about the residency issue. I'm currently a 2nd year DO student and I'm thinking of practicing in Canada some time in the future. I was born in Alberta but only lived there until I was 1. My wife, however, was born and raised in Alberta. I plan on doing a residency in family practice in the states, but is it recommended that I do an ACGME residency over an AOA residency? Does it really matter? Would Alberta still approve an AOA residency? Anway, any thoughts would help. Thanks!

Ooh sticky issue. I never read anything about this, but I dont know if Canada even recognize the DO degree at all. As far as I know DO is strictly an American degree. And I dont know if doing a residency in AOA program is going to be recognized outside US. I'd say your best bet is do an ACGME residency, pass everything ACGME way and get board certified in family practice, and hope that the particular province you want to practice will overlook your degree and look at your board certification and hopefully that will fly with them. Although I wont be surprised at all they wont recognize DO's at all. There are a lot of hoopla even as US med school grads will have to go through to practice in Canada, so I'd imagine DO's will have even a harder time.

 

[moo]

Originally posted by mkmgal
I recently saw the topic of discussion and thought I'd drop a quick question about the residency issue. I'm currently a 2nd year DO student and I'm thinking of practicing in Canada some time in the future. I was born in Alberta but only lived there until I was 1. My wife, however, was born and raised in Alberta. I plan on doing a residency in family practice in the states, but is it recommended that I do an ACGME residency over an AOA residency? Does it really matter? Would Alberta still approve an AOA residency? Anway, any thoughts would help. Thanks!

As far as I know, there are only 12 DO's practicing in Canada, most if not all in FP. the amount of rights granted DO's varies from province to province.

 

[Thewonderer]

Originally posted by Apollyon
Every accredited fellowship for IM requires you to be IM BC/BE, which you can't be after only 2 years. Which programs are you thinking of?

There are plenty of IM residents who enter fellowships after only 2 years of IM residency. I don't know how they go around being IM BC/BE. It could be that when they finish their fellowships, they are eligible to be BC/BE? That I am not certain. But if you want to a rheumatologist or cardiologists, mostly likely you would LOVE the idea of doing gen med for only 2 years. Many residents who have fellowships in mind can't wait until their gen med days are over. Just ask around. This is fairly common in the hospital I train in but I have no plan to go into internal medicine.

 

[Apollyon]

Originally posted by Thewonderer
There are plenty of IM residents who enter fellowships after only 2 years of IM residency. I don't know how they go around being IM BC/BE. It could be that when they finish their fellowships, they are eligible to be BC/BE? That I am not certain. But if you want to a rheumatologist or cardiologists, mostly likely you would LOVE the idea of doing gen med for only 2 years. Many residents who have fellowships in mind can't wait until their gen med days are over. Just ask around. This is fairly common in the hospital I train in but I have no plan to go into internal medicine.

Just name some places where. I have 12+ years of healthcare experience all over the east coast of the US, and have never, ever heard someone get around it (except for FMG's, granted some credit (1/2 to 1 year) for residency or board certification elsewhere, and this was extremely (as in 1 in IM, and 1 in Peds) rare).

 

[Thewonderer]

You signature suggests that you are from Durham, NC. Just go ask some IM residents there at Duke and I guarantee that you will hear some who have fast-tracked. Just use the words, "fast track."

 

[Renovar]

No need to argue on something like this. The reality is that these "fast track" candidates do 2 years of residency and then go straight into their fellowships. Plenty of programs in the country have these tracks. You do NOT need to be BC in IM when you get into your fellowship, fast-track or regular track. All you have to do is pass step 3. I am currently working with 2 or 3 renal fellows right now who are taking their IM boards now while they are in the first year of their fellowship. In fact, the fellows I worked with said you never have to pass anything past step 3 throughout the fellowship. You can still only have pass step 3 even after you finish. The problem is, in order to get BC in that particular field in which you do your fellowship, your prerequisite is IM boards. So if you finish your fellowship but still want to do GP, you really never have to pass anything other than step 3...

 

[Apollyon]

I said "BC/BE" - you can't get your boards that fast after residency.

But I will look into it here about "fast-tracking"; I'd only heard of it in osteopathic programs.

 

[Renovar]

Originally posted by Apollyon
I said "BC/BE" - you can't get your boards that fast after residency.

But I will look into it here about "fast-tracking"; I'd never heard of it.

Dude, I know my fellows (1st years) are taking it next week. And you can take it at anytime in your fellowship. Who said you have to be BC/BE when you go into your fellowship?

 

[Apollyon]

Originally posted by Renovar
Dude, I know my fellows (1st years) are taking it next week. And you can take it at anytime in your fellowship. Who said you have to be BC/BE when you go into your fellowship?

Next week is the 3rd week in August - after fellowship has started. The 19-20 August dates is the only time this year the ABIM exam is being given.

But I did misspeak; please excuse me. You don't per se have to be BC/BE, but, for all the programs on FREIDA that I looked at that completed the long survey, 3 years of prior GME in IM was needed for those fellowships; I looked at random programs in GI, Cards, Renal, and Endocrine.

I'm not trying to argue - I just simply want to know of MD fellowships in the US that will take someone with only 2 years of GME; I don't think there are any. If there are 'fast-tracked' people, they're DO's.

 

[Thewonderer]

Originally posted by Apollyon
I'm not trying to argue - I just simply want to know of MD fellowships in the US that will take someone with only 2 years of GME; I don't think there are any. If there are 'fast-tracked' people, they're DO's.

What is the nature of your "12 years of clinical experience?" Did you get to talk to residents or fellows a lot?

Renovar and I have between us probably no more than 3 years of clinical experience "combined" in the United States of America. However, we eat and sleep with residents and fellows (figuratively, not literally of course ) and we know that it is 100% true that people can fast track. Seriously, just go to Duke Hospital and ask around (assuming that you are a med student in Durham). These are regular MD who has gone through regular IM programs and has fast tracked into renal, cards, etc.

No matter how much time you spend on FREIDA, it is no substitute for spending all of your awake hours with the residents and fellows and getting info directly from horses' mouths. It is evident that you have not started your clinical years yet.

 

[Renovar]

Originally posted by Apollyon
I'm not trying to argue - I just simply want to know of MD fellowships in the US that will take someone with only 2 years of GME; I don't think there are any. If there are 'fast-tracked' people, they're DO's.

That's a legit question. Sorry if I misunderstood you. Normally if you are applying to another program's fellowship they usually require the entire completion of your IM residency. (ie if you are a resident at institution X and you want to apply to a fellowship at institution Y, they will probably require you to finish 3 years of IM at X) but many institutions have fast track programs that allows their residents to go straight into THEIR OWN fellowship after serving 2 years at that same institution. (ie if you are in fast-track for say ID at instutition X, you do 2 years of IM residency at X and then you plug right into the ID fellowship at X on your 3rd year). You have to apply as a fast track applicant and generally it is harder if you are applying to fast-track in some popular specialty like cards since you pretty much applying for a guaranteed fellowship spot at that institution. ( just think about it as all those combined "7 year BS/MD" schools, fast track works in the same in principle.)

And yes, you can take your IM boards with only 2 years of GME. I am not sure about the timing, but as I said, board exam passage (be it IM board or specialty board) is not a requisite for entering fellowship, nor is it a requisite for completing fellowship.

 

[Apollyon]

Originally posted by Thewonderer
It is evident that you have not started your clinical years yet.

I'm an EM-1 at Duke, and did prelim-IM at Elmhurst City Hospital in Queens last year. I AM the one that the students spend/spent all their awake hours with. I HAVE gotten the information straight from the horses' mouths. That's why I raise the question.

All I'm saying is that, in the US, you need 3 years of GME to do fellowships, and I can't find any evidence against that. Just name me some specific program that has people with less than 3 years of GME, or PM the name of someone who has done it, and I'll be a believer. And FREIDA is actually not a bad resource.

And, Renovar, you are absolutely right - you don't have to have your boards - as I tried to make clear in an earlier post, I was implying that, after 3 years of IM, you should be BE.

 

[Renovar]

Just type in the words "internal medicine fast track" on Yahoo and see the links and some of the programs that offer fast track, some of which can explain the process better than I.

 

[Apollyon]

Originally posted by Renovar
Just type in the words "internal medicine fast track" on Yahoo and see the links and some of the programs that offer fast track, some of which can explain the process better than I.

I did it on Google, and only got DO's - all AOA-approved residencies, but not ACGME. The Yahoo search yields the same results. I still haven't seen an MD fast track yet.

 

[Thewonderer]

When I did my internal medicine sub-I, I did ask a resident who fast-tracked and he said that he did apply to many programs (i.e. not just the one at his institution). I did not go into the finer details with him but apparently he just flew around, applying to fellowships as an intern (rather than waiting until he is PGY-2)??? This part I am not sure about.

I ALREADY gave you a name of a hospital that allows fast track. There are IM residents around you all the time. I just don't know why you would not open your mouth and are intimdated by the IM residents who rotate through the ED there.

Are you an FMG? Because if you were a med student in the US, you must have heard of somebody who has fast-tracked. Are you interested in IM fellowships?

 

[Apollyon]

Originally posted by Thewonderer
I ALREADY gave you a name of a hospital that allows fast track. There are IM residents around you all the time. I just don't know why you would not open your mouth and are intimdated by the IM residents who rotate through the ED there.

This is rather virulent and circumlutory. I don't know why you have such agitas.

And how can you say I'm intimidated by Duke IM? For one, they're not "around all the time", and, moreover, as an EM resident, you are on a bunch of other services, depending on the month. Finally, this is not a point that is first and foremost in my mind, causing me to strive for a rapid answer. Oh, and, unless you know me, I'll tell you - no one in medicine scares me.

Just name some programs (specialties and hospitals) where people can do IM fellowships with 2 years of GME. Saying "the name of a hospital that allow fast track" seems like you're avoiding saying Duke. You say it's failry common in the hospital you train in. Is it a Canadian hospital, or an AOA-accredited hospital?

 

[Stephen Ewen]

bump

 

[TheEyesHaveIt]

can someone clarify this for me please - What does a canadian who graduates from a foreign school (ie non canadian non usa) have to do after completing a US residency (ensuring that he or she completes the same number of years as a canadian program in the same field) to come back and practice in canada?
and...can they practice wherever they can get a job or are there limitations?

 

[Apollyon]

Just name some programs (specialties and hospitals) where people can do IM fellowships with 2 years of GME. Saying "the name of a hospital that allow fast track" seems like you're avoiding saying Duke. You say it's fairly common in the hospital you train in. Is it a Canadian hospital, or an AOA-accredited hospital?

I eat my own shoe...at Duke, there are 3 people doing fast-track now, after 2 years of IM. All are MD/PhD...cardiology (Harvard), renal (UCSF), endocrine (Vanderbilt).

 

[Old MD]

Appolyon,

They must be talking about the ABIM research track program.

It is true that in this program you only do two years pure IM, and then fellowship. It is also true that it is widely available at academic centers.

But it is a RESEARCH/ACADEMIC program. It is quite competitive.

You are REQUIRED to do:

1. minimum 2 years straight IM
2. Minimum 2 years *pure* research (ie. you can't do a stupid chart review) in some sort of accredited graduate program (either MSc/MPH or PhD), or post-grad research fellowship (if you already have a PhD)
3. The full fellowship period (ie. 3 years pulmo/crit care, etc)

ABIM tracks your progress.

You BC will only be valid if you practice in an academic setting, ie. if you decide after 2yr IM + 3 yr fellowship that you don't want to do research, they will force you to do another year of IM to get your BC. I understand they have a very low threshold of making people finish another year, even if you complete the full research requirements, because they look at your clinical performance (presumably from your PDs report) and if they feel you aren't up to the mark they'll recommend the extra year.

 

[Old MD]

woops! I see you have come to your senses I didn't see your last post.