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Caribbean Med School Graduates

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Symmetry11

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What is life like after you graduate from a Caribbean school? Will pay be same? Will I be limited to only the most undesirable locations to practice in? These are my main presumptions about Caribbean graduates. Is this mostly true SDN?
 

bedevilled ben

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What is life like after you graduate from a Caribbean school? Will pay be same? Will I be limited to only the most undesirable locations to practice in? These are my main presumptions about Caribbean graduates. Is this mostly true SDN?

The outcomes are as varied as the students who apply to the program. There is no pre-set pathway. I know some SGU students who are chiefs of specialized surgery at well-known clinical centers and some who are still waiting 3+ years for a residency. If you can nail the Step exams and secure a residency, your pay will pretty much be the same as US-trained physicians. If you botch the Steps and fail to establish solid contacts, you might have to settle for FP at an undesirable location. There is no guarantee either way. It's a high-risk venture no matter how you slice it.
 

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N=1. 2005 graduate from Ross. I landed in a strong university-based anesthesia program for residency training side-by-side with U.S. MD and DO graduates. I am board-certified. I am fully employed in private practice. I make $400k/yr plus benefits. I have an excellent professional life.

I am treated and respected the same as any U.S. graduate among my patients and colleagues.

-Skip
 
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Symmetry11

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Also, how tough would it be to land a competitive fellowship like in pain medicine?
 

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Also, how tough would it be to land a competitive fellowship like in pain medicine?
SGU 2000. PMR at EVMS and Pain fellow at Emory.
Now in private practice.
Sitting on the membership committee for AAPMR.

Well prepared. No regrets. Would do it again.
PMR at several locations takes IMG.
 

Skip Intro

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What did you score on your step 1, Skip?

Also, how tough would it be to land a competitive fellowship like in pain medicine?

I scored 231 on Step 1, 220 on Step 2/CK, and 205 on Step 3, which I took at the beginning of my second year of residency. These were taken in 2003, 2004, and 2006 respectively. I submitted my Step 2 score before interviews and the Match. I think I would've done better on Step 2 if I'd completed my Surgery core rotation before taking it (scheduling limitations with Ross).

I think you can get a pain fellowship no problem provided you show up and do okay during your residency and not be a douche (etc.). Pain has gone way downhill in recent years. It may make a comeback.

-Skip
 

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Depends on how well you perform and of course luck. If you get good grades, but more importantly, rock the Steps, you'll be more likely to get your choice of residency (within reason, of course. You probably won't be getting derm or ENT coming from the Caribbean). If you come to the Caribbean highly motivated, you'll have a pretty good chance of succeeding. Your pay will be the same as that of an AMG in the same specialty.
 

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Skip, I read in one of your other posts that you would not go to the Caribbean again. Could you elaborate on that? And would you advise a 26 year old applicant with limited options and over 51 hours of non academic withdrawals on their transcript to consider the Caribbean now?
 

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N=1. 2005 graduate from Ross. I landed in a strong university-based anesthesia program for residency training side-by-side with U.S. MD and DO graduates. I am board-certified. I am fully employed in private practice. I make $400k/yr plus benefits. I have an excellent professional life.

I am treated and respected the same as any U.S. graduate among my patients and colleagues.

-Skip

Hey Skip,

I'm currently a medical student in the U.S. but I'm thinking about anesthesiology. Do you think the 400k/year salary is sustainable in the future esp. with Obamacare coming into action and decreasing reimbursement every year? I'm also worried about the CRNA encroachment. Can you give us any insight on this? Thanks.
 

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Skip, I read in one of your other posts that you would not go to the Caribbean again. Could you elaborate on that? And would you advise a 26 year old applicant with limited options and over 51 hours of non academic withdrawals on their transcript to consider the Caribbean now?

You must have searched back very far (haha).

It is a tough path. It's not for everyone. Things worked out for me. You have to do a serious soul-search and play the financial numbers game with yourself, recognizing that most graduates will land somewhere in primary care. For me, it turned out well. I think what I would've done differently is to start much earlier than I did. Fortunately, I live my life without a lot of overhead (i.e., I don't drive a fancy car, etc.) I'm able to put a lot of money away, pay my loans, and live a good comfortable life easily. This may not be true for everyone.

Depending on the exact lifestyle you want and if you want to be in healthcare, there are many allied health professions that may be suitable as well and not present quite the arduous path you will embark on going this route. Risk = reward. But, with that risk comes a lot of potential heartache.

Hey Skip,

I'm currently a medical student in the U.S. but I'm thinking about anesthesiology. Do you think the 400k/year salary is sustainable in the future esp. with Obamacare coming into action and decreasing reimbursement every year? I'm also worried about the CRNA encroachment. Can you give us any insight on this? Thanks.

I think that you should go to the Anesthesia sub-forum where this topic is heavily discussed.

If you have your heart set on working in a specific geographic area that is already saturated with providers, you're not going to make what I make. Just today we were discussing (with a colleague) some job opportunities where the sky is the limit on salary. These are in relatively undesirable geographic areas, unless of course living in the mountains far away from all that the "big city" has to offer appeals to you.

Good luck with your decision,

-Skip
 

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You must have searched back very far (haha).

It is a tough path. It's not for everyone. Things worked out for me. You have to do a serious soul-search and play the financial numbers game with yourself, recognizing that most graduates will land somewhere in primary care. For me, it turned out well. I think what I would've done differently is to start much earlier than I did. Fortunately, I live my life without a lot of overhead (i.e., I don't drive a fancy car, etc.) I'm able to put a lot of money away, pay my loans, and live a good comfortable life easily. This may not be true for everyone.

Depending on the exact lifestyle you want and if you want to be in healthcare, there are many allied health professions that may be suitable as well and not present quite the arduous path you will embark on going this route. Risk = reward. But, with that risk comes a lot of potential heartache.



I think that you should go to the Anesthesia sub-forum where this topic is heavily discussed.

If you have your heart set on working in a specific geographic area that is already saturated with providers, you're not going to make what I make. Just today we were discussing (with a colleague) some job opportunities where the sky is the limit on salary. These are in relatively undesirable geographic areas, unless of course living in the mountains far away from all that the "big city" has to offer appeals to you.

Good luck with your decision,

-Skip
Skip what do you make of this article


http://www.usatoday.com/story/news/...poses-record-funding-for-new-doctors/5836317/
 

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Good news. And, as predicted.

Except...

Recruiting primary care practitioners for the residencies makes sense because young people are interested in working with teams of providers, the officials said.

... I don't necessarily agree with that statement. Most doctors don't want to become bureaucrats simply signing charts for midlevels who provide all the "hands on" care. It's just not a rewarding way to practice medicine.

-Skip
 

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Your pay will be the same. You do not get paid based on your school locations. Asking if you will be restricted to the most undesirable locations is highly subjective. Why? Because what one person considers an undesirable location would be the perfect for another. I wanted to be in the rural midwest or south. Most people would say this is undesirable. Some of those "undesirable locations" pay physicians a lot. Look at Barrow, AK. Undesirable to most, appealing to some. I will be working in a town of 2500 in the Appalachian mountains. A lot of people would consider this "undesirable" but is where I want to be.
 

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Your pay will be the same. You do not get paid based on your school locations. Asking if you will be restricted to the most undesirable locations is highly subjective. Why? Because what one person considers an undesirable location would be the perfect for another. I wanted to be in the rural midwest or south. Most people would say this is undesirable. Some of those "undesirable locations" pay physicians a lot. Look at Barrow, AK. Undesirable to most, appealing to some. I will be working in a town of 2500 in the Appalachian mountains. A lot of people would consider this "undesirable" but is where I want to be.

Excellent point.

-Skip
 

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You might not match and may have to give up your career. True story - it happened to my husband who went to SGU, and a few of his classmates.
Happens all the time, and it's tragic. In fact, I can count at least 7 former college acquaintances who went unmatched for multiple years after their graduation from the Caribbean. Many just decided to change careers altogether because they just couldn't get into a residency so they stopped trying.

Stay in the US at all costs. I'm a US allopathic graduate and when I was interviewing for residency at top programs in a competitive specialty, I rubbed elbows with DO students not infrequently. Caribbean students -- not once. There is a humongous prejudice against carib IMG s. DOs face a little bit of prejudice, but far far far less than carib.
 

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    The UK will allow anyone who graduates from a UK medical school to stay and do foundation and speciality training you don't have to be a UK or EU citizen. The UK is hard to get in though.
     

    drcrispmd

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    Did your husband have failures on his steps? Or did he limit himself on location when applying. I highly doubt he went unmatched if he passed the steps on the first time.

    I know 1 person who has not been able to match and that is because he had too many failure between the steps.
     

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    I'm a US allopathic graduate and when I was interviewing for residency at top programs in a competitive specialty, I rubbed elbows with DO students not infrequently. Caribbean students -- not once. There is a humongous prejudice against carib IMG s. DOs face a little bit of prejudice, but far far far less than carib.

    First, none of us here has ever suggested that Caribbean grads will get "top choices" in "competitive specialties" (assuming you mean derm, ortho, plastics, rad onc, neurosurg, etc.). However, I have always recommended that prospective students and students who are looking at where to submit their applications for the Match should look at the programs that have historically accepted graduates from that school into GME programs. There are many who get into radiology, emergency medicine, anesthesiology (like myself) and not just primary care fields, although those form the bulk of Matches, by choosing this system. I trained side-by-side with mostly U.S. allopathic graduates, some D.O.s and a few other Carib graduates. I did quite well. Yes, that was almost ten years ago now.

    Secondly, in this new era of exposing and challenging prejudices, I find it funny that this is still allowed to be openly expressed and wonder why it is not questioned. There are subsequently many qualified graduates who, once they get into a Carib program, excel. They are often the exception, clearly, but to summarily dismiss them just because they went to St. George's or AUC or Ross seems like it should be consider among the worst forms of profiling. Likewise, I'm sure you met more than one or two students, MallorWeiss, in your class who struggled. They were I'm sure stellar students in undergrad and maybe had the same MCAT scores that the Carib students had but, for whatever reason, they got their invitation to the U.S. allopathic party and the other kid didn't. These students in your class who struggled were likely coached along because "attrition" is a dirty word in U.S. medical school, subsequently passed their exams, got their letters, and went on interviews with the imprimatur of your school emblazoned on their curriculum vitae. Is this anymore fair that a weak U.S. student automatically gets access to certain programs just because of their pedigree? Excluding a stronger Carib graduate from the residency selection process at a particular program simply because they went the Carib route now sounds an awful lot like bigotry to me. What would you say if we were talking about allowing a white person into a country club and excluding someone else simply because of their race or religion? Before you call that a straw man you're going to have to demonstrate to me precisely how it's different.

    Lastly, as I've said mulitple times before, the tides are changing. There are far more U.S. allopathic schools opening. There are more spots at the current ones. The caliber of student who barely didn't get into a U.S. program and choose to go the Caribbean route will be changing dramatically over the next few years. So, in essence, I can't say that the Caribbean pathway will be the same ten years from now as it was ten years ago. But, I can say that people continue to and have been having these types of discussions and offering these kinds of warnings since the Caribbean pathway became a reality. Not much has changed. The only thing that is certain is that more U.S. spots means more options for U.S. citizens and graduates of premedical programs. How this is a bad thing for them is beyond me.

    -Skip
     
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    n=1....I had a friend go to one of the minor caribbean schools (not big 4), had 50 percentile step scores and took 3 years of applying literally everywhere to land a family medicine residency in the frozen north.
     

    BestDoctorEver

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    n=1....I had a friend go to one of the minor caribbean schools (not big 4), had 50 percentile step scores and took 3 years of applying literally everywhere to land a family medicine residency in the frozen north.
    What is a 50 percentile step scores?
     

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    n=1....I had a friend go to one of the minor caribbean schools (not big 4), had 50 percentile step scores and took 3 years of applying literally everywhere to land a family medicine residency in the frozen north.

    Was the N=1 in reference to your own post or in response to mine?

    Founded in 1978, RUSM has over 10,000 alumni who are practicing in all 50 U.S. states, Canada, and beyond.
    ...
    Over the last five years, RUSM has placed more graduates into U.S. residency programs than any other school in the world.

    http://www.rossu.edu/medical-school/About-Ross-University-School-of-Medicine.cfm

    -Skip
     

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    the n=1 was in reference to my friend's story being just one person's story....sorry for the confusion

    No problem. There are certainly horror stories of graduates that don't get into some program. I think the big schools should look at why and perhaps better advocate strategies to help students.

    For me, I applied to a massive amount of anesthesia programs. I didn't get invited to an interview to most of those. But, I got interviews at enough. I applied to a couple of back-up plans, as well, but decided not to go on those interviews after I had enough invitations from other programs.

    It can be daunting. I think you have to have the right strategy from the start. One very nice, very good student from my class did not get invites to any anesthesia programs. I don't know what the specific deficiencies in his application were, but if he had gone "all in" for anesthesia he wouldn't be practicing now.

    Also, you can start, say, an Internal Medicine program at a particular institution and transfer into another program at that same institution after a year or two. I know of at least one other guy in my class who started in Internal Medicine and then transferred to anesthesia. He's board-certified and practicing now.

    The point is, be realistic and be flexible. Most importantly, have a back-up plan. The ones I saw who failed (including one guy who was "surgery or bust") did not have a reasonable back-up plan... and are now out of work.

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    MalloryWeiss

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    First, none of us here has ever suggested that Caribbean grads will get "top choices" in "competitive specialties" (assuming you mean derm, ortho, plastics, rad onc, neurosurg, etc.). However, I have always recommended that prospective students and students who are looking at where to submit their applications for the Match should look at the programs that have historically accepted graduates from that school into GME programs. There are many who get into radiology, emergency medicine, anesthesiology (like myself) and not just primary care fields, although those form the bulk of Matches, by choosing this system. I trained side-by-side with mostly U.S. allopathic graduates, some D.O.s and a few other Carib graduates. I did quite well. Yes, that was almost ten years ago now.

    Secondly, in this new era of exposing and challenging prejudices, I find it funny that this is still allowed to be openly expressed and wonder why it is not questioned. There are subsequently many qualified graduates who, once they get into a Carib program, excel. They are often the exception, clearly, but to summarily dismiss them just because they went to St. George's or AUC or Ross seems like it should be consider among the worst forms of profiling. Likewise, I'm sure you met more than one or two students, MallorWeiss, in your class who struggled. They were I'm sure stellar students in undergrad and maybe had the same MCAT scores that the Carib students had but, for whatever reason, they got their invitation to the U.S. allopathic party and the other kid didn't. These students in your class who struggled were likely coached along because "attrition" is a dirty word in U.S. medical school, subsequently passed their exams, got their letters, and went on interviews with the imprimatur of your school emblazoned on their curriculum vitae. Is this anymore fair that a weak U.S. student automatically gets access to certain programs just because of their pedigree? Excluding a stronger Carib graduate from the residency selection process at a particular program simply because they went the Carib route now sounds an awful lot like bigotry to me. What would you say if we were talking about allowing a white person into a country club and excluding someone else simply because of their race or religion? Before you call that a straw man you're going to have to demonstrate to me precisely how it's different.

    Lastly, as I've said mulitple times before, the tides are changing. There are far more U.S. allopathic schools opening. There are more spots at the current ones. The caliber of student who barely didn't get into a U.S. program and choose to go the Caribbean route will be changing dramatically over the next few years. So, in essence, I can't say that the Caribbean pathway will be the same ten years from now as it was ten years ago. But, I can say that people continue to and have been having these types of discussions and offering these kinds of warnings since the Caribbean pathway became a reality. Not much has changed. The only thing that is certain is that more U.S. spots means more options for U.S. citizens and graduates of premedical programs. How this is a bad thing for them is beyond me.

    -Skip

    I'm not saying I agree with the prejudice, I'm simply pointing out that it exists and subsequently puts IMG applicants at a significant disadvantage when it comes to the match. That's the current reality, and premeds considering the Carib route need to be very familiar with this. I'm glad the AAMC began publishing IMG match statistics, revealing just how abysmal the match rates are compared to american graduates. It just seems like far too big a financial gamble to go overseas with the expectation that there will be a postgraduate training program waiting for you in 4 years. Many program directors at top academic centers, unfortunately, won't even consider extending an interview invite to a student, even if they meet (or exceed) the numeric criteria, purely because of their IMG status. It's sad, but it is a fact.

    My advice to all premeds is this: if you want to practice medicine in the United States, then put in the extra work to get accepted here. The DO option, is a significantly better choice than going overseas.
     

    laricb

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    I'm not saying I agree with the prejudice, I'm simply pointing out that it exists and subsequently puts IMG applicants at a significant disadvantage when it comes to the match. That's the current reality, and premeds considering the Carib route need to be very familiar with this. I'm glad the AAMC began publishing IMG match statistics, revealing just how abysmal the match rates are compared to american graduates. It just seems like far too big a financial gamble to go overseas with the expectation that there will be a postgraduate training program waiting for you in 4 years. Many program directors at top academic centers, unfortunately, won't even consider extending an interview invite to a student, even if they meet (or exceed) the numeric criteria, purely because of their IMG status. It's sad, but it is a fact.

    My advice to all premeds is this: if you want to practice medicine in the United States, then put in the extra work to get accepted here. The DO option, is a significantly better choice than going overseas.
    The real problem is, PD's have to much power with US dollars
     

    Skip Intro

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    I'm not saying I agree with the prejudice, I'm simply pointing out that it exists and subsequently puts IMG applicants at a significant disadvantage when it comes to the match. That's the current reality, and premeds considering the Carib route need to be very familiar with this. I'm glad the AAMC began publishing IMG match statistics, revealing just how abysmal the match rates are compared to american graduates. It just seems like far too big a financial gamble to go overseas with the expectation that there will be a postgraduate training program waiting for you in 4 years. Many program directors at top academic centers, unfortunately, won't even consider extending an interview invite to a student, even if they meet (or exceed) the numeric criteria, purely because of their IMG status. It's sad, but it is a fact.

    I wish they'd break the numbers down further (i.e., students who failed one part of the USMLE at least once, students who took longer than four years to graduate, etc.). I think there is more of a story there. Likewise, if you go this route you have to be realistic and have a back-up plan for every contingency. (I'm sounding like a broken record.) No one is arguing that the weeding out comes, at various places, at the back-end as opposed to the front. You'd better fly straight and tight if you choose this route.

    But, I know what you mean. They bathe in their bias. I recall a friend innocently (and perhaps a bit naively) applying to Johns-Hopkins for residency. He had killer board scores (250+ on both of the first parts). He received a nice letter back where they said essentially (and I'm paraphrasing, but I did see the letter), "Thank you for your application. But, unfortunately, we do not recognize the program you are attending as a bona fide medical education institution able to confer the Doctor of Medicine degree." I suppose the World Health Organization is also bogus? What a bunch of arrogant snobs.

    I think he's having the last laugh, though, as he is now on faculty as an Assistant Professor at a bona fide U.S. "medical education institution" in Boston teaching U.S. medical students how to be doctors. Maybe some of those graduates will go on to train at Johns-Hopkins? Wouldn't that be the irony of ironies.

    My advice to all premeds is this: if you want to practice medicine in the United States, then put in the extra work to get accepted here. The DO option, is a significantly better choice than going overseas.

    Which is why I said this... (to quote myself)

    Lastly, as I've said mulitple times before, the tides are changing. There are far more U.S. allopathic schools opening. There are more spots at the current ones. The caliber of student who barely didn't get into a U.S. program and choose to go the Caribbean route will be changing dramatically over the next few years. So, in essence, I can't say that the Caribbean pathway will be the same ten years from now as it was ten years ago. But, I can say that people continue to and have been having these types of discussions and offering these kinds of warnings since the Caribbean pathway became a reality. Not much has changed. The only thing that is certain is that more U.S. spots means more options for U.S. citizens and graduates of premedical programs. How this is a bad thing for them is beyond me.

    -Skip
     

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    I read that same quote on the SGU webpage (more doctors then any other school) They must have both tied LOL

    St. George's website says this...

    The University’s over 13,000 graduates include physicians, veterinarians, scientists, and public health and business professionals across the world.

    http://www.sgu.edu/about-sgu/index.html

    And...

    Now, with more than 13,000 graduates—more than 11,000 of which are practicing medicine across the world...

    http://www.sgu.edu/about-sgu/history-of-sgu.html

    I could find nothing countering or purporting to match the claim that Ross has on their website regarding the past five years. It appears that SGU probably has more doctors counting back from when they opened. Ross has likely produced more in the past 5 years, which is their claim. Unless you can find this stated somewhere (and I looked at all of the tabs where such a claim on SGU's website might be), I don't think they are "tied".

    -Skip
     

    BestDoctorEver

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    I was told if someone wants to do primary care or psych, the big 4 is not a bad option. I always wonder why some people don't consider podiatry school before going into a carib med school adventure...
     

    drcrispmd

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    I was told if someone wants to do primary care or psych, the big 4 is not a bad option. I always wonder why some people don't consider podiatry school before going into a carib med school adventure...


    Because some hate feet. If I had to deal with people's nasty feet every day I would need a psychiatrist because I would want to shoot myself. That is why I did not even think about podiatry period.
     

    laricb

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    St. George's website says this...



    http://www.sgu.edu/about-sgu/index.html

    And...



    http://www.sgu.edu/about-sgu/history-of-sgu.html

    I could find nothing countering or purporting to match the claim that Ross has on their website regarding the past five years. It appears that SGU probably has more doctors counting back from when they opened. Ross has likely produced more in the past 5 years, which is their claim. Unless you can find this stated somewhere (and I looked at all of the tabs where such a claim on SGU's website might be), I don't think they are "tied".

    -Skip
    Here you go, SGU now says residency, they say in 3 yrs. I will find the doctor statement and get back to you

    http://www.sgu.edu/index.html
     

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    In the meantime (and for what it's worth), I have no skin in the game and it doesn't really matter to me personally. If SGU is producing more, then fine. I just like people to be able to back-up whatever claims they are making. Nothing more. It's not personal to me. Just the facts, ma'am.

    -Skip
     
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