Is being a physician repetitive work?

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I didn't find another thread on this.

I want to select a career that is challenging and that changes a lot. My three great passions in life are helping others out (the more directly, the better), learning new things (anything) and traveling (everywhere). Being a physician I believe would fulfill all three of these desires, as I'd have enough money to do the traveling.

But I'm afraid I'll go to school for all those years, finish my residency, and be burnt out or even worse, bored. I used to work in a pharmacy as a technician, and the repetition was horrible. I loved learning about all the medicine (knowledge is another one of my passions), but after a year and a half I felt like I would never see anything new again. I was always filling the same prescriptions for people, always the same counts and directions, etc. I'm afraid the same thing will happen if I become a physician.

The three specialties that appeal to me as a med newbie are Psychiatry, Radiology, and Pediatrics. But I don't see any great amount of variety in any of these fields. I feel like, from a non-physician standpoint, I'd pretty much be doing the same thing every day...

Anyway, if anyone would like to answer my question, I'd appreciate it. BTW, since this is my first post, "Hello." 🙂

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I didn't find another thread on this.

I want to select a career that is challenging and that changes a lot. My three great passions in life are helping others out (the more directly, the better), learning new things (anything) and traveling (everywhere). Being a physician I believe would fulfill all three of these desires, as I'd have enough money to do the traveling.

But I'm afraid I'll go to school for all those years, finish my residency, and be burnt out or even worse, bored. I used to work in a pharmacy as a technician, and the repetition was horrible. I loved learning about all the medicine (knowledge is another one of my passions), but after a year and a half I felt like I would never see anything new again. I was always filling the same prescriptions for people, always the same counts and directions, etc. I'm afraid the same thing will happen if I become a physician.

The three specialties that appeal to me as a med newbie are Psychiatry, Radiology, and Pediatrics. But I don't see any great amount of variety in any of these fields. I feel like, from a non-physician standpoint, I'd pretty much be doing the same thing every day...

Anyway, if anyone would like to answer my question, I'd appreciate it. BTW, since this is my first post, "Hello." 🙂


I was thinking the same thing today. I'd like to know the answer to this, also. Adult ADD (<--self diagnosed...thanks) is a biaaa! 👎 High amounts of repetition = :scared: (although, I'm sure I'd get a subspec in peds; not sure if that would make a difference)
 
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Every job has repetiton and every specialty has its bread and butter.
 
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Every job has repetiton and every specialty has its bread and butter.

Yea. Despite what job you have, it's always gonna have its ups and downs.

From what I've heard, though, the job with the most variety (generally, again, these are from peoples' opinions) is emergency medicine, just because it's a general area people go with a whole range of injuries, etc...
 
Every job has repetiton and every specialty has its bread and butter.

Although I appreciate you replying to my post, is there any way you could elaborate?

I know every job is repetitive (especially in an economy where specialization is the norm), but some are more so than others. My question is on the scale of repetitiveness, where does being a physician land.

As an example, engineering sounds interesting because you get to work on different projects, but I REALLY want to help people out. I know most people don't appreciate their physician nowadays as much as in the past (this is another subject, though), but I think I would be internally satisfied as a physician.
 
I would recommend EM or FP...probably the widest variety.
 
I'd bet medicine would be right in the middle of professional jobs as it relates to repetition, depending on how one defines the term. My primary evidence is the need to keep patients safe and to offer the same level of care to all patients. For example, a patient comes into the ER with chest pains. What happens, if they're in any ER around the country? "rule out" applies and they're given an aspirin & seen quickly by a physician, even the type of room (trauma room or one with better equipment) is predetermined. There's a procedure for stroke, pregnancy, etc. Medicine in general is not intended to be a field where a practitioner can see new, different things daily that require him or her to come up with a new solution.

For jobs with less repetition than medicine, how about project manager for a firm that develops new concepts? There used to be a consultancy called Arthur D. Little (I think that's spelled right) that helped companies be entrepreneurial. Lots of room for creative people who hate repetition in the business/arts/nonprofit worlds.

I see medicine as more repetitious in that the physician is constantly helping people and can do so in a way that makes the patient feel valued, even if it's the same type of solution to the same type of patient time & time again.
 
Yes it is repetitive, but there will always be interesting cases. And at least the repetition involves some heavy intellectual material in it's own right. You never know when some rare condition lies just around the corner. As a physician you must balance consideration of common AND rare conditions...so while you may find yourself bored for a few days, like clockwork something will come up that challenges you and forces you to learn something new. If you enjoy when that happens, you'll be fine.

The three specialties that appeal to me as a med newbie are Psychiatry, Radiology, and Pediatrics. But I don't see any great amount of variety in any of these fields. I feel like, from a non-physician standpoint, I'd pretty much be doing the same thing every day...
Well on a superficial level, you will be doing the same thing every day. Radiologists read imaging studies. Pediatricians treat kids. Psychiatrists manage psych patients. That is what you will do every day. The variety comes in what exactly it is that you are doing. Most of the time a diagnosis will be fairly easy. But sometimes it will take all of your training and knowledge to get it right. And still, you will occasionally get it completely wrong. Unexpected situations arise frequently in medicine and only someone with experience can handle those. In the course of gaining that experience though, you will inevitably have to slog through the "bread-and-butter" - all those common conditions that seemingly everyone has, for which the treatment is protocol driven. But even in these cases, things pop up that interfere with the protocol. That's why a computer program couldn't practice medicine.

Happyhospitalist blogs frequently about this (the value of cognitive medicine) if you want reassurance 🙂
http://thehappyhospitalist.blogspot.com/
 
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Well if you are looking for a different problem to solve every day think about what you want to do. Every specialty has a bunch of the same however there are little differences in each patient that could make the situation more complicated/interesting.

There are going to be alot of bread and butter cases no matter what though. Peds are gonna see ear aches, Family med is gonna see hypertension, surgeons have a repertoir of select surgeries . But if you are passionate about your field you wont mind doing some of the same because you will notice what makes this patient different from the last.

if you are looking to going into medicine with only a specializations in mind think long and hard about it.

Take what I am saying with a grain of salt I am a lowly premed.
 
Thank you all so much for the answers. They've been extremely helpful, and now I have a different viewpoint on the issue.

I guess life and the career I choose is only as boring as I make it. 🙂
 
I would recommend EM or FP...probably the widest variety.

You will still have some repetition. In the 20 hours I've spent in the emergency room shadowing (20 more at the end of this week!) I have seen three things repeatedly (3+ times):
1) Urinary tract infections
2) People thinking they were having an ectopic pregnancy
3) Cardiac Arrests
Now I'm not sure if there was a special on 1 and 2 this month, but across the board in every ER in the country you will do a lot of cardiac arrests. You do get to see a wide variety of stuff, but they all fall under the motto "stabilize and admit" (for those real emergencies at least, you have to play urgent care sometimes too). So I think it was hit on the head when you said it's as boring as you make it. You could say "I saw a cardiac arrest, a grand mal seizure, and a serious head trauma today. Stabilized and admitted them all. Man my job is so boring and repetitious!" but you may want to see a therapist if that is your outlook haha.
 
You will still have some repetition. In the 20 hours I've spent in the emergency room shadowing (20 more at the end of this week!) I have seen three things repeatedly (3+ times):
1) Urinary tract infections
2) People thinking they were having an ectopic pregnancy
3) Cardiac Arrests
Now I'm not sure if there was a special on 1 and 2 this month, but across the board in every ER in the country you will do a lot of cardiac arrests. You do get to see a wide variety of stuff, but they all fall under the motto "stabilize and admit" (for those real emergencies at least, you have to play urgent care sometimes too). So I think it was hit on the head when you said it's as boring as you make it. You could say "I saw a cardiac arrest, a grand mal seizure, and a serious head trauma today. Stabilized and admitted them all. Man my job is so boring and repetitious!" but you may want to see a therapist if that is your outlook haha.
I think you are confusing cardiac arrests with Chest pains....but yeah, you are gonna have repetition everywhere. Ortho-hips, acls, shoulders

Radiology-xrays
ENT-sinusitis, and ear infections
Plastics-boobies
 
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I think you are confusing cardiac arrests with Chest pains....but yeah, you are gonna have repetition everywhere. Ortho-hips, acls, shoulders

Radiology-xrays
ENT-sinusitis, and ear infections
Plastics-boobies

Haha that's true, but I did see 3 legitimate cardiac arrests. I don't think I can count the number of people that were tachy, or had chest pain, or thought they were having a heart attack in general that weren't.
 
Depends on the specialty I'm sure. I shadowed a dermatologist once and the repetition drove me nuts, same problems over and over.
 
2) People thinking they were having an ectopic pregnancy

LOL, "I still think we should do the ultrasound" 🙂 Actually abdominal pain is the #1 chief complaint in the ED, although ectopic is quite rare. EM is a good field for people who like variety, because literally *anything* could walk through the door on your shift. Some people relish that feeling, others dread it because they are afraid of missing something. That next female GU/abdominal pain COULD be an ectopic pregnancy and it is your job to rule it out. This is the routine aspect of EM - ruling out the lethal diagnoses and maybe figure out what is going on, but not always.
 
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Medicine is incredibly repetitive. Practioners have to be because you have to get to where you approach a complaint systematically everytime or else you miss big stuff. Even the "exciting" fields of medicine are repetitive.

It is not a career for self-described "ADD" types.
 
^ ADD thing again eh? It's a symptomatic diagnosis nothing more. Lot's of EM people are very ADD and they're still good, maybe better than the rest. Carrying a diagnosis of ADD does not magically interfere with my ability to make a differential. Yes you follow the rules and protocols but that's not all there is to medicine. I guess my point is that one shouldn't represent medicine as being so repetitive that only the most robotic person would enjoy it. It's not like that and you know it.
 
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^ ADD thing again eh? It's a symptomatic diagnosis nothing more. Lot's of EM people are very ADD and they're still good, maybe better than the rest. Carrying a diagnosis of ADD does not magically interfere with my ability to make a differential. Yes you follow the rules and protocols but that's not all there is to medicine. I guess my point is that one shouldn't represent medicine as being so repetitive that only the most robotic person would enjoy it. It's not like that and you know it.

I dont think he said that
 
While medicine doesn't have to be repetitive, the folks who do a single procedure, do it well, and can do it multiple times a day are going to generate a lot more money than someone constantly on a learning curve and spending time thinking. Which is why a specialist in GI who does nonstop endoscopy all day is going to bill a lot more per day than an internist, have a higher percentage of it reimbursed, and consequentially earn a lot more. But that doesn't mean you can't find something a bit less routine that you like, if you are willing to take the financial hit. Everything is going to be routine to a degree. You will see a large number of the "same" patients these days; the obese, hypertensive, diabetic smoker. This is who keeps coming in the door to the hospital each day, and yes, the workup is pretty routine. But there will periodically be the zebra who slips in with the herd of horses.
 
Others have said it, but I'll repeat - every specialty is repetitive.
(To a degree!)
The key is to approach each situation fresh - something that seems like just another case of X might be a little different and a little more weird. Most peds see a billion scrapes, cuts, colds, sore throats, and eye infections (cause kids like to play), and each psych sees a million cases of depression and anxiety. Then again, peds also see some more complex conditions and interesting injuries, and psychs see some really interesting patients with really interesting mental states once in a while.

That's one of the biggest things I've had to come to terms with - if I do what I want (ob/gyn), I'll be seeing a ton of normal pregnancies and a ton of yeast infections/regular appointments/urinary tract infections on a daily basis. The interesting ones will be few and far between. However, I've decided that doing a service to women (not *that* kind of service, pervs) is more important than having a fast-paced and hectic lifestyle with new and interesting things to see every day =) I think that's something for you to think about - do you care about these *issues* and these *people* enough to be bored pretty frequently? (for you, it'll be 'just another depressed person,' but for them, it'll be a life-changing diagnosis that makes their horrible childhood and destructive relationship make total sense)
 
Every job has repetiton and every specialty has its bread and butter.

👍

I don't think it matters what you go into, there is going to be some degree of repetition in every career out there. I shadowed a FP doc recently and it was the first time I had done that and boy was I surprised! I did it for a couple of months and the days that I was in there brought about the same variety of things: flu symptoms, upper respiratory problems, ear infection, blood work for cholesterol, repeat. Every now and then there would be a diabetes case or some type of open wound/infection that needed treatment, but it was generally never anything more than that. Of course they do get more variety than that but, like its been said, every career will have repetition to some extent
 
Thank you guys. I am learning so much from your answers!

And I'm starting to realize it could be exciting if I wanted it to be. For example, I could specialize in some sort of pathology (infectious diseases) and move to the African jungle, or something else like that. I don't want to do that, but that's not really the point. The point is its an option, and I still have a lot of time to decide what specific path to go down.

I guess I was afraid my career choice would pigeon-hole me into doing on thing for the rest of my life, but I'm starting to realize there's enough diversity in each field that I won't be stuck in one place forever.
 
I would recommend EM or FP...probably the widest variety.

EM is good because you have many different types of patients at once. However in my experience thus far, EM is full of Chest Pains (that usually aren't heart attacks), Abdominal pains (either Prego's or appendicitis, mostly neither), and small wounds (small cut on forehead, removed fingernail, etc.) Plus many (many) drug seekers. Like I believe L2D said above, every specialty has it's repetitions but EM is good at spreading it out.
 
^ ADD thing again eh? It's a symptomatic diagnosis nothing more. Lot's of EM people are very ADD and they're still good, maybe better than the rest. Carrying a diagnosis of ADD does not magically interfere with my ability to make a differential. Yes you follow the rules and protocols but that's not all there is to medicine. I guess my point is that one shouldn't represent medicine as being so repetitive that only the most robotic person would enjoy it. It's not like that and you know it.

I've said it before and I've said it again: people with true ADD are not going to be "maybe better than the rest," they will struggle to be competent. The fact that you like variety and don't like to sit in one spot and study for 5 hours does not mean that you have ADD.

The DSM criteria for ADD are listed below, with the parts that would be crippling for a physician in any specialty highlighted. You don't get to make up mental illnesses and then claim that they boost your clinical acumen.

-often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
-often has difficulty sustaining attention in tasks or play activities
-often does not seem to listen when spoken to directly
-often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
-often has difficulty organizing tasks and activities
-often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
-often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
-often easily distracted by extraneous stimuli
-often forgetful in daily activities

There are no "good" EM people who are "very ADD." There are good EM people who have a wide variety of interests, like to see a variety of cases, are able to work fast, and like to joke that they have ADD.
 
I've said it before and I've said it again: people with true ADD are not going to be "maybe better than the rest," they will struggle to be competent. The fact that you like variety and don't like to sit in one spot and study for 5 hours does not mean that you have ADD.

The DSM criteria for ADD are listed below, with the parts that would be crippling for a physician in any specialty highlighted. You don't get to make up mental illnesses and then claim that they boost your clinical acumen.

-often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
-often has difficulty sustaining attention in tasks or play activities
-often does not seem to listen when spoken to directly
-often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
-often has difficulty organizing tasks and activities
-often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
-often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
-often easily distracted by extraneous stimuli
-often forgetful in daily activities

There are no "good" EM people who are "very ADD." There are good EM people who have a wide variety of interests, like to see a variety of cases, are able to work fast, and like to joke that they have ADD.

ADD isn't in the DSM IV-R is it? ADHD only...
 
People are unique. When I've volutneered at our free clinic, I've been surprised at how different each visit was even though most of the complaints were identical.
 
People are unique. When I've volutneered at our free clinic, I've been surprised at how different each visit was even though most of the complaints were identical.


This is what I was thinking. Remember you'll be working on different PEOPLE rather than just cutting the same body part up again and again.

The more repetitive a task, though, the better you'll get at it, and the better success rate you'll have with patients. I think Gawande talked about this in his book "Better".

Wouldn't you feel better doing 15 cataract surgeries in a day and having mostly everyone seeing better and happy vs. doing 5 completely different procedures, unsure of what to do and having massive complications as a result?
 
Not to mention that you can go into different areas of medicine (teaching, research, seeing patients, etc) if you want to mix it up a little.
 
LOL, "I still think we should do the ultrasound" 🙂 Actually abdominal pain is the #1 chief complaint in the ED, although ectopic is quite rare. EM is a good field for people who like variety, because literally *anything* could walk through the door on your shift. Some people relish that feeling, others dread it because they are afraid of missing something. That next female GU/abdominal pain COULD be an ectopic pregnancy and it is your job to rule it out. This is the routine aspect of EM - ruling out the lethal diagnoses and maybe figure out what is going on, but not always.

This is very true...but most of what we see is still fairly routine. I probably see two really critical patients on every shift who require immediate interventions and decisions, a handful of real emergencies that need action soon, and the rest are a mix of general medical complaints, both legitimate (vaginal bleeding, for example) and ridiculous ("My Ass is Sweating").

But nail-biting excitement? Seat of your pants thrills? Not that often. In fact, it can be a real grind.

And I swear I have a patient or two who come in every shift because they are bored or lonely.

By the way, do not do Family Practice if you want "variety." From a disease point of view, family medicine is incredibly, shoot-yourself-in-the-head, Dear-God-Please-Make-it-Stop boring.
 
People are unique. When I've volutneered at our free clinic, I've been surprised at how different each visit was even though most of the complaints were identical.
This is EXACTLY what I wrote for EVMS's prompt on what I think I will like the best. Every patient is different, meaning every case is different. Two people can come in with the exact same problem, but if you treat the person and not the case, then you have two different situations. We're not treating white blobs. We're treating people. Georgetown's cura personalis sums it up the best.
 
All jobs, in and out of medicine, are repetitive.

Maybe wearing a combination of "hats" in academic, research, and clinical medicine could be the ticket? On paper, it appeals to me...not sure if it will still make sense to me in 4 to 10 years from now...
 
ADD isn't in the DSM IV-R is it? ADHD only...

I think you're right, those were the criteria for the "inattention" aspects of ADHD. Most people who say that ADD=good emergency docs say "ADD" rather than "ADHD" so I was trying to be consistent.
 
I'm aware that this thread is NOT about ADD but rather the repetitive vs. non-repetitive nature of the medical field, but I couldn't help but put my 2 cents in on the topic.

I tend to disagree with the idea that people with ADD can't become successful physicians. Granted, it may be a bit more difficult for them in some aspects, but I think it is definitely possible, especially if they seek a professional diagnosis and get on the proper meds.

I know quite a few people with ADD who have learned to get their condition under control and go on to lead incredibly successful lives and do incredibly well in school...even far above average.

I happen to have ADD and I did have professional diagnosis and am on medication. I haven't finished college yet but when I graduated high school I still managed to graduate in the upper portion of my class, with honors, AP/honors coursework under my belt, and four honors cords around my neck. I got accepted into a good college, in an advanced study program, and plan to go on to be a first rate doctor.

Don't generalize. Thank you. 🙂
 
I'm aware that this thread is NOT about ADD but rather the repetitive vs. non-repetitive nature of the medical field, but I couldn't help but put my 2 cents in on the topic.

I tend to disagree with the idea that people with ADD can't become successful physicians. Granted, it may be a bit more difficult for them in some aspects, but I think it is definitely possible, especially if they seek a professional diagnosis and get on the proper meds.

I know quite a few people with ADD who have learned to get their condition under control and go on to lead incredibly successful lives and do incredibly well in school...even far above average.

I happen to have ADD and I did have professional diagnosis and am on medication. I haven't finished college yet but when I graduated high school I still managed to graduate in the upper portion of my class, with honors, AP/honors coursework under my belt, and four honors cords around my neck. I got accepted into a good college, in an advanced study program, and plan to go on to be a first rate doctor.

Don't generalize. Thank you. 🙂

1. Congratulations.

2. No one plans to be a second rate doctor, sometimes it just happens.

3. I am not trying to deny that people with succesfully treated ADD can achieve great things, I take issue with those who try to claim that they are going to be great BECAUSE of their ADD. On a thread in the past we learned that there are several SDN posters who think that their diagnosed learning disability somehow conveyed special skills that make them better clinicians.
 
1. Congratulations.

2. No one plans to be a second rate doctor, sometimes it just happens.

3. I am not trying to deny that people with succesfully treated ADD can achieve great things, I take issue with those who try to claim that they are going to be great BECAUSE of their ADD. On a thread in the past we learned that there are several SDN posters who think that their diagnosed learning disability somehow conveyed special skills that make them better clinicians.

I don't think my ADD gives me (or anyone else for that matter) "special skills," (this actually made me laugh) I'm just trying to make a point that it's my belief that a person can still go on to be a successful doctor despite having ADD/ADHD.

P.S. I meant no offense by my post. I'm just tired of people who don't have ADD/ADHD trying to tell people who have in fact been diagnosed with this disorder what they are or are not capable of doing...in my opinion that's fairly ridiculous. 🙄
 
I've said it before and I've said it again: people with true ADD are not going to be "maybe better than the rest," they will struggle to be competent. The fact that you like variety and don't like to sit in one spot and study for 5 hours does not mean that you have ADD.

The DSM criteria for ADD are listed below, with the parts that would be crippling for a physician in any specialty highlighted. You don't get to make up mental illnesses and then claim that they boost your clinical acumen.

-often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
-often has difficulty sustaining attention in tasks or play activities
-often does not seem to listen when spoken to directly
-often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (no if oppositional behavior or doesn’t understand instructions)
-often has difficulty organizing tasks and activities
-often avoids, dislikes, or is reluctant to engage in tasks or activities that require sustained mental effort (such as schoolwork or homework)
-often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
-often easily distracted by extraneous stimuli
-often forgetful in daily activities

There are no "good" EM people who are "very ADD." There are good EM people who have a wide variety of interests, like to see a variety of cases, are able to work fast, and like to joke that they have ADD.

It's scary that half of these traits applies to me...
 
Everything in life becomes repetitive. You doing things so many time you can do them in your sleep and that's what makes you the expert.
 
I think the ADD traits could definitely make one better at certain types of medicine. And I'm not referring to the "traits" listed above (which everyone struggles with at some point in their lives, before learning how to be organized). I'm thinking about the hunter/farmer hypothesis which says basically that ADD trait individuals are todays hunters - able to hyperfocus. Farmers are the rest, more suited to long term planning and maintenance of the nest. Who would be better at running a code? Managing lifetime health?
 
I think the ADD traits could definitely make one better at certain types of medicine. And I'm not referring to the "traits" listed above (which everyone struggles with at some point in their lives, before learning how to be organized). I'm thinking about the hunter/farmer hypothesis which says basically that ADD trait individuals are todays hunters - able to hyperfocus. Farmers are the rest, more suited to long term planning and maintenance of the nest. Who would be better at running a code? Managing lifetime health?

1. The traits listed above are the definition of ADD. What disease are you talking about? What traits does it have?

2. Explain how "attention deficit" leads to "hyperfocus."
 
I've heard about Hyper-ALERTNESS in a theory about the evolutionary explanation of ADHD.

It basically says that in the cavemen days if two cavemen were working on a task and a predator approached, the more hyper-alert (ADHD) caveman survived because he noticed the predator and the less ADHD caveman died because he was too focused on the task at hand.

this assumes that ADHD runs on a continuum, which seems to be supported by research.
 
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