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Military Pathology

Discussion in 'Pathology' started by DrBloodmoney, Oct 17, 2002.

  1. DrBloodmoney

    DrBloodmoney Pathology
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    Hi, I am new to this forum. I am a MSIII who is interested in path. I also have a military commitment to the Army when I am finished with school.
    Can anyone tell me about the caliber of training at the 3 army programs? What has been your experience? How difficult would the transistion to a civilian fellowship be? Thanks in advance, Scott
     
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  3. GreatPumpkin

    GreatPumpkin Mystical Treatbringer
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    Welcome to the group.

    I do not know much about the military training in pathology. The AFIP has a great reputation as does Walter Reed so if either is one of the choices for your residency I don't think you will have any problems. The patient population will be a little different than some places, but should be no big deal. And, you should have no real problems with getting a fellowship depending on your choice. Derm path will be very tough no matter where you get training. Cyto and heme are competitive as well but nothing like Derm.

    I don't think anyone I have seen here has military path experience. So maybe you can tell us yours in a couple of years. I am sure training will be tougher just because you have on top of your normal residency requirements, normal military duties and problems.

    Good luck.
     
  4. Hrothgar

    Hrothgar Junior Member

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    hi,
    I'm a MSIV on the Army scholarship. Over the last two months, I have rotated through the Dept's of Pathology at both Walter Reed and Madigan. Both programs are excellent and appear to be a great deal better than most civilian programs (i.e., more staff and resident one-on-one training, and most residents scoring above the 90th percentile on inservice tests.) Walter Reed is getting a brand new pathology ward next year and the training there is great. On the other hand D.C. is a less than optimal place to live for most people. Madigan is in a great location with excellent staff and good teaching.
    The third Army program, Brooke, is notorious for sucking. I wouldn't go there if I could avoid it.
    As far as fellowships go, you will probably wind up doing yours in the Army (unless you want to do forensics, which is for now a deferred fellowship). Dermatopathology is only offered to path residents every other year, rotating with the derm residents. The current trend is to do your first two years of pay back as a general pathologist, and then go to the AFIP for fellowship training if you want it. Otherwise, you can just do your fellowship in the civilian programs when you finish your payback time.
     
  5. DrBloodmoney

    DrBloodmoney Pathology
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    Thanks for your quick replies. It's too bad to hear that about Brooke; I was leaning more toward that facility based on geographic location, and the fact that my wife is a lawyer (and they are a dime a dozen in DC). At any rate, why does Brooke have such a poor reputation. I could understand that many people would prefer to work at AFIP instead.
     
  6. mrpeters714

    mrpeters714 Member
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    I don't know if you can do a residency in a Naval hospital, but the pathology residency at the Balboa Naval Hospital in San Diego is reputed to be excellent.

    -mrp
     
  7. DrBloodmoney

    DrBloodmoney Pathology
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    Hey, just thought I'd bump this up.

    I'm applying for path residencies in the Army. Walter Reed is my number one, so hopefully we'll hear good things in December.

    Any other military match people here?
     
  8. josara

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    I'm also a MS4 army hpsp. I rotated at BAMC, that's my first choice for family reasons. I did phone interviews at the other 2, so I can't really compare. The residents seemed happy. I've heard that about BAMC before but I don't know what it's about. December can't get here soon enough. Dr. Casey said he thought there were about 10 applicants for 5 spots. 2 of the 7 will probably go to interns. Dr. Adair said there were 3 interns so who knows. Either way they all said hpsp'ers would be deferred if we didn't get straight into path.
     
  9. GeoLeoX

    GeoLeoX Ancient
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    Well, it looks like a lot of us read this forum! I am a 4th year Army HPSP who rotated at both Madigan and Walter Reed. I have heard the same things about BAMC, but let's remember that things can change quickly in the military. Most of the staff turns over pretty quickly and it is likely that the people who make the residencies at MAMC and WRAMC great may not be there for much longer (hint). They are all solid programs with good reputations. The philosophies at MAMC and WRAMC are different, you'll have to look at both (I should also include BAMC) to see which is more your style.

    As far as spots go this year, this is what I have heard. 7 spots, likely 3 at WRAMC, 2 at MAMC, 2 at BAMC. There are 3 PGY-2 applicants and of them at least one (for joint domicile reasons) would like to be at MAMC. Since they have first dibs over us lowly medical students that leaves 4 spots for us to fight over (or do we have to fight?). The news that I get from Drs. Adair, Myers, and Casey is that it looks good for those of us interested in Army pathology.

    I hope this helps!

    G

    ps. I know that you all are talking about Dec, but the residency directors are actually meeting next week at WRAMC to decide our fates. Good luck!
     
  10. DrBloodmoney

    DrBloodmoney Pathology
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    After speaking with one of the residency directors this week, the new update is 12 medical students, 3 PGY-2 applicants for 7 spots. The interns are being sent one to a program, leaving 4 spots: 2 at WRAMC, 1 at BAMC, and 1 at MAMC.

    On the bright side it sounded likely that the 8 medical students who don't match in will all be deferred out (unless the student would like to do a transistional year).
     
  11. GeoLeoX

    GeoLeoX Ancient
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    dibs, Walter Reed. I called it first! Just kidding, usually it works out that there are some of us who are applying who would like to do a transitional year and some who would like to be deferred. There are very few who don't get some kind of satisfaction out of the whole thing.

    GeoLeoX
     
  12. pbp4

    pbp4 Member
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    for you guys who might get deferred- why do you think ERAS asks if you have a military committment after training ? i have may own thoughts but i am curious.

    -p
     
  13. GeoLeoX

    GeoLeoX Ancient
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    I don't know why ERAS asks for military commitment, nor do I know where that information would show up. We are told that it is wise to apply for civilian residencies in the event of a deferment (even if you would like to be in a military residency). I was very up front with each of the civilian programs that offered me an interview about my military obligation and they uniformly seemed like it was no big deal.

    As far as news for those of us in the Army Path pool, I heard today that the board selection results will be finalized just after Thanksgiving.

    Good luck!
     
  14. pbp4

    pbp4 Member
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    i cannot think of any reason that a program would need that information. i think you are wise being up front but you have no chioce in the matter due to ERAS.

    i am sure if a program offered you an interview it is no big deal to them. however, in the future, if path does become more popular, that info will only be used against you. as i think it is in other specialities.

    i am not military but i really think some of you military types ought to find out why they ask that question. as i said in path i think it is moot but i am certain in other specialities it does hurt people.

    -p
     
  15. Adrian Cocot

    Adrian Cocot Junior Member
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    I've heard about Navy and Army programs. Anyone know about the Air Force ones?

    ac
     
  16. GeoLeoX

    GeoLeoX Ancient
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    I think the only program is the joint Army/Air Force program in San Antonio (SAUSHEC for the acronymophile)
     
  17. Adrian Cocot

    Adrian Cocot Junior Member
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    I should have been more specific. I'm considering doing the FAP, and was looking for the post-residency Air Force billets, trying to find out which ones have decent path departments.

    ac
     
  18. GeoLeoX

    GeoLeoX Ancient
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    i pulled this post back up from the depths because it will be interesting to see where we land tomorrow when the match results are posted. good luck, more later.
     
  19. josara

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    Well, I got deferred. Congrats to the 4 who got selected. I guess I'll get to be anxious again in March.
     
  20. DrBloodmoney

    DrBloodmoney Pathology
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    I matched at WRAMC. At least the deferred folks don't have to worry about transistional year. I was sweating that this morning- thought I would have an unpleasant surprise waiting for me. Good luck in March josara.
     
  21. GeoLeoX

    GeoLeoX Ancient
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    josara:

    good luck in the match, I hope that you get to stay in TX (that was what you wanted, isn't it?)

    Geo
     
  22. Zerosixjt

    Zerosixjt Member
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    I'm bumping this forum to get some current info. Considering the ARMY scholarship and very interested in path.

    How are the 3 locations now?

    Research?

    Fellowship outlook?

    Thanks.
     
  23. GeoLeoX

    GeoLeoX Ancient
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    Now that's a bump - resurrecting an over 5 year old thread. I wonder how many of us involved in the initial postings are still alive.

    Anyhoo, some things have changed over the years - Brooke has become very desirable with greater case volume than either WRAMC or MAMC and much improved leadership/training. Both WRAMC and MAMC are still very highly regarded. Many changes are occurring at both WRAMC and BAMC in light of the BRAC - both programs will become even more robust. Research is still a little stale compared to academic programs, but I think that the tide is turning and the impetus for research is mounting as more junior staff infuse each program. The fellowship outlook is good, too. The number of military fellowships in path has dwindled to almost nothing (cyto and forensics). However, the number of positions offered for military-sponsored civilian fellowships has jumped to replace the military ones that closed. WRAMC is even making plans to resurrect the dermpath fellowship.

    Any specific questions you can drop me a PM or email.

    Hope it helps,
    G
     
  24. DrBloodmoney

    DrBloodmoney Pathology
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    Wow I don't even remember this thread.

    I agree with all of the above^

    By the time you would get close to an Army residency BRAC consolidation at BAMC and WRAMC (now WRNMC) will be complete. I view it as a very good thing for residents (at least at WRNMC - can't really speak about BAMC). Not having to move back and forth between hospitals and having a static desk for 4 years will be really great.
     
  25. Zerosixjt

    Zerosixjt Member
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    I know it has been a while, but I was actually hoping that someone from the original post was still around. Good to see that you are.

    What happens post-residency? Do you just get sent anywhere, or do you have some say in the location? Is it possible to stay at the residency location?
     
  26. DrBloodmoney

    DrBloodmoney Pathology
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    Both of us (GeoLeo) are actually staying at our residency location (WRAMC). The process is that they basically take an inventory of where they're going to need pathologists and then they solicit a list of places that people would like to go and try to match them up. Sometimes you get to go exactly where you want. But it's all based on where the Army needs a pathologist. Sometimes you get where you want, other times you won't. My experience is that people mostly get to where they want, but people do catch bad breaks and are forced to move somewhere they don't want, on occasion. The more time you put in, the chances of this happening increase of course.

    As far as hot sandy climates with nearby explosions, we've never had a pathologist in Afghanistan, and there is one in Baghdad. It's a 6 month deployment. So far, the spot has been filled purely with volunteers to go. But if nobody volunteers then your card could easily be pulled. But compared to other specialties we've got it extremely easy. The deployment percentage for the psych and peds folks is near 100% and it's usually 12-15 months.
     
  27. EMH

    EMH ARNG - MC
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    I found the perfect thread for me. I just finished my M1 year and am also considering the Army HPSP. Path and Rads are the two specialties that I am weighing and I am wanting to know if joining the military will hurt or help my chances of matching into two residencies that are already pretty competitive in the civilian world. What kind of stats do you need for Mil Path. I have no research but I suspect I will be otherwise competitive enough for the civilian world.
     
  28. josara

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    Wow, that was a walk down memory lane. Anyway, here's my update. I did AP/CP at UTMB in Galveston which I enjoyed. I tried to get another year deferment for civilian forensic path but they said no, to wait til after I am on active duty. So after residency, I am off the San Antonio for OBLC because I didn't get to do it in med school, then to the Germany to practice general pathology.
     
  29. dermpathdoc

    dermpathdoc DO Path
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    S0 where in germany??? and don't sweat it...The experiene will be really useful when you go back to private practice....
    Those pathologists i know who did Germany much prefered it over those who did Korea.
     
  30. josara

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    I will be at Lanstuhl Regional Medical Center which is near Ramstein AFB and really close to border between France and Germany. My husband and I are very excited about getting to live in Europe for 3 years, we've never been. I am a little uneasy because I have not done a fellowship but everyone says it isn't a big deal. I am actually planning to do a forensic fellowship when I get done.
     
  31. maymoon32

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    So all of you guys that are residents, have you enjoyed military pathology?

    Is is super competitive to get a spot?

    Thanks!
     
  32. bogatyr

    bogatyr Senior Member
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    So who runs the labs and blood bank at the CSH? Not a pathologist?
     
  33. DrBloodmoney

    DrBloodmoney Pathology
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    Armed Services Blood Program does the blood. We run the lab in Baghdad. I don't know who does it in Afghanistan (I suspect it's the Air Force since they run Bagram AFB and that's the big show over there).
     
  34. djmd

    djmd an Antediluvian
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    Most likely Air Force. They were running that airlift hospital program for Afghanistan.
     
  35. JNS

    JNS

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    Do any of the army residency programs require a FYGME clinical year prior to entering the four year residency? I know WRAMC has in the past. If so, does this count as an internship year or as a transitional year?

    My understanding is that the internship would not acrue more ADO, but the transitional year would.

    Also, does anyone have stats from a recent army pathology match? Postions available, applicants per slot, etc.
     
  36. GeoLeoX

    GeoLeoX Ancient
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    There is no difference between an "internship" and a "transitional year", except that the transitional year is a type of internship. There are really no more "non-categorical" transitional year internships available in the Army, at least not at the bigger training hospitals. The Army only has "categorical" transitional years, that is you are training for a specific residency but you are in the same pool as the other transitional interns. There are some differences with surgery, though, but that's not germane to this topic.

    There is no clinical first year for the pathology residency and there hasn't been one for over 5 years. The first year (technically, the "intern" year) is simply the first of the four years of the residency. The way the Army works, residency counts toward the payback of your HPSP obligation. However, during your military residency you accrue another obligation. That's why if you have a three year HPSP scholarship and take a 4 year residency you end up owing 4 more years.

    The number of spots changes from year to year. Usually there are 3 for WRAMC, 3 for BAMC, and 2 for Madigan. However, like I said it changes. There are also civilian-deferred positions often available in pathology, though I can't say that I know much about the figures surrounding that.

    Hope it helps.

    Geo
     
  37. JNS

    JNS

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    Thanks Geo.

    I am in the process of applying for the HPSP 3 year scholarship. If selected, is there anything I can do to enhance my chances of getting a military residency in Pathology (other than doing as well as I can on Step 1 and my classes)?
     
  38. GeoLeoX

    GeoLeoX Ancient
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    For some reason the conventional wisdom is to get good grades, high Step 1 scores, letters of recommendation from pathologists, etc, etc. Let me tell you, however, the most important thing is to be normal and inquisitive. Someone with straight As, 250+ Step 1, and the like won't impress anyone if they can't carry on a conversation or show an interest in learning pathology and the potential for success.

    Do a rotation or two at the sites that you are interested in, be involved (but not creepily overinvolved), do a little reading, etc. And please, be able to carry on a conversation.

    Good luck,
    Geo
     
  39. Gene_

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    I completely agree.
     
  40. ArmPath

    2+ Year Member

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    New to the forum, excited to possibly have a big question answered. Currently, I am a second year AP/CP resident in a civilian program on deferrment with a three year Army HPSP obligation. I have accepted the fact that fellowship aspirations will likely have to wait until my active duty time is up.

    However, one question remains. At what point during fourth year does the Army notify where you will be stationed? (ie. January, March, May, etc.) My wife is a second year medical student who will be going through residency match at that time, and we are hoping to correlate her rank list with my station location. Thanks so much for your insight.
     
  41. GeoLeoX

    GeoLeoX Ancient
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    You don't have to give up on fellowship aspirations. The Army needs fellowship-trained pathologists, too. It just depends if you want to incur an additional service obligation (and MUCH better pay) to do your fellowship while in the Army.

    It's a moving target. The selection board for residencies/fellowships meets in mid/late November and publishes its results in mid-December. The consultant (the person who is most responsible for placing people) must put in their staffing list shortly thereafter. Since it depends on who's leaving, who's coming in, etc. it is a moving target. I can tell you, however, that it is settled for the most part by this time of year and most of the 4th year residents know where they will be in June. I think that it's fair to say that with 90% certainty that you will know where you will be by early March (about 4 months out). You may know even earlier and may be able to match up your wife's ROL w/ your station.

    If you have any other questions feel free to PM me.
     
  42. ArmPath

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    Geo,

    Thanks for the rapid response. Having read through this thread a few times, I was hoping you would be willing to share your experiences (you seem to know the Army pathology training system well). You certainly have more insight than my Army GME contact. However, you may have opened a can of worms with your offer to answer additional questions. I'll put a few of the bigger ones together and shoot you a PM. Thanks again.
     
  43. DrBloodmoney

    DrBloodmoney Pathology
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    Army GME is near-useless in this situation (to say nothing of other instances either...). You definetly need to get in touch with the consultant. She is currently deployed to Iraq and isn't going to be back until ~August. She will probably still be the consultant when you are getting ready to get out of residency.

    This year our fourth-year residents had more-or-less verbal confirmation of where they were going by late January. Their RFO (requests for orders) came out the last week of February. It basically takes an act of Congress to get those changed.
     
  44. dermpathdoc

    dermpathdoc DO Path
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    Josara,
    Landstuhl is a plum posting.. It is a regional medical center and fairly busy, but you have the central european location for traveling...also you get a range of specimens from those encountered in a midsized community hospital to the exotic infectious disorders from Iraq and afghanistan....your dermpath skills should be enhanced considerably.
    Have fun!!
     
    #43 dermpathdoc, Mar 6, 2009
    Last edited: Mar 6, 2009
  45. Microdoc

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    My fellow pathologists and I have recently been informed that a fellow pathologist may (probably) be deployed as a Medical Consultant to some sort of sustainment brigade for 1 year, ie a non-Pathology job. That unfortunate pathologist is one of us that has to get recertified by the ABP (every 10 years all of the pathologists passing the boards in 2006 or later have to retake some kind of board exam-pathologists who passed the boards prior to that do not have to recertify).

    The above pathologist will be sent to a non-pathology job where he will not look at a slide for 1 year. This is creating a panic among fellow pathologists who are trying to improve their diagnostic skills in their early careers.

    These actions by higher ups are apparently to appease physicians in other specialties who have been deployed 3, 4, 5 times. Unfortunately ruining careers of young pathologists will do nothing to appease the surgeon who has been deployed 3 years of 6 or the cardiothoracic surgeon who was deployed to Iraq as a GMO. This is just the usual- big wigs caving in to pressure instead of protecting their people.

    If anyone else has heard news like this, please respond via the real grapevine (Phone a friend). This is just bogus!- we have been sold out by our specialty.
     
  46. GeoLeoX

    GeoLeoX Ancient
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    I can't say that I am surprised. I have heard the consultant on more than one occasion state that we are probably the best-suited for admin work due to our background training (however little of it we get) in laboratory administration. I don't know why this isn't a MSC position, if CAP is okay with it why shouldn't the military. Besides, MSC officers stand to benefit more from a career standpoint in a deployment than a MC officer.

    I knew this was coming, but it is particularly distressing that junior officers are being tasked. As you mentioned it's a potential career killer, not to mention a sure means of increasing attrition.

    oh, well. As we always say when bad things happen, "at least we're not the Navy".
     
  47. caribstud

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    MicroDoc, any update on this pathologist???
     
  48. Microdoc

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    The latest is that 2 unfortunate staff pathologists in a southern MEDDAC will be splitting this tour (6 mos each). First however they each must do 1 month rotations in the Internal Med or Family Med Clinic as they will be expected to see patients while they are serving as admin officers. This is real great patient care. You take doctors who have not seen patients since they were interns (roughly 8 years ago), give them a one month refresher course in how to be a clinician, and then expect them to treat patients. Sounds great to me. I would argue that they should not be credentialled to see patients in these clinics at this MEDDAC. It sounds like a great lawsuit just begging to be filed- malpractice due to forced transfer into a specialty I was untrained for. The saga continues.
     
  49. EMH

    EMH ARNG - MC
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    Do you know these guys? I'm curious what their attitude is about this.
     
  50. GeoLeoX

    GeoLeoX Ancient
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    To lay this one to rest - no pathologists are being deployed for this position. At first it came to the MEDDAC of question that they needed to provide a brigade surgeon and it was thought that it would be primarily administrative. When it became clear that there is not enough administrative work and that the position would entail some clinical work. A phone call from the consultant cleared the whole thing up. The only positions at this time for which pathologists are deployable are the single pathology 6 month deployment to Ibn Sina, which for years has been volunteer-only. For LTC/COL there is a risk of a DCCS deployment, but that is rare. Nothing for junior officers. Take a breath. This info comes from the top.
     
  51. PathMd

    PathMd PathMd

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    Thanks for clarifying this. I have followed this thread peripherally for the last few days and was concerned myself about what's been going on.
     

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