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NPs can now do dermatology residencies
- Thread starter exPCM
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Anyone's who is saying mid-levels won't enter X field is just in denial. Like someone said earlier, it's the uber competitive, weird mindset that makes you feel special and think it's cool if the rest of docs are suffering, as long as you're fine.
I guarantee a few years ago, there were derms who would laugh at the prospect of their job being practiced by a NP ... enter Dr Shelby and her USF derm nursing residency program. Spend the effort trying to find a solution, not convince everyone your desired field will make it out alive, because if the problem isn't handled, there's absolutely no guarantee that it will.
I guarantee a few years ago, there were derms who would laugh at the prospect of their job being practiced by a NP ... enter Dr Shelby and her USF derm nursing residency program. Spend the effort trying to find a solution, not convince everyone your desired field will make it out alive, because if the problem isn't handled, there's absolutely no guarantee that it will.
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A thread in the Emergency Med forums lead me to this; it appears that USF's nursing programs won't stop at derm.
http://health.usf.edu/nocms/nursing/AdmissionsPrograms/dnp_concentrations.html
http://health.usf.edu/nocms/nursing/AdmissionsPrograms/dnp_concentrations.html
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Rabbit Hole ...
I'm having issues with a few emails. I can't get the contact page on the AOA site to work, and I can't find an email for the Florida Medical Association. Also, do you know, specifically, who we should email at the Florida Medical Board??
I'm having issues with a few emails. I can't get the contact page on the AOA site to work, and I can't find an email for the Florida Medical Association. Also, do you know, specifically, who we should email at the Florida Medical Board??
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Gimme a break dude. You know absolute nothing about me. Even if I was going into family medicine I would have said all the same things I've said above. You're just making personal attacks because I have a dissenting opinion - which is pretty sad. The funny thing is that I even stated that I don't wish for the mid-levels to be able expand their practice yet you seem to be harping on it like as if I've said the complete opposite. I can't help it that I'm interested in a field that I coincidentally don't believe will be affected by midlevels the same way as the rest. I guess I'm just lucky that I have no interest in going into derm or anesthesia. You need to get your emotions under control or I can promise you that you won't be able to solve anything.
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LOL, dude, there is absolutely no reason for us to bicker. It's foolish to assume your desired field is safe. Every single medical student right now wants to think their field is safe, every single person is thinking 'I guess I'm just lucky I have no interest going into ..., and 'I don't believe X field will be affected by midlevels.' You can bash on my 'emotions' or attack me however you like, but I really think the fact that you maybe see some small sliver of truth in what I'm saying bothers you more than my attitude.
My objective is pretty simple here ... we really shouldn't assume any field is safe, and we should simply stand up for physicians, not surgeons, or family practitioners, or dermatologist, etc ... just physicians.
If you disagree with that, then we really don't see eye to eye. However, if you think I'm being too reactionary, etc, then I have no real desire to argue with you.
Your whole argument was that you didnt care because 1. family practice is not a specialty your interested in and 2. you dont think that nurses can get into surgery.
so no, you would not be saying the same thing if you were interested in FP.
The other reason people are jumping down your throat is that all you say is that it wont happen to surgery, well thats what everyone thought about anesthesia and derm and clearly its happening. There a precedent, people had your attitude and look where it got them.
And even if it was impossible for them to get into surgery, which it isnt, wouldnt you want to help your friends who are interested in other fields? Dont you want to help keep the quality of medicine high?
Its not that you have a dissenting opinion its that your opinion is baseless and quite contrary to precedent.
This situation always reminds me of this story:
"THEY CAME FIRST for the Communists,
and I didn't speak up because I wasn't a Communist.
THEN THEY CAME for the Jews,
and I didn't speak up because I wasn't a Jew.
THEN THEY CAME for the trade unionists,
and I didn't speak up because I wasn't a trade unionist.
THEN THEY CAME for the Catholics,
and I didn't speak up because I was a Protestant.
THEN THEY CAME for me
and by that time no one was left to speak up."
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The contact page for AOA seems to be working fine for me. Here it is again, let me know if it works: contact
I didn't see an email for Florida Medical Association either.. it has a phone number listed on the contact page (Our toll-free number is 800.762.0233. You may also contact us at 850.224.6496.) I typed in "email" in the search portion of the website but it gave me a lot of results.. I wasn't sure which one to go for. Maybe you can call it and ask for an email address.
Florida Board of Medicine - maybe try (couldn't hurt anyway):
Department of Health Feedback
Medical Quality Assurance/Licensure Information
Deputy Secretary of Advocacy and Policy
Medical Quality Assurance
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why would you need the contact information for AOA?? I mean, most derm residents are AOA, but all my chapter does is invite speakers, elect new candidates (hah! the next derm candidates who need AOA for their future residency...) and largely unimportant stuff like that. I doubt the national organization can help.
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AOA = American Osteopathic Association, the organization that oversees DO schools, physicians, etc.
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Duh, I feel ******ed... I was thinking Alpha Omega Alpha. I guess does every DO candidate who applies to residency check of "AOA" then?? 😉
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Remember that phone calls and snail mail are worth a little "more" than email in terms of how many people they theoretically represent to politicians! =)
Holy cow.. if that isn't the biggest sign of what the nurses are doing, I don't know what is!
"Doctor of Cardiovascular Studies" (nurse)
"Doctor of Emergency Medicine" (nurse)
gah!
Holy cow.. if that isn't the biggest sign of what the nurses are doing, I don't know what is!
"Doctor of Cardiovascular Studies" (nurse)
"Doctor of Emergency Medicine" (nurse)
gah!
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Some more video footage that will make you barf
http://www.fox2now.com/news/morningshow/ktvi-nurses-acting-doctors-healthcare-041910,0,870525.story
Gotta love when she states that nurses have the right to be called doctor because they took the necessary "doctoral" coursework. 😱
http://www.fox2now.com/news/morningshow/ktvi-nurses-acting-doctors-healthcare-041910,0,870525.story
Gotta love when she states that nurses have the right to be called doctor because they took the necessary "doctoral" coursework. 😱
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Excellent! I think we should also email all medical societies.
scary shi-t!!!!! And who's going to cover the nursing shortage? MA's? TA's? are we going to call them nurse then?
Very Scary!!!
When a nurse can use the words doctor and board certified as this lady did in the darmatology residency program for half prepare/educated "doctors" then you know we are loosing this war by alot. And its fu-cking scary!!!!
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I have sent emails to the Amercian Dermatology Association (the physician one), the PD of the dermatology residency at USF (again, the physician one) and AMA (not that im expecting them to do anything).
what have you people done? and I ask to see if im missing any other association, person etc that I need to contact. Thanks
what have you people done? and I ask to see if im missing any other association, person etc that I need to contact. Thanks
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I haven't heard back from the AMA or the AAD, but I got a very nice email this morning from the president of the AOCD (American Osteopathic College of Derm) who is forwarding my email to a few departments within the AOCD.
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nice!!
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I emailed ACS, AAFP, ACP, ASA, AMA, AAD....and told them that its time for physicians to unite and that it would be foolish to think that some specialties are isolated.
The nurses have been deceitful all along. First primary care now everything.
No replies from anyone yet
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It feels awesome (sarcasm) that my 3 USMLE's, 3 year residency training with 75-80 hours week for 48 weeks of the year (take out vacation) and now upcoming board certification are not enough and that now I will have to compete with a half prepare/educated not USLME/not board certified nurse who thinks he/she's the same as a physician.
I dont know how the hell the AMA, ACP, all the other organizations are not doing more to really attack this problem. But as long as we keep paying the fees etc they are happy!!!
I dont know how the hell the AMA, ACP, all the other organizations are not doing more to really attack this problem. But as long as we keep paying the fees etc they are happy!!!
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Hello,
My name is Jeff & next month I'll graduate from a family NP program. I wanted to respond to some of the comments in this thread. For clarification, nurses do not go to work or school wondering how they can usurp physicians. You complain about physicians not uniting against nurses, but believe it or not, conspiracy theories don't work in the nursing world - it's difficult for nurses to unite as well. Currently, I'd like to be involved in a government-funded residency program, just like physicians, dentists and podiatrists, but none are readily available. Clinicians like me, that study hard and want to develop expertise, are looking for something to complement our existing didactic and clinical education. I don't want to go through a residency just so I can confuse patients into thinking I'm a physician - I like nursing & I believe NPs, like any other profession, can develop autonomy, competence & expertise. Rather, a residency is tantalizing to me because it will augment my knowledge base and make me a more competitive candidate.
I'd like to highlight the DO profession, as others have hinted at earlier in this forum. Ideologically, they have their own perspective on medicine & the delivery of care. They have their own boards, the COMLEX, but can take the USMLEs if they wish (though their first-time pass-rate is lower than allopathic physicians). These providers have fought for recognition as competent providers and as a legitimate profession (the AMA at one time held the opinion it was unethical for MDs to teach in DO schools). Similarly, NPs subscribe to their own school of thought regarding how care should be provided, & we have our own boards-certifying process & test.
I'm sure my post will receive responses akin to a gatling gun, but my take-home message is that we are not part of a conspiracy. We are individuals with training, experiences, background and competence. We have statistically shown we provide safe and effective care (as can be found in the AMAs "Scope of Practice Data Series: Nurse Practitioners" - their lit review provides a plethora of data showing that NPs are competent and effective).
Furthermore, be careful for what some of you wish for. Some have suggested NPs should be required to take the USMLEs - there are those of us who are very competitive & would welcome the challenge, so long as the rewards are similar. Demand that I take your boards, then let me attend your residencies. If NPs are required to take the USMLEs (as opposed to the voluntary watered-down step 3 last year), then we'll have even more right to demand compulsory equivalence, just as DOs have successfully done.
Only as a point of interest, for the sake of argument, I'd like to point out the job prospects for NPs in my area: dermatology, family practice, sleep medicine, emergency medicine, neurology - all in physician or hospital owned facilities. A residency would obviously make me competitive for any of these positions.
My name is Jeff & next month I'll graduate from a family NP program. I wanted to respond to some of the comments in this thread. For clarification, nurses do not go to work or school wondering how they can usurp physicians. You complain about physicians not uniting against nurses, but believe it or not, conspiracy theories don't work in the nursing world - it's difficult for nurses to unite as well. Currently, I'd like to be involved in a government-funded residency program, just like physicians, dentists and podiatrists, but none are readily available. Clinicians like me, that study hard and want to develop expertise, are looking for something to complement our existing didactic and clinical education. I don't want to go through a residency just so I can confuse patients into thinking I'm a physician - I like nursing & I believe NPs, like any other profession, can develop autonomy, competence & expertise. Rather, a residency is tantalizing to me because it will augment my knowledge base and make me a more competitive candidate.
I'd like to highlight the DO profession, as others have hinted at earlier in this forum. Ideologically, they have their own perspective on medicine & the delivery of care. They have their own boards, the COMLEX, but can take the USMLEs if they wish (though their first-time pass-rate is lower than allopathic physicians). These providers have fought for recognition as competent providers and as a legitimate profession (the AMA at one time held the opinion it was unethical for MDs to teach in DO schools). Similarly, NPs subscribe to their own school of thought regarding how care should be provided, & we have our own boards-certifying process & test.
I'm sure my post will receive responses akin to a gatling gun, but my take-home message is that we are not part of a conspiracy. We are individuals with training, experiences, background and competence. We have statistically shown we provide safe and effective care (as can be found in the AMAs "Scope of Practice Data Series: Nurse Practitioners" - their lit review provides a plethora of data showing that NPs are competent and effective).
Furthermore, be careful for what some of you wish for. Some have suggested NPs should be required to take the USMLEs - there are those of us who are very competitive & would welcome the challenge, so long as the rewards are similar. Demand that I take your boards, then let me attend your residencies. If NPs are required to take the USMLEs (as opposed to the voluntary watered-down step 3 last year), then we'll have even more right to demand compulsory equivalence, just as DOs have successfully done.
Only as a point of interest, for the sake of argument, I'd like to point out the job prospects for NPs in my area: dermatology, family practice, sleep medicine, emergency medicine, neurology - all in physician or hospital owned facilities. A residency would obviously make me competitive for any of these positions.
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Under two conditions, this is reasonable:
1. That (D)NP's take and pass the SAME boards as physicians.
and
2. That (D)NP's attend the SAME residencies as physicians.
Until then, autonomy is not warranted. Physicians are hardly able to keep their OWN autonomy right now.
mooneclipsesun, you mention to let nurse take usmle and get board certification if you go to our residency then why wont you attend medical school and then apply with the other 30,000 aplicants for a residency spot. Is very easy to bypass medical school and think that it can be replace with nursing school? we are not asking nurses to take the usmle, board certification in order to practice as equal because we wont allow it, nurses didnt go to med school. TWO very different schools with two very different objectives.
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Absolutely! What's fair is fair. You take our boards and pass them and I will be the first one to support your right to compulsory equivalence.
Until then, if you want to play doctor. Go to medical school!
DOs are real doctors, they learn pretty much the same stuff.
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So take a que from the D.O.s have nursing school as long as medical school, have them take the same boards and then do the same residencies. The reasons DOs are now thought of as equal is because they their educational training matches that of MDs they didnt try the end run around of legislation over education.
I dont understand why NPs should be held to a lesser standard for independent practice if, as your organization claims, you are equal to physicians. And 1000 hours of clinical experience should not be called a residency.
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Wow ... just wow. A few things:
1. Catch phrases like 'augment my training,' 'more opportunities,' etc, are the foot in the door that has been used to get us into these situations. Frankly, you may have the best intentions in the world, but the people who want all the rewards with none of the work, say the exact same thing.
2. Sit for the USMLE or COMLEX. Please, do ... see what happens. As you mentioned before, 50% of NPs failed a watered down version of USMLE Step III - a test that 95% of interns passed on their first try. This mentality of how competent you are and how you can do anything physicians can is seriously what leads to the attitude that you should be able to practice independently and complete dermatology residencies.
What makes you feel this way??? I'm curious. Your quip about DOs tells me you're extremely unfamiliar with medical school curriculum, so I'm curious as to why you think that you would be equipped to take and pass the Steps????
3. Your example with DOs doesn't work. DOs started in outer space, and through years of molding their curriculum so that it was (for all intents and purposes) identical to that of MDs, they were able to take the same tests, complete the same residencies, and practice in the same manner.
If you want this ... two options: 1. Go to medical school, MD or DO. 2. Make the DNP curriculum identical to that of MD/DO, get a body to approve new schools, figure out appropriate rotations, pass the Steps, apply for residency, spend 3-7 years in a residency, then practice like a doctor.
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hey jeff you have an inflated self worth. You are a nurse and thats all you are. A nurse with a little bit of specialized knowledge. DO's are physicians. Nurse practicioners are NOT. I dont care how many DOCTORates they have. They are NOT PHYSICIANS. DOs have a college degree with a pure science backround. they took the mcats and their schools are pretty much the same. they DO have their own boards only because of the manipulation. You dont know what you are talking about and you are insulting the osteopaths. Im not an osteopath and im insulted.
And here-in lies the problem. The PA's, a well-respected physician devised their scope of practice and their educational methodology. For NP's, they are the ones that decided that they deserve more autonomy, and they are the ones that decided on how to certify and accredit their additional training.
I was curious about this, so I googled this document and looked it over briefly. Perhaps others are better equipped to comment on this.
http://www.aanp.org/AANPCMS2/publicpages/08-0424%20SOP%20Nurse%20Revised%2010-09.pdf
This "plethora of data" is either subjective data (eg "patient satisfaction") or of questionable relevance (eg "resource utilization"). They were invariably of short duration (all were <1 year). From my (admittedly cursory) reading of the abstracts, only one of the cited studies looks at independent nurse practioners compared to attending physicians. Several of them compare nurse practioners to PAs and resident physicians. In fact, the AACN apparently was so upset at the "bias" of the cited studies that it felt compelled to circulate a letter of condemnation -- which directly contradicts your assertion that this lit review "provides a plethora of data"..
Anyone can study to pass a test... and yet, your cohorts couldn't manage to pass a simplified step 3 -- one that the DNP proponents deliberately misconstrued as "comparable" to Step 3.
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I'm not being sarcastic when I express my gratitude that some here are willing to acknowledge the USMLEs as standards for competence, and that if NPs passed these tests, then they could claim that standard and be eligible for GME-funded residencies.
To Saga1:
"I'm a Caribbean medical student, probably the 2nd most hated and betlittled group after NPs and I find your comparison between NPs and DOs extremely insulting. DOs are real doctors, they learn pretty much the same **** except OMM. You cannot even begin to make the comparison between NPs and DOs. A NP is NOT a doctor, forget the whole 'school of thought' difference, the knowledge base is not even close to being equivalent to what MDs and DOs have"
This is interesting - many in this forum have been eager to point out NPs lack the same level of training as physicians. In response, we develop a doctoral program and expand our clinical hours. Rather than recognize this as a legitimate move in the right direction, Saga1, instead you belittle my profession while knowing very little of our curriculum and the steps we are taking to improve it. Additionally, if DOs are equivalent to MDs, then why do they perform poorer on the USMLEs? Perhaps I should have compared IMGs with their MBBS degrees instead. But they also perform poorer than US trained allopathic physicians on the USMLEs.
Dr Oops,
As I mentioned above, NPs are working to expand and improve their educational standards (despite the ironic criticism of our physician peers). Furthermore, I agree with you - it's difficult to believe 1000 hours of clinical time is equivalent to a residency, rather, I agree it should be much longer, and funded through the GME.
To mig26x,
It would be a poor move for me to disregard my previous training as a nurse, as well as all the incredible and valuable experiences I've had. Rather than invalidate nursing as a credible, knowledgeable profession, the far more logical approach would be to seek an avenue that expands on the professional opportunities I've had. Ultimately, there are NPs that excel above others - those who are able to stick to their ideals & reach their goals, and there are those whose performance is lackluster at best. I've had the pleasure and misfortune of working with physicians who were just the same. Those who leave everyone around them glowing in awe, and those that force others' eyes to the heavens, making them wonder how this person ever got through undergrad, let alone med school.
To Saga1:
"I'm a Caribbean medical student, probably the 2nd most hated and betlittled group after NPs and I find your comparison between NPs and DOs extremely insulting. DOs are real doctors, they learn pretty much the same **** except OMM. You cannot even begin to make the comparison between NPs and DOs. A NP is NOT a doctor, forget the whole 'school of thought' difference, the knowledge base is not even close to being equivalent to what MDs and DOs have"
This is interesting - many in this forum have been eager to point out NPs lack the same level of training as physicians. In response, we develop a doctoral program and expand our clinical hours. Rather than recognize this as a legitimate move in the right direction, Saga1, instead you belittle my profession while knowing very little of our curriculum and the steps we are taking to improve it. Additionally, if DOs are equivalent to MDs, then why do they perform poorer on the USMLEs? Perhaps I should have compared IMGs with their MBBS degrees instead. But they also perform poorer than US trained allopathic physicians on the USMLEs.
Dr Oops,
As I mentioned above, NPs are working to expand and improve their educational standards (despite the ironic criticism of our physician peers). Furthermore, I agree with you - it's difficult to believe 1000 hours of clinical time is equivalent to a residency, rather, I agree it should be much longer, and funded through the GME.
To mig26x,
It would be a poor move for me to disregard my previous training as a nurse, as well as all the incredible and valuable experiences I've had. Rather than invalidate nursing as a credible, knowledgeable profession, the far more logical approach would be to seek an avenue that expands on the professional opportunities I've had. Ultimately, there are NPs that excel above others - those who are able to stick to their ideals & reach their goals, and there are those whose performance is lackluster at best. I've had the pleasure and misfortune of working with physicians who were just the same. Those who leave everyone around them glowing in awe, and those that force others' eyes to the heavens, making them wonder how this person ever got through undergrad, let alone med school.
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Nope??? I put in all the info, type a short message, hit 'send' and nothing happens. I'm going to try it in internet explorer really fast.
Nope - absolutely doesn't work. Wow this is frustrating the hell out of me. I hit submit and just nothing happens. adslfkjalsdkfjladskfj
D
deleted87716
Pass all three steps of the USMLE, and maybe I'll be impressed.
Nobody even studies for Step III. Puh-leez...
Nobody even studies for Step III. Puh-leez...
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Because I'm such a nice gal, I won't even require that DNPs or other such charlatans posing as docs pass all three steps.
For me, all it would take is that you pay the same amount in malpractice insurance premiums as the docs whose practices you so covet.
Oh wait, maybe yours should be higher because you do pose a significantly greater risk to an insurer.
For me, all it would take is that you pay the same amount in malpractice insurance premiums as the docs whose practices you so covet.
Oh wait, maybe yours should be higher because you do pose a significantly greater risk to an insurer.
nicely said!!!
*sigh*
To be eligible for GME-funded residencies, you have to:
1- Pass Step 1, Step 2CK, and Step2CS.
2- You have to complete a 2-year basic science curriculum.
3- You have to complete a 2-year clinical curriculum with exposure to a variety of medical specialties. You are supervised and evaluated at every turn.
It's not just the USMLE, my friend.
To get an MD degree, you have to go to 4 years of medical school. To get a DO degree, you have go to 4 years of medical school. To get an MBBS degree, you have to go to 6 years of combined college and medical school.
You are operating under the fallacy that entry into the medical profession is defined by the USMLE. It is not. USMLE score is not equivalent to performance as a physician, no more than the MCATs can be equated to performance in medical school.
Ah, the GME - Do you realize what the "M" stands for?
If you want to have the training, opportunities, and experience of a physician, there is way for you to achieve this- go to medical school.
Don't think that going on FOX News and making up claims that your NP training makes you just as qualified as a residency-trained physician.
To be eligible for GME-funded residencies, you have to:
1- Pass Step 1, Step 2CK, and Step2CS.
2- You have to complete a 2-year basic science curriculum.
3- You have to complete a 2-year clinical curriculum with exposure to a variety of medical specialties. You are supervised and evaluated at every turn.
It's not just the USMLE, my friend.
To get an MD degree, you have to go to 4 years of medical school. To get a DO degree, you have go to 4 years of medical school. To get an MBBS degree, you have to go to 6 years of combined college and medical school.
You are operating under the fallacy that entry into the medical profession is defined by the USMLE. It is not. USMLE score is not equivalent to performance as a physician, no more than the MCATs can be equated to performance in medical school.
Ah, the GME - Do you realize what the "M" stands for?
If you want to have the training, opportunities, and experience of a physician, there is way for you to achieve this- go to medical school.
Don't think that going on FOX News and making up claims that your NP training makes you just as qualified as a residency-trained physician.
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Totally agree. I worked with very well-respected NPs with over 10 years experience as NPs during my third year rotations... and they were asking me about pathophysiology of disease because they truly didn't understand it. And not complex matters - but run of the mill stuff they were seeing every day and for which they were manipulating medications. I was truly truly frightened for the patients.
As for the 1000 clinical hours - any third year med student completes that in four months. Ridiculous to even think about calling that a "residency".
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If there were troubles passing a watered down version of Step 3, I shudder in horror at the bloodshed that would ensue from attempting to take the board exams of each individual specialty. "Be careful what you wish for" is absolutely right, those derm boards are no laughing matter.
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You are not qualified to make that assessment. You don't know what you don't know.
The lay public may think that your nursing experience is valuable, but physicians are not so easily mislead.
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http://health.blogs.foxnews.com/2010/04/15/nurses-masquerading-as-doctors/
Slightly lowered my blood pressure (the article, not the comments)
Slightly lowered my blood pressure (the article, not the comments)
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Okay I see what you mean.
Take a look here: DO-Online.org
Some of the email addresses you can email according to that site:
Advocates for the AOA
[email protected]
Board Certification
[email protected]
Credentialing, Fraud & Abuse, and Legal Issues
[email protected]
Division of Student, Intern, Resident and Member Affairs
[email protected]
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Also, I'd like to thank all of you who are being proactive. Any of you who can take the time to send an email it makes all the difference.
Thanks especially to JaggerPlate for putting together that impressive email so that people can use it as an example.
I'll be MIA for a little while because I have a big quiz (usmle) coming up but keep on going guys. This is very encouraging. PM if you need anything.. I'll be checking back sporadically. 🙂
Thanks especially to JaggerPlate for putting together that impressive email so that people can use it as an example.
I'll be MIA for a little while because I have a big quiz (usmle) coming up but keep on going guys. This is very encouraging. PM if you need anything.. I'll be checking back sporadically. 🙂
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Aren't there DNP programs that offer ONLINE education? Perhaps DNP programs don't get respect because they use non-traditional media.
I was a paramedic before medical school, but I wouldn't dare petition the medical school to give me credit for prior experience. Likewise, DNP programs should be 4-year programs regardless of prior nursing experience if they want to eventually earn respect that they are on equal footing as physicians.
If I wanted to be a lawyer, I'd go to law school. If I wanted to be an engineer, I'd go to engineering school. If I wanted to be an accountant, I'd go to business school. If I wanted to be an epidemiologist, I'd go to public health school. Likewise, if people want to be a physician, they should go to medical school.
