Reporting a classmate?

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Boy it would look silly if you try to report this and it turns out their lazy evaluator just told them "you're great write yourself a generous eval and submit it"

People even write their own letters of rec sometimes now, let alone an eval rotation slip...completely different than seeing someone clearly cheating or falsifying records imho

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That is right. We protect patients by taking the COMLEX PE exam.
Oh, but wait, NPs, PAs, and CRNAs never take a COMLEX PE exam or any similar PE board exam.
So how exactly is the public being protected?
Since NPs, PAs, and CRNAs are not killing people at a sky-high rate, then just maybe the PE exam is unnecessary.
You’re all over the place, stay on topic
 
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That is right. We protect patients by taking the COMLEX PE exam.
Oh, but wait, NPs, PAs, and CRNAs never take a COMLEX PE exam or any similar PE board exam.
So how exactly is the public being protected?
Since NPs, PAs, and CRNAs are not killing people at a sky-high rate, then just maybe the PE exam is unnecessary.
Whataboutisms are not a defense of the actions reported by the OP.
 
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The undisputed facts are as follows. In June 2007 two young physicians commenced their residency training in general surgery at MHMH. (Doc. 138 ¶ 8.) Dr. Knapik and her colleague, who is identified as “Dr. Doe,” became friends in the early years of their training. Over time and as a result of several small slights and disputes, the friendship between the two women cooled. (Doc. 138–8 at 41.)

In February 2011, Dr. Samuel Finlayson, program director for the general surgery residency program, sent Dr. Doe a letter detailing serious concerns about her performance as a resident. (Doc. 138–3 at 31–32.) The letter urged her to address these shortcomings in order to complete the residency program on time. The letter expressed Dr. Finlayson's concern that Dr. Doe needed to show improvement in the areas of patient care, medical knowledge, clinical decision-making, and professional relations. It warned that without “[c]lear improvement in your performance ... you will either have to repeat the 4th year [of residency], or end your training at DHMC.” (Id. at 32.) The letter noted that informal reviews of Dr. Doe's recent performance in the vascular service were good and that this “hopefully signals that you have begun to turn the corner in your progress from junior to senior level work.” (Id. )

Defendant's official name is Mary Hitchcock Memorial Hospital at Dartmouth–Hitchcock Medical Center. (Doc. 138–3 at 20.) In this case, MHMH, “Dartmouth–Hitchcock” and DHMC are used interchangeably to refer to defendant.

The letter from Dr. Finlayson does not state that Dr. Doe was placed on probation, and Dr. Doe was never on probation at any time during her residency at MHMH. (Id. at 32, 47; Doc. 138–9 at 4–5.)

At some point in the spring of 2011, Dr. Knapik came into possession of a copy of Dr. Finlayson's letter. The parties disagree about whether Dr. Doe voluntarily shared the letter with Dr. Knapik. (Doc. 9 ¶ 24; Doc. 138 ¶ 33.) For purposes of MHMH's motion for summary judgment, the court assumes that Dr. Knapik's version—that Dr. Doe gave her a copy of the letter—is correct.

In the spring of 2012, both Dr. Doe and Dr. Knapik were approaching the end of their residencies. Graduation was scheduled for June 2012. Prior to graduation, Dr. Doe was accepted into a surgery fellowship at the University of Kentucky. (Doc. 138 ¶ 54.) As part of the application she submitted to the Kentucky Board of Medical Licensure, she was required to disclose any disciplinary proceeding against her, including whether she had ever been placed on probation by MHMH. (Doc. 138–3 at 41–46.) The specific question was “Have you ever been dismissed from, resigned while under investigation, been placed on a disciplinary probation or reprimanded at a medical school or a postgraduate training program? (Academic probation is not reportable.)” (Id. at 42.)

Dr. Doe checked with Dr. Finlayson to make certain that his letter of February 2011 did not place her on probation. (Doc. 138–8 at 24–25.) He advised her that she had not been placed on probation. (Id. ) She answered the question concerning probation and other discipline “No.” (Doc. 138–3 at 42.)

Through an informal conversation with Dr. Doe's mother at a social gathering in the spring of 2011, Dr. Knapik learned that Dr. Doe had not disclosed the February 2011 letter to the fellowship program or the licensing authority in Kentucky. (Doc. 138–8 at 26–27.) In May 2012, Dr. Knapik mailed a copy of the letter to both offices in anonymous envelopes that bore the MHMH return address. (Docs. 138–2 at 10; 138–13 at 16.)

The director of the Kentucky fellowship program, Dr. Endean, was disturbed when he received the anonymous mailing. (Doc. 138–7 at 2.) He contacted the director of the vascular surgery fellowship program at MHMH. (Id. ) Through a process of tracing computer inquiries on the MHMH system, the MHMH administration developed a suspicion that Dr. Knapik was the source of the anonymous letter. (Doc. 138 ¶¶ 119–21.)

When confronted by administrators of the residency program, Dr. Knapik first denied and later admitted that she had sent the letter. (Docs. 138–13 at 17; 138–6 at 5.) Dr. Knapik believed she was required to send the letter as a matter of professional ethics because in her view, Dr. Doe had been dishonest with the medical authorities in Kentucky. (Docs. 9 ¶¶ 42–43; 138–13 at 9.)

The administrators of the residency program determined that Dr. Knapik had acted in a manner incompatible with the role of a physician and in violation of the Dartmouth–Hitchcock Code of Ethical Conduct. On June 13, 2012, Dr. Paul Kispert, director of the General Surgery Residency Program, and Dr. Marc Bertrand, Associate Dean for Graduate Medical Education, sent Dr. Knapik a letter which informed her of her dismissal from the General Surgery residency program. (Doc. 138–2 at 1.) The letter stated in part:

On or about May 5, 2012, you sent a Dartmouth–Hitchcock privileged Quality Assurance (QA) document regarding a colleague to that colleague's future employer. You have admitted to anonymously sending this QA document to the fellowship director. Your printing and forwarding of this document was not authorized by your colleague, nor was it authorized by the author of the document. This egregious action violates the Dartmouth–Hitchcock (D–H) Code of Ethical Conduct (Practice Respect for Persons; Protect Confidential and Proprietary Information; Maintain Personal Honesty and Integrity; Respect for Property and Laws) and Dartmouth–Hitchcock Information Systems Policies (Appropriate Use of Computer Resources; Electronic Mail). Additionally, according to the ACGME [Accreditation Council for Graduate Medical Education], “residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.” Your actions violate the ACGME core competency of Professionalism.
Furthermore, you have not taken responsibility for the consequences of your actions. Although you admit to sending the QA documents without permission, you do not appear to understand the seriousness of this behavior and have shown no remorse for your actions....
Included with this notice of termination is a copy of our GME grievance process and procedures. Should you choose to pursue the grievance option described in these attachments, you must notify Dr. Bertrand in the Offices of Graduate Medical Education within five (5) days of receipt of this letter. (Id. )

Dr. Knapik did not request a hearing or seek a review of her case by the Director of Graduate Medical Education. (Doc. 138 ¶ 141.)

On the same day that he sent the letter to Dr. Knapik, Dr. Kispert informed the general surgery faculty and residents of Dr. Knapik's termination. (Doc. 143–7 at 16.) He also contacted the plastic surgery fellowship program in Miami where Dr. Knapik was scheduled to work following graduation from DHMC. He informed the Miami program that Dr. Knapik had been dismissed from the DHMC program on June 13, 2012 and that he would “not be certifying her to be eligible to sit for the General Surgery Boards.” (Doc. 143–7 at 14–15.) As a result, the Miami program rescinded its offer of employment to Dr. Knapik. (Doc. 143–3 at 19.)


One guess as to who is NOT a plastic surgeon today.

The above is a classic example of a poster posting something he/she doesn't understand. Totally irrelevant to this thread.
 
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This is a reportable offense likely to become part of his permanent record, making it impossible to match with any program

There's a reason for that.

Boy it would look silly if you try to report this and it turns out their lazy evaluator just told them "you're great write yourself a generous eval and submit it"

People even write their own letters of rec sometimes now, let alone an eval rotation slip...completely different than seeing someone clearly cheating or falsifying records imho

Speaking as an attending, we never, ever ask med students to forge our signatures.
 
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Thanks everyone for the replies! I saw him fill the whole eval out and sign it. I heard he’s trying to match surgery and he’s known in our school for being a gunner. I know I should report him but it makes me feel bad thinking he might not get the specialty or match because of me. He doesn’t have a great reputation among students so I’ve barely talked to him. My school has an anonymous reporting system so I don’t know if I should go with that?
Boy it would look silly if you try to report this and it turns out their lazy evaluator just told them "you're great write yourself a generous eval and submit it"

People even write their own letters of rec sometimes now, let alone an eval rotation slip...completely different than seeing someone clearly cheating or falsifying records imho
There's a reason for that.



Speaking as an attending, we never, ever ask med students to forge our signatures.

Yeah i agree. Forging the signature is the main problem here. So it's basically a no brainer to report the guy
 
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Boy it would look silly if you try to report this and it turns out their lazy evaluator just told them "you're great write yourself a generous eval and submit it"

People even write their own letters of rec sometimes now, let alone an eval rotation slip...completely different than seeing someone clearly cheating or falsifying records imho

One thing they could do is give this as a part of the anonymous reporting. Like something along the lines of, "I'm not sure if this was done at the prompting of the preceptor, but I saw x fill out their preceptor evaluation and sign it...".
 
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I must have missed the part where he forged a signature, I thought he just filled it out and wrote their name into the evaluator line. Obvs different if he's out there copying signatures somehow. Though I honestly don't even know how I'd find a copy of an attending's signature to forge if I wanted to.
 
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I must have missed the part where he forged a signature, I thought he just filled it out and wrote their name into the evaluator line. Obvs different if he's out there copying signatures somehow. Though I honestly don't even know how I'd find a copy of an attending's signature to forge if I wanted to.

The poster said "Thanks everyone for the replies! I saw him fill the whole eval out and sign it."

The signing it is what crosses the line and makes it reportable.
 
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I must have missed the part where he forged a signature, I thought he just filled it out and wrote their name into the evaluator line. Obvs different if he's out there copying signatures somehow. Though I honestly don't even know how I'd find a copy of an attending's signature to forge if I wanted to.
The poster said "Thanks everyone for the replies! I saw him fill the whole eval out and sign it."

The signing it is what crosses the line and makes it reportable.

Yes. If the preceptor wanted him to fill out the evaluation he would’ve signed it themselves preemptively or would’ve sign it afterwards. The fact the student took it upon themselves to sign the paper makes your theory invalid
 
Yes. If the preceptor wanted him to fill out the evaluation he would’ve signed it themselves preemptively or would’ve sign it afterwards. The fact the student took it upon themselves to sign the paper makes your theory invalid
@ydf108 can you confirm? You watched him copy or invent an attending's signature?
 
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I've had preceptors tell me to "fill out the eval..... and let me sign it when you're done". Never to fill it out and that's that. Forging the signature here is the kicker. Who cares about subjective ass eval sheets. Forging a signature is illegal, is it not? That's not okay in any sense, let alone in med ed.

Who cares if he's a gunner or wants surgery. If he really did this, he should be reported. The Nassar case or the Dr Death case are extreme examples of what happens when we don't report sketchy **** right away. But they are still relevant.

You either report it and don't look back, or pull him to the side and ask him if he forged the signature. If you do the latter than he knows it's you that rats him out if he's in trouble for this. If the former you're more likely staying out of it. Or, you don't do anything and let him go on. I think if you know he forged the signature, and you know this without a doubt, then report him.
 
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@ydf108 can you confirm? You watched him copy or invent an attending's signature?

That’s not a defense to a position because you know for a fact I was not a part of this. OP brought the facts and we are debating it. OP is saying they saw the student sign it. So then for sake of this entire thread’s discussion the answer would be yes. Yes the student did witness that and now they are asking for advice on the next course of action.
 
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That’s not a defense to a position because you know for a fact I was not a part of this. OP brought the facts and we are debating it. OP is saying they saw the student sign it. So then for sake of this entire thread’s discussion the answer would be yes. Yes the student did witness that and now they are asking for advice on the next course of action.
Sorry didnt mean to seem like I was asking you. Wondering whether "he signed it" might have been signing his own name, as some of my eval forms have included. If he def saw his classmate falsify an attending signature then I'm on board with reporting too
 
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Sorry didnt mean to seem like I was asking you. Wondering whether "he signed it" might have been signing his own name, as some of my eval forms have included. If he def saw his classmate falsify an attending signature then I'm on board with reporting too

Seems like you're the only one not taking 'Thanks everyone for the replies! I saw him fill the whole eval out and sign it.' at face value.

It doesn't make sense that the OP would have said "I saw him fill the whole eval out and sign it" if the OP didn't legitimately see this person fill the whole eval out and sign it. To suggest he meant signing it with his own name (as opposed to the attending) is reaching.
 
Seems like you're the only one not taking 'Thanks everyone for the replies! I saw him fill the whole eval out and sign it.' at face value.

It doesn't make sense that the OP would have said "I saw him fill the whole eval out and sign it" if the OP didn't legitimately see this person fill the whole eval out and sign it. To suggest he meant signing it with his own name (as opposed to the attending) is reaching.
Humor me and my skepticism... like I said, I've had forms that wanted MY signature and cannot fathom a gunner med student being stupid enough to forge an attending signature (that they've probably got no reference for) in front of a classmate.
 
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Humor me and my skepticism... like I said, I've had forms that wanted MY signature and cannot fathom a gunner med student being stupid enough to forge an attending signature (that they've probably got no reference for) in front of a classmate.

This is true and odd to me. Makes me wonder if the OP is indeed the forger and wanting to know the risks.
 
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Does that sound believable to you?

As a matter of fact, yes, because I live in the real world where med students and residents do some pretty sketchy things. You don't think there are residents out there falsifying medical records? You don't think there are med students out there boldly cheating in front of their classmates? Sorry, but that's not reality. Reality is that people do these things and they count on others not noticing/believing the accusation.
 
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You don't think there are med students out there boldly cheating in front of their classmates? No. I think cheaters will almost always make some attempt to disguise the cheating.

LOL
 
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Roughly the same.
It seems to be going out of the way to print an eval out and sign it in front of your classmates haha. The only way I can reasonably see this is if the person doing the forging thought OP was his friend, and was cool with it. My question overall is why not say to the person while they're doing it "hey that's unethical and undermining to every other medical student in the school." ? Let's not forget it's also your duty to stop these kinds of things from happening in the moment, and becomes ever more important with patient care. I can recall several times I've told an attending or senior resident "hey we really shouldn't be doing this." Sometimes they listen, sometimes they don't.
 
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He ruined his own career, seriously.

Don't feel guilty, this is not just something that "happened" to him. He chose to do it. Someone else did not get to go to medical school because he is there.
 
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It seems to be going out of the way to print an eval out and sign it in front of your classmates haha. The only way I can reasonably see this is if the person doing the forging thought OP was his friend, and was cool with it. My question overall is why not say to the person while they're doing it "hey that's unethical and undermining to every other medical student in the school." ? Let's not forget it's also your duty to stop these kinds of things from happening in the moment, and becomes ever more important with patient care. I can recall several times I've told an attending or senior resident "hey we really shouldn't be doing this." Sometimes they listen, sometimes they don't.
Not everybody thinks in the moment.
 
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Not everybody thinks in the moment.
In this profession, you need to. It's hard and I'm guilty of it sometimes. I think the most effective way of learning is by making mistakes. I guess the idea is you have people who've near-perfected this craft above you, correcting them before it becomes an issue. I can't even count how many times I've said "I missed that." It becomes a problem for the student when they get too comfortable and start to cut corners, like in this case. This is where most negligence takes place.
 
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In this profession, you need to. It's hard and I'm guilty of it sometimes. I think the most effective way of learning is by making mistakes. I guess the idea is you have people who've near-perfected this craft above you, correcting them before it becomes an issue. I can't even count how many times I've said "I missed that." It becomes a problem for the student when they get too comfortable and start to cut corners, like in this case. This is where most negligence takes place.
Not everybody is perfect, especially in M3 or M4
 
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In this profession, you need to. It's hard and I'm guilty of it sometimes. I think the most effective way of learning is by making mistakes. I guess the idea is you have people who've near-perfected this craft above you, correcting them before it becomes an issue. I can't even count how many times I've said "I missed that." It becomes a problem for the student when they get too comfortable and start to cut corners, like in this case. This is where most negligence takes place.

Always remember that for yourself. Some students don't and that's why they get in trouble. They usually fly under the radar in med school, but end up on the residency forum with one of those "I'm on probation" or "I was forced to resign" threads. Many things in medicine people look the other way, but there are some things that can derail your career in a flash.
 
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Always remember that for yourself. Some students don't and that's why they get in trouble. They usually fly under the radar in med school, but end up on the residency forum with one of those "I'm on probation" or "I was forced to resign" threads. Many things in medicine people look the other way, but there are some things that can derail your career in a flash.
Dishonesty is the one thing I’ve seen people get canned in residency for. My program is well known to have an extremely rough intern year in medicine and I saw some brutal stuff but more or less everyone got through it. There were two residents who were let go in the first two years, both because of lying. Haha what does forced to resign mean?
 
Dishonesty is the one thing I’ve seen people get canned in residency for. My program is well known to have an extremely rough intern year in medicine and I saw some brutal stuff but more or less everyone got through it. There were two residents who were let go in the first two years, both because of lying. Haha what does forced to resign mean?

You either resign in good favor or are fired. The former let’s the person try to apply to another residency program. The latter sinks their ship
 
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You either resign in good favor or are fired. The former let’s the person try to apply to another residency program. The latter sinks their ship
Ah makes sense and good that some programs are cognizant about implication of ending careers entirely. Which also speaks to the egregiousness of the case posted earlier. I don’t think Med students have that luxury though.
 
Dishonesty is the one thing I’ve seen people get canned in residency for. My program is well known to have an extremely rough intern year in medicine and I saw some brutal stuff but more or less everyone got through it. There were two residents who were let go in the first two years, both because of lying. Haha what does forced to resign mean?

Yes, dishonesty will get you fired faster than anything else, except maybe purposefully or negligently killing a patient. That's why I roll my eyes when people have such trouble believing the story in this thread. When you've been on the receiving end of a med student or resident literally lying to your face about something you can easily check, you'll realize med students/residents do dumb things all the time that get them in big trouble.

Forced resigntation goes something like this: resident screws up big time, either because of the above or they fail rotations and remediations/are found to be incompetent/etc and the program says "we can't let you continue. We'll give you a chance to resign so you can re-apply to residency as opposed to having a termination on your record." Resident resigns to avoid having to report a termination for the rest of his/her career. I would always encourage a resident in that position to seek legal advice before doing anything of course.
 
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In the meantime, encouraging the offender to do the right thing, while making him aware of consequences is what I would do.

If in the future this issue is discovered, and it's also discovered that you knew about it, you'll be facing the disciplinary council yourself.

Boy it would look silly if you try to report this and it turns out their lazy evaluator just told them "you're great write yourself a generous eval and submit it"

People even write their own letters of rec sometimes now, let alone an eval rotation slip...completely different than seeing someone clearly cheating or falsifying records imho

Already commented upon, but I disagree. The OP reports what they saw - perhaps there's a benign reason for it, or perhaps they completely misinterpreted the situation. No problem, it gets investigated and there's no issue, nothing happens at all. If it turns out the faculty told the student to do this, then hopefully the faculty gets some sort of corrective action.

The poster said "Thanks everyone for the replies! I saw him fill the whole eval out and sign it."

The signing it is what crosses the line and makes it reportable.
I'm going to disagree (less so) with this also. Even if it's not signed, it might be fraudulent. Faculty who make students complete their own evaluations (something I can't stand -- it's not clever, it's lazy) still should review them. The sig does make this situation very provable, though.
 
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If in the future this issue is discovered, and it's also discovered that you knew about it, you'll be facing the disciplinary council yourself.



Already commented upon, but I disagree. The OP reports what they saw - perhaps there's a benign reason for it, or perhaps they completely misinterpreted the situation. No problem, it gets investigated and there's no issue, nothing happens at all. If it turns out the faculty told the student to do this, then hopefully the faculty gets some sort of corrective action.


I'm going to disagree (less so) with this also. Even if it's not signed, it might be fraudulent. Faculty who make students complete their own evaluations (something I can't stand -- it's not clever, it's lazy) still should review them. The sig does make this situation very provable, though.
Yeah I'll never understand this. I hate doing formal evaluations. Hate them. I much prefer targeted feedback on a more regular basis than end-of-rotation forms.

But its part of the job when you agree to precept medical students.
 
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I’m pretty sure the moral of that story in MYOB. I find it shocking you didn’t get that.
Yeah, this wasn't a case of a person who was reported for doing something unethical. It was a case of a person who reported another individual despite thay individual being given a pass by their faculty. That's egregiously unprofessional. If I had a concern about another resident not being competent I would bring it to the PD, but it is the PD who has to make that determination, not myself. Going out of her way to attempt to torpedo another resident's fellowship was just stupid.
 
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Let he who is without sin cast the first stone. In the meantime, encouraging the offender to do the right thing, while making him aware of consequences is what I would do.
I've never cheated on an exam, nor would I think to. It always concerns me when people have this attitude that "oh everyone does it" when the majority of us do not With regard to consequemces, those are up to faculty to determine. This is the same sort of thing you have to deal with in the professional world- if you know someone is committing fraud you don't just tell them to not do it again, because they'll keep doing it but hide it better. You need to let the authorities deal with it.
 
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Yeah I'll never understand this. I hate doing formal evaluations. Hate them. I much prefer targeted feedback on a more regular basis than end-of-rotation forms.

But its part of the job when you agree to precept medical students.

Maybe the attending is a Scrubs fan :)

 
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Honestly, I encourage all second years to watch scrubs before starting clinicals. Scrubs I think portrays life in medicine best, even the jokes.
And then again at the beginning of intern year
 
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