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Bryan Carmody @jbcarmody.bsky.social · 23/03/2026

Another Match Day has come and gone. And you know what that means. It’s time to break it down, Winners & Losers style. Match Day 2026: Winners & Losers Edition youtu.be/IFQOBeaQRbc

youtu.be

Match Day 2026: Winners & Losers Edition

YouTube video by Sheriff of Sodium

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Reposted by Bryan Carmody

David Winchester @drdavemd.bsky.social · 28/01/2026

Another video from @jbcarmody.bsky.social with pure gold advice, this time on how to assemble your rank list www.youtube.com/watch?v=VMD1... Sell: work hours, Buy: good attitude colleagues 💯

youtube.com

Making the Rank Order List: Buyers & Sellers Edition

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 09/01/2026

Some interesting figures from the AAMC’s Post-MCAT Questionnaire: 88% of MCAT test-takers say they are “very likely” to apply to MD-granting medical schools - but only 32% say the same for DO-granting schools

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Bryan Carmody @jbcarmody.bsky.social · 30/10/2025

OpenEvidence has revenue of $50 million. But investors value it at $6.1 BILLION. So… a couple of questions for the “AI won’t replace doctors!” crowd: What do you think OE’s long-term monetization pathway looks like? And what do investors expect to happen that could justify this valuation?

Screenshot of OpenEvidence investment prospectus, noting revenue of $50,000,000 with valuation of $6,100,000,000.

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Bryan Carmody @jbcarmody.bsky.social · 14/10/2025

Another year, another increase in USMLE Step 2 CK performance. Notice how the distribution shifts rightward every year.

Graphic demonstrating the distribution of USMLE Step 2 CK scores in four eras: 2013-2016, 2016-2019, 2019-2022, and 2022-2025. Each year, the distribution shifts slightly rightward and becomes slightly more compressed.

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Bryan Carmody @jbcarmody.bsky.social · 24/09/2025

Last week, the president issued a proclamation imposing a $100,000 fee on new H-1B visa applications. It’s generated lots of discussion - much of which isn’t grounded in facts or logic. So who really wins - and who loses - with the six-figure H-1B? thesheriffofsodium.com/2025/09/24/t...

thesheriffofsodium.com

The $100,000 H-1B Visa: Winners & Losers Edition

Last week, President Trump signed a proclamation requiring a $100,000 fee for all new H-1B visas. (For anyone unaware, the H-1B program allows American companies to employ skilled foreign workers w…

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Bryan Carmody @jbcarmody.bsky.social · 11/09/2025

On September 24, ERAS will open to programs. Which means applicants have only 2 weeks left to decide which programs to signal. And if you want to know how to allocate your signals in the most effective manner possible, I’ve got something for you: thesheriffofsodium.com/2025/09/10/t...

thesheriffofsodium.com

The Applicant’s Guide to Strategic Preference Signaling

Whenever I discuss preference signaling on social media, one of the first replies is always “Wait – what’s that?” In the olden days, when an applicant was interested in a particular residency…

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Bryan Carmody @jbcarmody.bsky.social · 04/09/2025

Preference signaling in the 2026 Match

Number of preference signals allowed, by specialty, in the 2025-2026 residency application cycle. Some specialties like orthopaedic surgery and urology allow 30 signals; others like pediatrics and emergency medicine only allow 5. Some specialties like dermatology, anesthesiology, radiology, and internal medicine have both gold and silver signals.

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Bryan Carmody @jbcarmody.bsky.social · 30/07/2025

Let the residency application Bot Wars commence. May the odds be ever in your favor. www.thalamusgme.com/blogs/thalam...

Headline: Thalamus Acquires Medicratic to Accelerate AI-Powered Innovation in Medical Education and Transform Physician Workforce Intelligence

SANTA CLARA, CA — July 30, 2025 — Thalamus, the leading platform for Graduate Medical Education (GME) and emerging physician recruitment solutions, announced today the acquisition of Medicratic, a healthcare technology company specializing in using Artificial Intelligence (AI) to improve the evaluation of medical residency and fellowship applications. This strategic acquisition expands Thalamus’s mission to ensure that the right doctor ends up at the right hospital to treat the right patients — from medical school through practice — using advanced technology and values-driven design thinking.

“Thalamus and Medicratic were both born from an aspiration to transform the transition to residency for the betterment of applicants and programs,”said Jason Reminick, MD, MBA, MS, CEO and Founder of Thalamus. “This acquisition enhances the Thalamus platform to create a force multiplier for the future of medical education and physician workforce planning.”

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Reposted by Bryan Carmody

Leah Pierson @leahpierson.bsky.social · 19/07/2025

New episode of Bio(un)ethical is out now, with @jbcarmody.bsky.social! Bryan Carmody: Are doctor shortages real? We discuss: - Why people think there aren't enough doctors - Why many access problems reflect misallocation (vs shortages) - What models projecting shortages miss - AI (the 🐘 in the 🏥)

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Bryan Carmody @jbcarmody.bsky.social · 15/07/2025

If you’ve got a few minutes during your next workout or commute, I’d love to challenge your faith in the “doctor shortage.” Check out the latest episode of Bio(un)ethical here (or on Apple Podcasts, Spotify, etc.): www.biounethical.com/episodes/epi...

biounethical.com

EPISODES | Bio(un)ethical

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Bryan Carmody @jbcarmody.bsky.social · 17/06/2025

Starting in July, the minimum passing score for the USMLE Step 2 CK exam will increase from 214–>218. (Recent first-time pass rates for US students have been ~98%, so this is not a surprising move.)

Change to Step 2 CK Passing Standard Begins July 1, 2025. At its June 2025 meeting, the USMLE Management Committee conducted a review of the USMLE Step 2 Clinical Knowledge (CK) passing standard. Management Committee members include individuals with experience on state medical boards, medical school and residency program faculty from across the United States, practicing physicians, residents, and public members. The Committee decided that a four-point increase in the passing standard – used to determine a Pass or Fail outcome – will apply to Step 2 CK examinees testing on or after July 1, 2025. On the three-digit score scale, the passing standard will change from 214 to 218.

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Bryan Carmody @jbcarmody.bsky.social · 11/05/2025

Ever had a conversation like this?

Nervous doctor, to administrator: c-c-could I get…

Administrator: I’m afraid the budget is very tight…

Administrator: The hospital is operating at a loss…

(Doctor looks tired)

Administrator: In fact, we’re losing money on you!

Doctor is shriveled and dessicated

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Bryan Carmody @jbcarmody.bsky.social · 11/05/2025

In a news release filed under the category tag “Leadership”, the ACGME announced it will no longer enforce program and institutional standards related to diversity, equity, and inclusion. www.acgme.org/newsroom/202...

ACGME Board Executive Committee Action. The ACGME… is suspending enforcement of these requirements (see specific program and institutional standards in following screenshots).

The program, in partnership with a sponsoring institution, must engage in practices that focus on mission-driven, ongoing, systematic recruitment and retention of a diverse and inclusive workforce of residents, fellows (if present), faculty members, senior administrative staff members, and other relevant members of the academic community.

The sponsoring institution, in partnership with each of its programs, must engage in practices that focus on ongoing, mission-driven, systematic recruitment and retention of a diverse and inclusive workforce of residents/fellows, faculty members, senior administrative staff members, and other relevant members of its GME community.

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Bryan Carmody @jbcarmody.bsky.social · 26/04/2025

This week, the president issued an executive order targeting #MedEd accreditation. This is big news - and the intent, impact, and implications of this order all deserve scrutiny. So you know what that means. It’s time to break it down, Winners & Losers style. www.youtube.com/watch?v=XgHK...

youtube.com

Executive Order on Medical Accreditation: Winners & Losers Edition

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 24/04/2025

New executive order targets the organizations that accredit medical schools and residency programs. Will this be the end of the LCME and ACGME? www.whitehouse.gov/presidential...

Presidential actions - reforming accreditation to strengthen higher education; executive order, April 23, 2025

The Attorney General and the Secretary of Education, in consultation with the Secretary of Health and Human Services, shall investigate and take appropriate action to terminate unlawful discrimination by American medical schools or graduate medical education entities that is advanced by the Liaison Committee on Medical Education or the Accreditation Council for Graduate Medical Education or other accreditors of graduate medical education, including unlawful “diversity, equity, and inclusion” requirements under the guise of accreditation standards. The Secretary of Education shall also assess whether to suspend or terminate the Committee’s or the Accreditation Council’s status as an accrediting agency under Federal law or take other appropriate action to ensure lawful conduct by medical schools, graduate medical education programs, and other entities that receive Federal funding for medical education.

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Bryan Carmody @jbcarmody.bsky.social · 21/03/2025

Today is Match Day. So you know what that means. It’s time to break things down, Winners & Losers™️ style. Match Day 2025: Winners & Losers Edition youtu.be/ckbO6ykf2f8

youtu.be

Match Day 2025: Winners & Losers Edition

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 17/03/2025

Today, residency applicants will find out whether they matched or not. But to find out where, they’ve gotta wait another 4 days. Need something to pass the time? Might I recommend a 6 part video series covering the past, present, and future of the Match? thesheriffofsodium.com/2022/03/17/t...

thesheriffofsodium.com

The Match: The Movie

Over the past week, subscribers to the Sheriff of Sodium YouTube channel have been treated to a sprawling and expansive six-part video series on the Match – including the long-awaited Part 6,…

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Bryan Carmody @jbcarmody.bsky.social · 15/03/2025

DOs as a percentage of licensed physicians, by state: 1. Oklahoma - 22% 2. Michigan- 20% 3t. Iowa, Maine - 18% 5t. Idaho, Nevada, W. Virginia, Pennsylvania, Delaware - 16% . . . 46t. Georgia, Connecticut - 8% 48t. Louisiana, Maryland - 6% 50. Massachusetts - 5% 51. DC - 4%

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Bryan Carmody @jbcarmody.bsky.social · 09/03/2025

Why an applicant would use a pseudonym to send a complaining email, 9 days before rank lists were due, to a residency program at which they’d done an away rotation and a research project (and at which they were ranked highly) is beyond me. But anyhow, now they’re on PubMed.

Screenshot of the first page of the article “To Catch a Catfish: A Cautionary Tale of Internet Unprofessionalism.” Full text link below.

Figure from the linked article, showing rapid program leadership response to unusual email, resulting in unranking applicant in 4 days.

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Bryan Carmody @jbcarmody.bsky.social · 07/03/2025

Sad - but unsurprising news. (Last year, I covered what happened to the surgery residency program after the hospital got involved with Bartholomew Banks.) Death of a Program: The ACGME vs. Private Equity youtu.be/MqYUFy87UMM

youtu.be

Death of a Program: The ACGME vs. Private Equity

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 25/02/2025

Why don’t residents earn more money? How did resident salaries get standardized? And how much do hospitals receive to train residents, anyhow? Your questions, answered Following The Money: A Primer on Resident Physician Compensation youtu.be/0WhxiuD4Rb8

youtu.be

Following The Money: A Primer on Resident Physician Compensation

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 12/02/2025

We may be getting a new medical school in California… The University of Silicon Andhra School of Medicine

Screenshot from the Liaison Committee on Medical Education website, noting applicant status for the proposed “University of Silicon Andhra School of Medicine” in the San Joaquin Valley.

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Bryan Carmody @jbcarmody.bsky.social · 11/02/2025

Resident physician salaries rise only at the rate of inflation - completely untethered to any other market force. The median PGY-1 salary for current residents is $65,100… which is ~$48,000 in 2012 dollars in case you wanted to plot it on the graphic below.

Graphic from the New England Journal of Medicine demonstrating the mean salary of a first-year resident from 1968 to 2012, with values standardized to 2012 dollars. All of the points on the graphic range from ~$41,000 to ~$54,000, with values after 1983 more tightly clustered between ~$45,000 and ~$52,000.

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Bryan Carmody @jbcarmody.bsky.social · 03/02/2025

Starting today at noon, Match applicants can begin submitting their rank order lists. But before you do… here’s what residency applicants consistently overvalue - and what they consistently undervalue - when picking a program. Rank Order List: Buyers and Sellers Edition youtu.be/rDtlD1BH0Yw

youtu.be

Rank Order List: Buyers and Sellers Edition

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 03/02/2025

New data on the primacy of signaling in the residency application process. Note the massive drop-off in interview rate for signaled/non-signaled applications, especially in ‘big signaling’ specialties. Deciding where to signal is *the* new high stakes meta-game in residency selection.

Graphic demonstrating the interview rate at the median program in each specialty for MD applicants who signaled or did not signal the program with their application. There is a significant drop off in interview rates for non-signaled applications. In less-competitive specialties with low signal numbers (e.g., pediatrics - 5), 83% of signaled applications yielded an interview, while 40% of non-signaled applications did. In more competitive specialties with high signal numbers (e.g., neurosurgery - 25), 31% of applicants who signaled received an interview, while 1% of non-signaled applicants did.

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Bryan Carmody @jbcarmody.bsky.social · 01/02/2025

Should you tell your favorite program you’re ranking them #1? What about your backups? Should you tell them that, too? Or just say you’re ranking them VERY highly? Or should you just say nothing at all? Gimme a few minutes, and all your LOI questions will be answered… youtu.be/qTCuzYE7v5Q

youtu.be

Mailbag: Letters of Intent and Post-Interview Communication

YouTube video by Sheriff of Sodium

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Bryan Carmody @jbcarmody.bsky.social · 31/01/2025

Congratulations to Thalamus on the capital raise… …but why is the AAMC putting money into this? How do they envision they’ll achieve a return on their investment? Do we really need the AAMC to become a player in the physician recruitment game? thalamusgme.com/thalamus-rai...

thalamusgme.com

Thalamus Raises $30 Million Series B to Expand Physician Workforce for Health Systems and Patients Nationwide – Thalamus

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Bryan Carmody @jbcarmody.bsky.social · 29/01/2025

BREAKING NEWS: A federal judge has *dismissed* the class action lawsuit filed by two Nepali physicians alleging that the NBME unlawfully discriminated against them when invaliding their USMLE scores in last year’s cheating scandal.

Memorandum opinion from U.S. District Court judge Christopher Cooper dismissing Giri v. NBME.

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Bryan Carmody @jbcarmody.bsky.social · 25/01/2025

Prescription Bot will see you now. www.congress.gov/bill/119th-c...

Proposed federal legislation allowing AI bots to function as prescribers if allowed to do so by the state medical boards

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Bryan Carmody @jbcarmody.bsky.social · 22/01/2025

Articles like this absolutely wear me out. It comes SO close to acknowledging the real issues - then parrots back the same platitudes. Do we really just need more doctors? Or do we need a system that incentivizes doctors to practice in the ways/areas we need - instead of doing the very opposite?

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Reposted by Bryan Carmody

Micah Etter, MD @mettermd.bsky.social · 15/01/2025

absolutely incredible drop from @jbcarmody.bsky.social a must-watch for all physicians and trainees or anyone interested in healthcare systems issues 🫥 youtube.com/watch?v=gIHR...

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Bryan Carmody @jbcarmody.bsky.social · 10/01/2025

The total number of medical school applicants declined again last year, reaching the lowest number since 2017. (Meanwhile, the number of matriculants hit an all time high.)

Table from the Association of American Medical Colleges showing the number of total applicants from 2014 to 2024. After generally increasing from 2014 to 2020, there was a sharp peak in 2021, then a decline since.

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Bryan Carmody @jbcarmody.bsky.social · 09/01/2025

Yes and no. The NRMP Charting Outcomes reports show match rates by number of contiguous ranks submitted (which is a reasonable surrogate for interview number, since most applicants rank all programs at which they interviewed. e.g., here, for international medical graduates in general surgery:

Graphic from 2024 Charting Outcomes in the Match, showing probability of matching by number of contiguous ranks.

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Bryan Carmody @jbcarmody.bsky.social · 18/12/2024

Word of advice for residents considering their first job offers: It’s priced in. Nobody’s getting money for free. If Job X is paying 25% more than Job Y… there’s a reason for it.

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Bryan Carmody @jbcarmody.bsky.social · 11/12/2024

Announcement from the NBME today: There will be no increase to the USMLE Step 1 minimum passing score. (at least, not yet)

Screenshot of announcement from the National Board of Medical Examiners: “No change to minimum passing standard for Step 1.”

Graph of the minimum passing USMLE Step 1 score over time. Historically, every 3-5 years, the passing standard has been increased, resulting in an overall increase in the passing standard from 175 in 1994 to 196 in 2024.

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Bryan Carmody @jbcarmody.bsky.social · 05/12/2024

Percentage of available positions that filled in yesterday’s fellowship match.

Bar chart demonstrating the percentage of fellowship positions filled, by specialty, in the NRMP Fellowship Match on December 4, 2024. In cardiology, hematology-oncology, GI, and rheumatology, 99% of positions filled. In pediatric nephrology, just 37%, and in child abuse pediatrics, just 33% of positions were filled.

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Misha Rosenbach, MD @misharosenbach.bsky.social · 04/12/2024

If you’re a med student looking for someone to follow re ERAS / applying / Match info, @jbcarmody.bsky.social has a ton of interesting info generally.

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Bryan Carmody @jbcarmody.bsky.social · 03/12/2024

Fun fact: Although scientific journals have existed in some form since the 1600s, external peer review only became standard in the 1970s. (So yeah… Einstein’s theories, Watson & Crick’s double helix, penicillin, insulin, etc. - all published without helpful comments from Reviewer 2.)

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Bryan Carmody @jbcarmody.bsky.social · 03/12/2024

My take: The skills required to be a good resident and those required to pass the boards are overlapping… but distinct. At-risk residents *require* drilling with MCQs.

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Bryan Carmody @jbcarmody.bsky.social · 30/11/2024

The top 20 most common passwords 🤦‍♂️

The 20 most common passwords from link below

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Bryan Carmody @jbcarmody.bsky.social · 25/11/2024

“It is not hard to see why disease so severe that it rewrites the laws of homeostasis would have increased rates of devastating outcomes.”

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Bryan Carmody @jbcarmody.bsky.social · 23/11/2024

This is why I urge medical students to choose their specialty based on what they think they'll love doing - not what they think they'll earn, which may change with the stroke of a pen. www.washingtonpost.com/health/2024/…

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Bryan Carmody @jbcarmody.bsky.social · 22/11/2024

Very excited to be in Chicago for Grand Rounds at Lurie Children's Hospital tomorrow Be there (if you can)

Title slide for Grand Rounds at Lurie Children’s Hospital, showing an elephant, with the title Touching the Elephant - Examining and Re-Examining the Pediatric Subspecialty Shortage - the A. Todd Davis Memorial Lecture for November 22, 2024.

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Bryan Carmody @jbcarmody.bsky.social · 20/11/2024

Every now and again I peruse the state board's disciplinary notices. And every now and again, I see one that truly makes my jaw drop. (CW - sexual misconduct)

Disciplinary notice from the Virginia Board of Medicine describing disturbing allegations of highly inappropriate comments made by Dr. Dalton Renick. Link to Board website with notice below.

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Bryan Carmody @jbcarmody.bsky.social · 18/11/2024

New data on medical student debt from the AAMC: Average educational debt is up 2% to $205,000. …but that's for students who incur debt. Nowadays, 29% of students don't. Meanwhile, 23% of graduates owe >$300,000. (In other words, more debt is being heaped upon a smaller proportion of students.)

2024 AAMC Debt Fact Card. The median indebtedness is $205,000. While 23% of graduates have debt >$300,000, 29% have no educational debt.

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Bryan Carmody @jbcarmody.bsky.social · 16/11/2024

Aw jeez, not this again. According to this consultant, hospitals now *lose* an average of $304,312 per physician per year. 🤦🏻‍♂️ Guess it's time for another thread on budgetary gerrymandering.

Screenshot from the Kaufman Hall “Physician Flash Report,” which asserts that the average physician “subsidy” topped $300,000 for the first time in Q3 of 2024. “The employment model where hospitals subsidize physician employment is broken and needs to change.”

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