ERAS Filter

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akneuro

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I was looking around the internet and I found a powerpoint to teach programs how to use the ERAS system. One of them was how to put filters on- so that you can see only the applications that you want.

I find this unfair, but understand that it may be necessary esp. in a field that may get a hundred applications or something for 1 position. Although some of the filters seem discriminatory (ie sex, disability, picture), I want to know how would you approach a program that they should still consider you even though you may not make it past their initial filter.

My example is that I did not score that well on the USMLE, b/c I actually had to go to the hospital after taking the exam due to my appendix deciding that it was time to come out (still passed- and as you know if you pass you cannot take it again to improve you score), but have done a lot that would make me an excellent candidate (clinical, research, publications etc.), except I can't get past these filters.

What would you suggest I or anyone do in this circumstance? I've put in a lot of time and effort and just see it as unfair that one score would completely dictate the rest of my career or lack there of.

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Is this the first time you've heard of programs using a filter to screen applicants?? I don't think it's any big secret that most, if not all, programs use one or more filters when deciding which applicants to interview. When you have hundredes or even thousands of applications for very few positions, there needs to be a tool to allow a program to efficiently categorize "competitive" applicants vs. "non-competitive" applicants. Although this classification of competitive vs non-competitive is determined by many factors, including specialty, quality of the program, or number of positions available, you simply can't go through hundreds or thousands of applications page by page. Additionally, with so many strong applicants, you need an objective measure (such as Step 1 score, number of clerkship honors, AOA status, etc) in order to assess one's level of competitiveness. I would imagine that after applicants make it through the initial filters or screening process, then the more subjective material such as LOR, personal statement, etc. comes into play. Finally, for those that are offered an interview, the interview is used to assess personality, ability to hold a conversation, how well you might fit in at the program, and many other qualities that cannot be assessed on paper alone.

I think your opinion that these filters may seem unfair is ridiculous. As I stated above, there are so many strong applicants each year there needs to be some way to distinguish among them. Sure, every part of your application may seem relatively strong with the exception of your Step 1 score, but what about the countless other applicants with equally as strong applications and a better Step 1 score? Should you be ranked higher than them during the initial screening process?

Everyone has a reason why he/she didn't score as high as they would have liked on Step 1 and/or 2. Sure, you going to the hospital after your exam is a valid reason, but so is the person who randomly got a migraine during their exam or someone who got no sleep the night before because their dog got sick. If you had an experience that you truly believe the program should know about, I believe your personal statement is an avenue where you explain circumstances such as this. Although your score may not get you through the initial screening process for every program you are interested in, including it in your PS might get noticed by some programs where you are borderline.
 
Initially I thought that it might just have been that m250 wasn't hugged enough as a child, but then I saw this line:

I think your opinion that these filters may seem unfair is ridiculous. As I stated above, there are so many strong applicants each year there needs to be some way to distinguish among them. Sure, every part of your application may seem relatively strong with the exception of your Step 1 score, but what about the countless other applicants with equally as strong applications and a better Step 1 score? Should you be ranked higher than them during the initial screening process?

Yes, filters are an unfortunate fact of life in this little application game, but the party lines seem to be drawn pretty distinctly among those who did well on Step 1/were AOA/excelled on the objective aspects of the application versus those who did not. Those who did well feel threatened that their 240s might not be as important to a program as life experience or interpersonal communication, and those who scored 190s are afraid that programs will think they somehow aren't smart enough to excel.

Oddly enough, both are correct. Look at the "Ranking the Match" statistics. Not everyone with a high board score matches, thus there has to be more than just objective criteria that some programs feel is more important than what might be screened out with a filter. And on the other side, would you as a resident feel comfortable knowing that your PD thinks you're a ***** all the time because he/she values the almighty number? The thing I'm finding on the interview trail is that residency programs are all about fit. While one may not get a "name" program with a 190, he/she will still find a good education in a program that will value the particular skill set possessed by that applicant.

In the end, it's going to work out, but if you feel as if you'd like to do something more productive than going back to rewrite and resubmit your personal statement as suggested above, I think there's no shame in calling/emailing a couple of the programs in which you are most interested. Be prepared for rejection, but in the end, at least you know you've tried as best you could. And really, it will work out.
 
So providing information about the use of filters or screening criteria during the application process and being blunt about the OP's concern somehow equates to me not being hugged enough as a child? Also, I did not suggest that they go back and re-write their personal statement, as the deadline for submitting materials to most programs has already passed to the best of my knowledge. Rather, I offered it as a suggestion to those with similar concerns who will be applying next year as this topic seems to come up again and again each year...I am having a difficult time understanding why that is not considered constructive criticism as indicated by the title of your post?

The whole point of my post was to counter the OP's opinion that filters were "unfair." The reality is there are so many qualified or competitive applicants for any given program so there needs to be a way to efficiently screen those who are the most competitive in an objective manner. I completely agree that an applicant with a 240+ isn't a better "fit" for any given program than someone with a 213, but with an increasing number of applicants each year, your Step 1 and/or 2 scores are very important to "get your foot in the door." Now just because you got a 270 and honored every rotation, you are in no way guaranteed to match if you have no other life experiences or can't hold a conversation at an interview, but I thought that was common sense and went without saying.
 
The whole point of my post was to counter the OP's opinion that filters were "unfair."

Exactly. I just don't think that's the issue about which the OP was asking. :)
 
akneuro ----

You are correct in that many many programs, especially large university programs, will filter. It is no secret. Researching this will just solidify this truth. In fact, a handful programs post their USMLE score cutoffs on their website. For internal medicine, for example, Lenox Hill has a cutoff of 200 (shown on website), while Univ of Maryland says an applicant needs to have a 215 to be competitive.

However, did you take step 2 yet? The ERAS application on a program director's view looks completely different than what it looks like on an applicant's screen. Now here is the catch! Scores can be used to filter applicants, but the ERAS is set up so that program directors can only screen out based on whatever the applicant's highest score was.

For example, just say the PD wants 240 to be the screening cutoff. Just say you scored 220 on step 1 and 260 on step 2. With this scenario, you won't be screened out because only the higher score is used in the screening. Let's just say you scored the other way around -- 260 on step 1 and 220 on step 2. The outcome is still the same, and you won't be screened out.

This is another reason why it is important to take step 2 early, especially if you didn't do well on step 1 while battling appendicitis.
 
For example, just say the PD wants 240 to be the screening cutoff. Just say you scored 220 on step 1 and 260 on step 2. With this scenario, you won't be screened out because only the higher score is used in the screening. Let's just say you scored the other way around -- 260 on step 1 and 220 on step 2. The outcome is still the same, and you won't be screened out.

This is another reason why it is important to take step 2 early, especially if you didn't do well on step 1 while battling appendicitis.

Actually this information is a bit missleading. I'll try to clarify... PDs can set any filter criteria they want on any exam and/or other variables. They can set a filter for step 1 or step 2 or both. So, lets say the PD will set a cutoff for step 1 > 200 and you have a 198 on step 1 and a 260 on step 2. In this case, you will not show up as you will be filtered out. But in the same case if the PD set filter for Step 1 and/or step 2 > 200 then you will show up. This is unfortunate but programs have to have some way of getting through all of the apps and picking the "better" applicants to interview. Not everyone can be interviewed and it's true that a lot of good applicants don't get interviews because of these filters.
 
Scores can be used to filter applicants, but the ERAS is set up so that program directors can only screen out based on whatever the applicant's highest score was.

For example, just say the PD wants 240 to be the screening cutoff. Just say you scored 220 on step 1 and 260 on step 2. With this scenario, you won't be screened out because only the higher score is used in the screening. Let's just say you scored the other way around -- 260 on step 1 and 220 on step 2. The outcome is still the same, and you won't be screened out.

This is not correct. I can screen by Step 1, Step 2, or Step 3 individually or in any combination. If you fail a step and then retake it, I can only screen by your most recent score (which presumably is the highest, else you have failed the exam again which bodes poorly overall).
 
Board exams were never meant to be used to filter/weed out/rank applicants. That's what you should be upset about, OP.
 
Board exams were never meant to be used to filter/weed out/rank applicants. That's what you should be upset about, OP.
Many drugs are used off label. That doesn't mean that they don't work. Yes, the USMLE states that officially, their exam was not designed to assess residency candidates -- but just because they say so doesn't mean that it doesn't offer some insight into candidates' strengths and weaknesses.
 
Many drugs are used off label. That doesn't mean that they don't work. Yes, the USMLE states that officially, their exam was not designed to assess residency candidates -- but just because they say so doesn't mean that it doesn't offer some insight into candidates' strengths and weaknesses.

To the extent that candidates are weeded out because of it?

If the board exams were meant to rank candidates, then retakes would be allowed, as they are for the MCAT.
 
To the extent that candidates are weeded out because of it?

If the board exams were meant to rank candidates, then retakes would be allowed, as they are for the MCAT.
Are you seriously implying that the eligibility to retake an exam defines its ability to be used to rank applicants? That's pretty hilarious.

Anyhow, I am certain there are much more absurd characteristics used to rank candidates: Why don't we complain about personal favors, sexism, "brand name" schools, regional bias, etc. instead of a standardized exam.
 
To the extent that candidates are weeded out because of it?

If the board exams were meant to rank candidates, then retakes would be allowed, as they are for the MCAT.

No, not necessarily.

Sure, there'll be a rare instance of burst appendix mid-exam, but I believe you can walk out and nullify your score if you feel your exam performance is compromised by a transient situation. The OP probably should have done that. We're not entitled to ANYTHING in this game, let alone multiple "do-overs" on performance. It may be harsh reality, but that's life.

Advice to future applicants: don't complain, accept the situation, give it everything you've got, no excuses, no regrets.
 
This is not correct. I can screen by Step 1, Step 2, or Step 3 individually or in any combination. If you fail a step and then retake it, I can only screen by your most recent score (which presumably is the highest, else you have failed the exam again which bodes poorly overall).

I stand corrected.
 
Are you seriously implying that the eligibility to retake an exam defines its ability to be used to rank applicants?

It's an observation, not something I can prove. It seems to me that once you've passed, you're done, you can get licensed (since it's a licensing exam) and proceed with your training. There was never any intention for it to be a competition for the highest score or a way to meet requirements for consideration by residency programs.

If you say it's hilarious, then why do YOU think retakes aren't allowed?
 
It's an observation, not something I can prove. It seems to me that once you've passed, you're done, you can get licensed (since it's a licensing exam) and proceed with your training. There was never any intention for it to be a competition for the highest score or a way to meet requirements for consideration by residency programs.
If this indeed was the case it would be pass/fail. The current scoring of the exam is designed to differentiate candidates. The concept of a simple 'licensing exam' may have been valid decades ago but I think it's fairly clear to everyone in the medical world now that it is being used as the most objective component of an applicant's file.

If you say it's hilarious, then why do YOU think retakes aren't allowed?
Uh so there wouldn't be thousands of med students retaking it everyday of the year trying to achieve that 260+ diluting the significance of the exam?
 
If this indeed was the case it would be pass/fail. The current scoring of the exam is designed to differentiate candidates. The concept of a simple 'licensing exam' may have been valid decades ago but I think it's fairly clear to everyone in the medical world now that it is being used as the most objective component of an applicant's file.


Uh so there wouldn't be thousands of med students retaking it everyday of the year trying to achieve that 260+ diluting the significance of the exam?

I wonder why it's not pass/fail, considering it's intended use.
 
tetris said:
I wonder why it's not pass/fail, considering it's intended use.
Because the intended use is antiquated.

tetris said:
It's not designed for that purpose at all; that's my whole point.
The exam is standardized among test-takers to fit a distribution such that a mean and standard deviation exist that does differentiate among test-takers.

Let's not delude ourselves shall we - the NBME may maintain for posterity that it's a simple licensing exam, but we all know that the practical application of the score is to say one person who scored the mean did not do as well as someone who scored one standard deviation above the mean.
 
Just because all the programs use it as such doesn't mean it's right.

I don't see this argument being settled easily. The question should really be put to the USMLE people themselves.
 
There are a lot of things that aren't 'right' in the world. I doubt many people are losing sleep over the ethics of using board scores in apps .. least of all the usmle people.
 
I've said it several times on SDN and I'll say it again:

A fair is a place to have fun... because nothing in life is really fair.

You can to do two things:

1. Complain excessively and use the defense mechanism of intellectualization (which ironically was on both Step 1 and 2).

2. Strive to do better

Everything you do matters in life... from boards to the other little things in your application. While one seldom makes or breaks your application, you should strive for personal excellence in your endeavors.
 
2. Strive to do better
People such as OP can't "strive to do better" on the exam; it is carved in stone, and will be used to size him/her up against others, more than any other criterion.
 
Tell that to people such as OP who don't make it past the ERAS filter and are never even looked at by humans.
Ya I bet just as many could cry about the honors/AOA filters, brand name school/location filter, gender filters, etc. At least with the boards you are competing against standardization (something very possible to overcome) and not BS such as pedigree or something as arbitrary as clerkship grades.
 
I'll say it again:

Just because all the programs use it as such doesn't mean it's right.

I don't see this argument being settled easily. The question should really be put to the USMLE people themselves.
 
You can say it as many times as you like .. no one cares buddy. :beat:
 
Honestly, if you are going into a specialty that is strong enough to weed people out based on their board scores, there is a good chance that they have plenty of applicants with all the qualifications that you have AND good board scores. I know it is tough to hear, but this is the sad truth is the competitive specialties. One screw up can effect the rest of your life, even if it is out of your control.
 
You can say it as many times as you like .. no one cares buddy. :beat:

With all your passionate replies, I thought you did care. /:rolleyes:

Thanks for showing your true colors.
 
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Ya I tend to 'care' about issues when I'm not talking to a brick wall that replies with "Let me repeat what I've said for the nth time, because I have no real arguments, just complaints."
 
Feel free to close the thread .. I think all the salient points have been made.
 
Ya I tend to 'care' about issues when I'm not talking to a brick wall that replies with "Let me repeat what I've said for the nth time, because I have no real arguments, just complaints."

I can say the same about you. You've also made numerous posts and repeated your ideas over and over. Your arguments of "all programs do it" and "it's an outdated statement by the USMLE" and "it's a great way to rank candidates" (I'm paraphrasing you, not quoting) have not answered or discredited mine, and then you resorted to childish retorts of "noone cares" and "you have no real arguments".
 
:sleep: .. just boring now.
 
To the extent that candidates are weeded out because of it?

If the board exams were meant to rank candidates, then retakes would be allowed, as they are for the MCAT.

I have been closely watching this thread.
Tetris is absolutely right.
Why r not then retakes allowed at the USMLE steps like they r allowed at the MCAT?
If that would have been the case then the purpose of the exam would surely have been to rank the applicants.But,it is not so.
Good Luck, Tetris!
 
The US Medical License Exam is probably designed to decide who can practice medicine... not to rank people for residency.

Individual states have laws on how many attempts can be made for a passing score, and the lowest acceptable 2 digit score (that's the reason the 2 digit score still exists).

Maybe once you pass and are in the running, state licensing boards will not confuse themselves with multiple scores. Do they take your average score? Highest score? Lowest score? Most recent score? What if your score decreased... to failing? Once you've proved yourself competent to practice medicine, what does getting a higher score on a second attempt actually mean to the Licensing Board?

The world does not revolve around the NRMP.
 
Not boring at all,but a healthy discussion is going on.

What are you talking about? Your posts have added nothing to the thread. Until the complaint (properly categorized as such by Man in White) is substantiated with some real reasons why using a standardized test for selection criteria is wrong and unfair, this thread has nothing more than griping to add. But call a spade a spade and phrase your gripes as gripes, not as though you're throwing light on an injustice, which you're not.

And for the record (to beat this dead horse again) "it wasn't designed for that!" is not a good argument...technically grades aren't designed for residency selection, they're designed for feedback and evaluation of medical school performance. Technically AOA is not designed for residency selection, it's designed to reward, cultivate, and organize a group of students who did exceptionally well in medical school. Technically rotation evals are not designed for residency selection, they're to give feedback and evaluation to the student and medical school. The only things designed for residency selection are letters of recommendation, your personal statement, and your interview. Surely you don't suggest those be the only factors in residency selection.

And if you honestly believe that a 260 doesn't tell you anything helpful about a student compared to a 200, you're delusional.
 
Well, guys this is so amusing!!

It is somewhat true that is "unfair", you can have a bad day and perform poorly, but such is life! ( I am an IMG so I know how unfair the system can be)

And I do believe there is a difference between a 260 and a 200. If you got a 200 because of circumstances outside of your control, then do better next time, be sure to not only do better but outstanding.

How would programs know that you got 200 in your best effort or 200 but you did not study enough? Or you felt sick? It does not matter, at the end it is the same result. We are so many applicants that they cannot take the time to get to know how wonderful we are, right??

I did mediocre in one test, I made sure I had an amazing improvement. As they told you before, just contact the program, tell them the facts eg. "I got 200 on step 1 and 260 on step 2". And let them judge by themselves...

You can also do extra research and add stuff to your CV to compensate. That way you use your frustration towards something better than complaining. Systems is not perfect, but life isn't either.

Regards!
 
What are you talking about? Your posts have added nothing to the thread. Until the complaint (properly categorized as such by Man in White) is substantiated with some real reasons why using a standardized test for selection criteria is wrong and unfair, this thread has nothing more than griping to add. But call a spade a spade and phrase your gripes as gripes, not as though you're throwing light on an injustice, which you're not.

And for the record (to beat this dead horse again) "it wasn't designed for that!" is not a good argument...technically grades aren't designed for residency selection, they're designed for feedback and evaluation of medical school performance. Technically AOA is not designed for residency selection, it's designed to reward, cultivate, and organize a group of students who did exceptionally well in medical school. Technically rotation evals are not designed for residency selection, they're to give feedback and evaluation to the student and medical school. The only things designed for residency selection are letters of recommendation, your personal statement, and your interview. Surely you don't suggest those be the only factors in residency selection.

And if you honestly believe that a 260 doesn't tell you anything helpful about a student compared to a 200, you're delusional.
So, u have succeeded in expressing yur delusions here rather than answering the question that if the USMLE is really meant for ranking applicants like MCAT why then r the retakes not allowed on the USMLE Steps.
I hope u don't feed us again with the same delusions and I also hope u come up with some good and reasonable arguments.
Good Luck!
 
I have been closely watching this thread.
Tetris is absolutely right.
Why r not then retakes allowed at the USMLE steps like they r allowed at the MCAT?
If that would have been the case then the purpose of the exam would surely have been to rank the applicants.But,it is not so.
Good Luck, Tetris!

Thanks for supporting this very unpopular side of the argument.
 
"it wasn't designed for that!" is not just an argument, it's a fact straight from the horse's mouth - i.e., the USMLE itself.

At the very least, board scores shouldn't be used as the only criterion. But they certainly are, and ERAS gives programs a "filter" feature (which is what the OP was asking about) to easily weed out scores below whatever arbitrary # they choose.

What are you talking about? Your posts have added nothing to the thread. Until the complaint (properly categorized as such by Man in White) is substantiated with some real reasons why using a standardized test for selection criteria is wrong and unfair, this thread has nothing more than griping to add. But call a spade a spade and phrase your gripes as gripes, not as though you're throwing light on an injustice, which you're not.

And for the record (to beat this dead horse again) "it wasn't designed for that!" is not a good argument...technically grades aren't designed for residency selection, they're designed for feedback and evaluation of medical school performance. Technically AOA is not designed for residency selection, it's designed to reward, cultivate, and organize a group of students who did exceptionally well in medical school. Technically rotation evals are not designed for residency selection, they're to give feedback and evaluation to the student and medical school. The only things designed for residency selection are letters of recommendation, your personal statement, and your interview. Surely you don't suggest those be the only factors in residency selection.

And if you honestly believe that a 260 doesn't tell you anything helpful about a student compared to a 200, you're delusional.
 
So, u have succeeded in expressing yur delusions here rather than answering the question that if the USMLE is really meant for ranking applicants like MCAT why then r the retakes not allowed on the USMLE Steps.

We still haven't gotten a good answer to this (or to disprove my theory).
 
As for the retakes, why? A true measure of someone is how they do with the pressure. You have one chance to prove your mettle and that it's it. If you screw it up, it's no one's fault but your own. I'm more for a standardized window however where a MS-2 have X number of weeks after school ends to study and take the exam. This would remove some of the variation seen by students who spend months preparing.

Its been said that the USMLE and medical education in general mirrors the practice of medicine.

There is uncertainty in medicine, as well as the USMLE. You will not know every question on the USMLE, and you will not know every every anatomical variant in your patients. And what you dont know can kill them. So why shouldn't it hurt you?

You know that most patients' spinal cord ends around L1-L2 (if i remember correctly :oops:). But you dont know where your patient's spinal cord ends. Are you going to go into the patients back with a spinal needle based on what you know, and what is likely, or are you going to find out about this particular patient's anatomy? You're going to go in based on what you know, and what is likely. And it just... might.... paralyze your patient.

Many times, your patient's get ONE change at you being correct. So why shouldnt you have just one chance?
 
Its been said that the USMLE and medical education in general mirrors the practice of medicine.

There is uncertainty in medicine, as well as the USMLE. You will not know every question on the USMLE, and you will not know every every anatomical variant in your patients. And what you dont know can kill them. So why shouldn't it hurt you?

You know that most patients' spinal cord ends around L1-L2 (if i remember correctly :oops:). But you dont know where your patient's spinal cord ends. Are you going to go into the patients back with a spinal needle based on what you know, and what is likely, or are you going to find out about this particular patient's anatomy? You're going to go in based on what you know, and what is likely. And it just... might.... paralyze your patient.

Many times, your patient's get ONE change at you being correct. So why shouldnt you have just one chance?

The US Medical License Exam is probably designed to decide who can practice medicine... not to rank people for residency.

Individual states have laws on how many attempts can be made for a passing score, and the lowest acceptable 2 digit score (that's the reason the 2 digit score still exists).

Maybe once you pass and are in the running, state licensing boards will not confuse themselves with multiple scores. Do they take your average score? Highest score? Lowest score? Most recent score? What if your score decreased... to failing? Once you've proved yourself competent to practice medicine, what does getting a higher score on a second attempt actually mean to the Licensing Board?

The world does not revolve around the NRMP.

:thumbup::thumbup: the best posts in this thread, congrats HowellJolly

I took the MCAT once, worked my arse off on prepping for it and was happy with my score, and that score is probably what got me into med school. I'll do the same with the USMLE.

Retaking exams is for lazy people (i.e., too lazy to work hard the first time around) with a lot of disposable cash. We're in med school now, you won't ever get a 'sick day', and even if you're having a 'bad day' the day of the exam, you should already have the knowledge ingrained in your memory, so your temperament should have little effect.
 
All this gnashing of teeth about ERAS filters is a waste of energy. The filters are being used and will continue to be used. Many PDs in competitive programs do not want to read and sift through 600 applications individually and hence the filters are used. That is the reality and it ain't going to change.

I actually know a Urology residency program director who sets his filter for a Step 1 score of 240 or higher. I was astounded when he told me this.
 
:thumbup::thumbup: the best posts in this thread, congrats HowellJolly

I took the MCAT once, worked my arse off on prepping for it and was happy with my score, and that score is probably what got me into med school. I'll do the same with the USMLE.

Retaking exams is for lazy people (i.e., too lazy to work hard the first time around) with a lot of disposable cash. We're in med school now, you won't ever get a 'sick day', and even if you're having a 'bad day' the day of the exam, you should already have the knowledge ingrained in your memory, so your temperament should have little effect.

It is not about laziness or anything like that.
It is just about the fact that if a person ,somehow, could not do well first time,why then is he/she not given a chance to improve his/her rank next time if the exam is really about ranking.If he/she spends his/her money on improving him or herself why shud u bother about that.There r many people who waste their money on the things which degrade them or bring them no profit why donot u advise them against that.
Moreover,temperament has a profound effect on how well one performs on the exam.
 
It is not about laziness or anything like that.
It is just about the fact that if a person ,somehow, could not do well first time,why then is he/she not given a chance to improve his/her rank next time if the exam is really about ranking.If he/she spends his/her money on improving him or herself why shud u bother about that.There r many people who waste their money on the things which degrade them or bring them no profit why donot u advise them against that.
Moreover,temperament has a profound effect on how well one performs on the exam.

Read my posts.

All the money in the world will not give patients a second chance. Why shud you get one?
 
Read my posts.

All the money in the world will not give patients a second chance. Why shud you get one?

Because in today's politically correct world, there can be no losers or failures. Being told "you are not good enough" is unacceptable. :rolleyes:

/sarcasm off
 
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