My Vulnerable and Personal Caribbean Medical School Journey (Part 2-Final)

[DocHopeful1]

Hello again SDN! This is insane that I'm back on here years later. I am here to finally reveal the ending of a story I started several years ago.
✨spoiler alert✨ I matched into my #1 program!

Here is the link to Part 1 of my story: My Vulnerable and Personal Caribbean Medical School Journey
That was written pre-pandemic, so of course a lot has happened during that time, in terms of my medical training.

-Timeline-
Because of the pandemic, I (like many others, I assume) had big gaps in their medical education due to hospitals not allowing students to rotate. I'm sure being from a Caribbean school made returning to hospitals even more difficult.
The first gap (8 months) is when I studied for and took my NBME CBSE (passed on the third attempt) and Step 1 (220).
My second gap (4 months) was while I was waiting a hospital assignment for my core rotations. I got an offer to start in a rotation I did not prefer but accepted it nonetheless because I wanted to start my cores as soon as possible. It ended up being a blessing because I met amazing students, residents, and attendings. I also realized I wanted that family medicine is what I imagine myself pursuing! Though it was not the most ideal situation, it all worked out for the best.
My third gap (3 months) was used to study for the NBME CCSE (passed on the second attempt), and I took Step 2 (228) during a lighter rotation.

After that, my timeline was like any other student's timeline with getting LORs and the ERAS application. I made sure to have everything on my application ready on that very first day it became public for the programs to see. As you will see with my stats below, I applied VERY broadly. Even though I was applying to only FM, I did not want to take any chances. I applied for all the FM programs in my home state, but then for my non-home states, I applied to places that have historically accepted IMGs. There was a couple of regions I did not apply to at all due to be too far from home, but other than that, I applied to as many as I could.

I had an email solely for ERAS and set up my phone where I would be notified AS SOON as I was emailed with an interview offer. In the beginning, I was taking every single interview offer I got. But as a few weeks went by, I realized that I was booked all the way through the end of December with about 25 interviews at this point. So that's when I started to cancel my interview with programs that I really did not want/too far from home. This then lend itself to having more available dates for programs I actually wanted to interview with.

Here are my stats as a US IMG, applying for Match 2023:

Specialty: Family Medicine
Step 1: 220
Step 2: 228
Programs applied: 227
Interviews offered: 38
Interviews accepted: 28
Programs ranked: 22
✨Matched at my #1 program!✨

This journey as a Caribbean medical student has been a long and unpredictable one. I have had to repeat a basic science semester, had big gaps due to not passing NBMEs on the first attempt and studying for boards in general, had gaps due to covid, and delays in education. I still stand by all of the thoughts and feelings I have about Caribbean schools (and why people choose them) from Part 1. Now being on the other side of it, I have an even more complicated feeling about it. I would still encourage anyone on the fence about going to a Caribbean school to please read Part 1 and see that there are other options for you. For those of you who have already decided on attending a Caribbean school regardless of Part 1, I will say this. I had several advantages that helped me match. The two biggest ones being these:

1) I applied for FM. This is no reflection on the importance of FM, but out of all the specialties, it's the least competitive. My scores were not the best, but according to the NRMP US IMG data for FM, I was comfortably within range. Also, there's a lot of FM spots in general as compared to something like derm.
2) I did not dual apply.

If you are wanting to do anything other than primary care, I would take caution. I don't know people's experiences personally of having to apply to non-primary specialties. But I do know of several people who really wanted to do one specialty, dual applied with IM or FM as their backup, and ended up matching at their backup. So that's also a reality you need to be aware of.

-Final thoughts-
Before making any decision, please reach out and talk to those who have experienced it themselves. That's where you'll receive the most accurate information. For those of you who have read Part 1 and now reached this end of this Part 2, I hope you see my story as a cautionary tale but also a tale of hope.

I am no longer a DocHopeful but I am now a Doc👨‍⚕️

Wishing you all the very best of luck! And don’t hesitate to ask me any questions you have about my experience!

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[TopNepNep]

Congrats on a long journey! You definetly had perseverance to fight on, unlike many other Caribbean students who gave up mid way, or medicine was not right for them, or could not find residency. Covid must have been a huge hiccup. Must be a relief the uncertainty is over
I'm a current Caribbean med student as well who wants family medicine residency back in my home province in Canada, so I'll definetly look up to you!

 

[Highlander455]

TopNepNep. If you haven't discovered it already, you will find it is very hard to match to a residency in Canada, although Family Medicine is your best shot. IMGs are marginalized in the CaRMS Match by being streamed to a limited number of residency positions designated to IMGs so CMGs are protected from competition. The overall IMG match rate is about 20%, compared to a 60% match rate in the US Match, and for top Carribean schools as high as a 95% match rate if you make it through. For this reason many Caribbean grads end up matching in the US and return to Canada afterward. With the shortage of doctors in Canada, many Provincial Colleges of Physicians and Surgeons are creating pathways for US trained physicians and especially FM specialists, to easily return from the US. If you haven't already discovered them SOCASMA (Society for Canadians Studying Medicine Abroad) is a good resource for information and support.

https://m.facebook.com/100063678245744/

www.socasma.com

 

[TopNepNep]

I appreciate the information Highlander455! I will definetly check them out! I am not trying to be oblivious of what these schools stand for (mostly being for profit, etc.) . I will not discuss or glorify Caribbean medical school. In fact, as Canadians and trying to directly match back to Canada, going to these school should be discouraged if you do not do your research.

Many of the information I will be discussing will be not related to ERAS and American matching, but mostly CaRMS, postgraduate medical education annual report from my home province for 2022, and AFMC Student Portal. I will be only discussing IMG streams in Canada, not CMG streams.

There are certain provincial advantages when applying back to their own province:
Program Descriptions - First Iteration - CaRMS
For Alberta, no other IMGs can apply IMG streams unless you are from Alberta. You must be considered as "Alberta IMG."

In fact, many rural provinces such as Dalhousie have FM (family medicine) spots that you can only apply as an applicant from that home province called "NOVA SCOTIAN IMG STREAM" if you meet the criteria. These spots are almost never filled because no one ever heard of it that is from Maritimes; from Maritimes but not interested in FM, or wanted to match else where. I actually have a classmate who will be attempting to match in this exact stream. I wish him the best.

Certain Quebec family medicine seats mostly go unfilled because of French langauge requirement. Most of these go unfulfilled because many of us IMGs cannot speak French.
The information is under "University of Calgary," "University of Alberta," "Dalhousie University" and Quebec medical schools in CaRMS.

University Of Saskatchewan – Student Portal | Portail étudiant

afmcstudentportal.ca

For my home province, no other IMG may take electives in my province. Only "home students studying aboard" may take electives as long as they have a valid health card. So they have certain advantages of having on-site electives and finding on-site references when applying.
https://medicine.usask.ca/documents/pgme/2021-2022-pgme-annual-report.pdf
Because there is so little CMGs applying FM in my province, the CMG and IMG seats are combined (there is no IMG ONLY seats) because the number of CMG accepted applicants fluctuate so much. In fact for 2022, we had more IMG FM accepted applicants than CMG FM accepted applicants (28 IMG / 48 seats) page 23 in the PGME report.
In our province FM CaRMS application strongly considers "willingness to practice in [that province], as well as ties to the province." Because most of IMGs applicants do not have ties to our province, or leave the province after their return of service.

There may be other provincial advantages I may have overlooked as well.

https://www.carms.ca/pdfs/carms-forum-2022.pdf

But there are stats that should be considered.
(Page 37) The previous years of reports are not shown but the 2022 CaRMS report shows current IMG graduate match was ~90% (107/119). I believe it was 85%ish in 2021? However, once you delay your match by 1-3 years, the match chance fluctuates from 40-59%. So as IMG, it would be better to match immediately because the match rate is higher for current IMG graduates.
However, MAJORITY of IMG applicants have graduated medical school more than 3 years and had 21% match rate (208/969). These may be immigrant who were doctors overseas but want to restart their medical career once they got their permanent residence/citizenship because you CANNOT apply for CaRMS without PR/citizenship. But there may be other factors and I am speculating.

(Page 36) Also regional factor does come in the play of where one's MD degree came from where Central America/Caribbean match rate to Canada was 22% out of 198 final participants, while the higher match rate regionally was from Europe with 58% match with 297 final participants and Oceania/Pacific Islands was 71% match rate with 31 final participants. So there may be more preference choosing MD graduates from Europe/Australian than Caribbeans.

These are some of the stats from CaRMS, would be interesting to see % match rate for current IMG graduate match with regional factor included but that is not shown.

 

[S R K]

Awesome job! Caribbean Ross Grad here, similar scores to you and also just matched in IM

Want to also give my stats if anyone is wondering:

US IMG, 2023 grad year
Step 1: 230
Step 2: 232

Applied: 200 programs
Interviews offered: 34
Interviews attended: 24
Programs Ranked: 23. I got a prematch offer somewhere else but I ended up turning it down and stayed in the match
Matched into #3 choice, but very happy!

 

[S R K]

This is no reflection on the importance of FM, but out of all the specialties, it's the least competitive

Nah bro don't sell yourself short. Based on Match and SOAP for last couple of years, EM is now the least competitive lol

 

[Highlander455]

Hi TopNepNep. Sounds like you've done a lot of research. You raise some interesting points, and I hope you're right with your analysis, however based on my understanding of CaRMS stats and Provincial program eligibility requirements on the CaRMS website, I remain somewhat skeptical that things are a good as you seem to suggest.

First, regarding Quebec positions, you are quite right. Many go unfilled because they are French language positions. However, one requirement for most Quebec residencies for IMGs is a Provincial Assessment of the comparability of their degree by the Collège des Médecins du Québec.

Quebec - CaRMS

www.carms.ca

The timing of this assessment (must be completed by January 30th of the year applying) means that this assessment can't be done until after an IMG graduates. This means most IMGs can't match in Quebec in their year of graduation and must wait a year to apply. This discourages many IMGs from applying in Quebec.

You are right about Saskatchewan requiring that IMGs have ties to Saskatchewan to obtain an elective. This may well give you an edge. Certainly, it is very difficult for IMGs to find electives in Canada, and having Canadian electives greatly enhances chances of matching. However, you do realize there are only 10 FM IMG positions in Saskatchewan (Saskatchewan, competitive for all, La Ronge 3, Moose Jaw 1 , North West 1, Prince Albert 1, Regina 1, Saskatoon 1, Southeast 1, Swift Current 1). Competition for these positions, as for all Canadian IMG positions is pretty fierce.

You write that, "the 2022 CaRMS report shows current IMG graduate match was ~90% (107/119)." Yes, you are correct, for current year applicants, ie new IMG grads, the match rate was 90%. Match rate gets worse over time as degrees get "stale." CSAs (Canadians Studying Abroad) also tend to match at a higher rate than Immigrant IMGs, although this is anecdotal as CaRMS doesn't release stats on this since 2010. So, you may be right, you may have a pretty fair chance of matching, especially in your home Province.

However, 119 current year applicants seems pretty low to me. I suspect this low number is reflective of the number of IMGs who have gotten discouraged and given up on applying to CaRMS.

Also, according to CaRMS Table 1, for 2022 there were 1,943 IMG registrants, 1,661 active participants, and 1,322 final participants, as many of these IMGs didn't get interviews and therefore didn't submit Rank Order lists. A total of 439 IMGs of 1,322 final participants matched for a match rate of 33.1. If you consider all active participants, match rate drops to 439/1661=26.4%. In short, your figures of a 90% IMG match rate are not representative for many IMGs.
https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl1e.pdf

As for your comments about the Nova Scotian IMG Stream, are you aware that this Stream appears to have only one position? Personally, I'd not care to gamble on the odds of matching to that.

Program Descriptions - First Iteration - CaRMS

This is where you’ll find everything you need to know about each program in the match, including what they’re looking for from you.

www.carms.ca

Regarding only IMGs from Alberta being able to apply to residencies there, I don't see that anywhere in the Provincial eligibility criteria for Alberta. Maybe you could provide a reference? Not saying its not true, just can't confirm it.

Eligibility criteria - CaRMS

www.carms.ca

In total, Alberta has only 17 IMG FM positions: Edmonton 6, Grand Prairie 1, Red Deer 1, Calgary 9. It doesn't add up to a lot, especially when competing with 1,354 FM IMG applicants.

According to CaRMS, the total number of IMG applicants to FM in 2022 was 1,354. A total of 505 applied to FM only. I believe almost every IMG applied to FM, most likely as a backup for the specialties they were really interested in. So, this is 1,354 applicants for a total of 170 FM positions. This is about a 12.5% statistical chance of matching.
FM is competitive for IMGs in Canada.

https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl10e.pdf

https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl14e.pdf

The total match rate for Caribbean grads in Canada was 22.2%. In 2022, 189 Carribean grads applied to CaRMS, only 42 matched.

https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl50.pdf

As you say, new grads do better in the match than older grads. This is true in the US Match too. The problem is, with the US Match coming before the Canadian match the last few years (it didn't used to be this way), applying only to the Canadian match means missing the US Match and risking a delay of a year if you aren't successful in the Canadian match. If you do apply to both US and Canadian matches, if you match in the US, which is highly likely, you will be withdrawn from the Canadian match.

To summarize, assessing the odds of matching in Canada is not simple. You seem to have characteristics and options that may work in your favour. You sound like you are still some way from the match. I wish you all the best in your studies and exams, and hope whatever pathway you choose leads you to success.

 

[Highlander455]

Adding to the above, apparently 250 unfilled FM positions in the CaRMS Match yesterday. Wow!

 

[Highlander455]

Correction. I'm seeing 10 Nova Scotian IMG positions here:

Program Descriptions - First Iteration - CaRMS

This is where you’ll find everything you need to know about each program in the match, including what they’re looking for from you.

www.carms.ca

 

[DocHopeful1]

Congrats on a long journey! You definetly had perseverance to fight on, unlike many other Caribbean students who gave up mid way, or medicine was not right for them, or could not find residency. Covid must have been a huge hiccup. Must be a relief the uncertainty is over
I'm a current Caribbean med student as well who wants family medicine residency back in my home province in Canada, so I'll definetly look up to you!

Thank you! I appreciate that a lot! It is such a relief for sure that I'm finally on the other side but it was a journey to say the least. I'm hoping now that residency is going to start soon, I don't end up regretting choosing medicine😅I mean with FM, it very much does align with how I want to interact with my patients and all. But there were several times during medical school when I wished I looked at other options. I just didn't educate myself enough. But now I know that everything truly does happen for a reason. Several major players and events in my life would not have happened if it wasn't for medical school. I would not be the person I am today if it were not for everything I went through, and I'd like to say I'm pretty proud of the person I've become.

So I will say as a fellow Caribbean student, keep on fighting the good fight! There will be days when you are truly struggling and that is absolutely normal. I can guarantee you others are feeling the same way! Along with working my butt off and being very proactive in general, I will say the reason I am here today is because of my faith and my friends. Some people don't rely on religion and that's 100% okay. But your friends, the people you surround yourself with. They can literally make or break you so throughout this journey (if you have not already), find a truly amazing group of peers and friends that you can rely on and can also encourage😊 Let me know if you have any questions!

 

[DocHopeful1]

Awesome job! Caribbean Ross Grad here, similar scores to you and also just matched in IM

Want to also give my stats if anyone is wondering:

US IMG, 2023 grad year
Step 1: 230
Step 2: 232

Applied: 200 programs
Interviews offered: 34
Interviews attended: 24
Programs Ranked: 23. I got a prematch offer somewhere else but I ended up turning it down and stayed in the match
Matched into #3 choice, but very happy!

Congratulations!! You also reached the other side!😁all those years of hard work has finally paid off!

Nah bro don't sell yourself short. Based on Match and SOAP for last couple of years, EM is now the least competitive lol

I appreciate this actually! Having applied to FM, I never really validated my own anxiety about this entire process because I always thought "well, those derm/ortho/surgery/*insert more competitive specialty here*". Obviously those specialties are much more difficult to get into but you're right. I don't have to sell myself too short. Thank you!🤝

 

[TopNepNep]

Sorry for the late reply! Pretty busy with studies.

competitive for all, La Ronge 3, Moose Jaw 1 , North West 1, Prince Albert 1, Regina 1, Saskatoon 1, Southeast 1, Swift Current 1

Yes that is what the CaRMS matching statistics says but also under the FM description program (regardless if its CMG or competitive pool description): "Our program accepts applications from IMGs in the first round of the match." Which you can apply the CMG pool as IMG.

In fact if you dig bit deeper into their Postgraduate Medical Education Report for 2021-22 and in page 23:

https://medicine.usask.ca/documents/pgme/2021-2022-pgme-annual-report.pdf

It will break down the number of IMG, CMG and the total for each location:
(CMG, IMG, Total)
La Ronge 2 1 3
Moose Jaw 3 1 4
North Battleford 0 6 6
Prince Albert 4 3 7
Regina 3 9 12
Saskatoon 7 5 12
Swift Current 1 3 4

So if you do some math it becomes (28 IMG / 48 seats) ~58%. So the sad truth is that there was more IMG FM accepted applicants than CMG FM in the province. I am not sure why it is not posted like this on CaRMS.

However, 119 current year applicants seems pretty low to me. I suspect this low number is reflective of the number of IMGs who have gotten discouraged and given up on applying to CaRMS.

If you do apply to both US and Canadian matches, if you match in the US, which is highly likely, you will be withdrawn from the Canadian match.

I would most agree, most of my peers who are Canadians would rather match into America because they want to specialize, do not want FM, and America matching have so many more residency choices. So why would take the risk of CaRMS anyways and not get matched. I believe you are right if you got matched into both ERAS and CaRMS, ERAS does supersedes CaRMS and CaRMS application be withdrawn. So the ~90% (107/119) for recent IMG graduate could be inflated.

Regarding only IMGs from Alberta being able to apply to residencies there, I don't see that anywhere in the Provincial eligibility criteria for Alberta. Maybe you could provide a reference? Not saying its not true, just can't confirm it.

It would be under here for CaRMS and under IMG:

Alberta - CaRMS

www.carms.ca

More detail under their AIMG website:

Eligibility and Supporting Documents Requirements

www.aimg.ca

You "must substantiate that they are an Albertan" by one of 3 ways: 1) 2 full years of Albertan high school; 2) 2 full years of post-secondary; or 3) be physically present in Alberta for 24 weeks (~6 months) between a certain timeframe (around CaRMS matching period). So I guess the 3rd option you don't need to be Albertan but stick around in Alberta eh?

In total, Alberta has only 17 IMG FM positions: Edmonton 6, Grand Prairie 1, Red Deer 1, Calgary 9. It doesn't add up to a lot, especially when competing with 1,354 FM IMG applicants.

Also once they confirmed you are "Albertan" and of other conditions and qualifications (proof of English, MCCQE1, NAC, etc., on top of CaRMS application), you must go through their MMI process in the AIMG program and a score will be earned (only the Albertan residency programs will know this score, not the applicant):

Multiple Mini Interviews - AIMG

Multiple Mini Interviews, a structured clinical exam, mandatory for all candidates competing for CaRMS R-1 positions for the AIMG Program.

www.aimg.ca

What a lengthy process for Albertan IMG eh? So it would most likely not be all 1,354 FM IMG that would apply the Albertan FM IMG or the other Albertan IMG specialized residency because they are not "Albertian." But I do believe those 17 IMG FM is correct unlike my home province.

BC has a similar process but you don't have to be from BC. I believe its called: "UBC’s Clinical Assessment Program (CAP)." But you can apply as "B.C. resident" in that assessment, not quiet sure if you are given priority to the pool of 300 IMGs in the MMI.

According to CaRMS, the total number of IMG applicants to FM in 2022 was 1,354. A total of 505 applied to FM only. I believe almost every IMG applied to FM, most likely as a backup for the specialties they were really interested in. So, this is 1,354 applicants for a total of 170 FM positions. This is about a 12.5% statistical chance of matching.
FM is competitive for IMGs in Canada.
https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl10e.pdf https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl14e.pdf
The total match rate for Caribbean grads in Canada was 22.2%. In 2022, 189 Carribean grads applied to CaRMS, only 42 matched.
https://www.carms.ca/wp-content/uploads/2022/06/2022_r1_tbl50.pdf

Ah I forgot to find these stats!



Its a quiet lot of research and speculation! (probably should be on Canada subforum at this point haha) Maybe ill post on my medical journey on and see what happens!

wish you all the best in your studies and exams, and hope whatever pathway you choose leads you to success.

Thank you for your kind words, means a lot!

 

[Highlander455]

TopNepNep. Thanks for your detailed reply. This thread will be helpful for others too. You've done your homework! Best wishes for every success in your journey!

 

[Fluidity of Movement]

I am no longer a DocHopeful but I am now a Doc👨‍⚕️

Change SDN Screen Name

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Change your name you ABSOLUTE LEGEND! Congratulations, doctor!

 

[stethan]

Congratulations! It is always great hearing from successful students that have gone the Caribbean route.

 

[awaywiththefairies]

Sorry for the late reply! Pretty busy with studies.

Yes that is what the CaRMS matching statistics says but also under the FM description program (regardless if its CMG or competitive pool description): "Our program accepts applications from IMGs in the first round of the match." Which you can apply the CMG pool as IMG.

In fact if you dig bit deeper into their Postgraduate Medical Education Report for 2021-22 and in page 23:

https://medicine.usask.ca/documents/pgme/2021-2022-pgme-annual-report.pdf

It will break down the number of IMG, CMG and the total for each location:
(CMG, IMG, Total)
La Ronge 2 1 3
Moose Jaw 3 1 4
North Battleford 0 6 6
Prince Albert 4 3 7
Regina 3 9 12
Saskatoon 7 5 12
Swift Current 1 3 4

So if you do some math it becomes (28 IMG / 48 seats) ~58%. So the sad truth is that there was more IMG FM accepted applicants than CMG FM in the province. I am not sure why it is not posted like this on CaRMS.


I would most agree, most of my peers who are Canadians would rather match into America because they want to specialize, do not want FM, and America matching have so many more residency choices. So why would take the risk of CaRMS anyways and not get matched. I believe you are right if you got matched into both ERAS and CaRMS, ERAS does supersedes CaRMS and CaRMS application be withdrawn. So the ~90% (107/119) for recent IMG graduate could be inflated.

It would be under here for CaRMS and under IMG:

Alberta - CaRMS

www.carms.ca

More detail under their AIMG website:

Eligibility and Supporting Documents Requirements

www.aimg.ca

You "must substantiate that they are an Albertan" by one of 3 ways: 1) 2 full years of Albertan high school; 2) 2 full years of post-secondary; or 3) be physically present in Alberta for 24 weeks (~6 months) between a certain timeframe (around CaRMS matching period). So I guess the 3rd option you don't need to be Albertan but stick around in Alberta eh?

Also once they confirmed you are "Albertan" and of other conditions and qualifications (proof of English, MCCQE1, NAC, etc., on top of CaRMS application), you must go through their MMI process in the AIMG program and a score will be earned (only the Albertan residency programs will know this score, not the applicant):

Multiple Mini Interviews - AIMG

Multiple Mini Interviews, a structured clinical exam, mandatory for all candidates competing for CaRMS R-1 positions for the AIMG Program.

www.aimg.ca

What a lengthy process for Albertan IMG eh? So it would most likely not be all 1,354 FM IMG that would apply the Albertan FM IMG or the other Albertan IMG specialized residency because they are not "Albertian." But I do believe those 17 IMG FM is correct unlike my home province.

BC has a similar process but you don't have to be from BC. I believe its called: "UBC’s Clinical Assessment Program (CAP)." But you can apply as "B.C. resident" in that assessment, not quiet sure if you are given priority to the pool of 300 IMGs in the MMI.

Ah I forgot to find these stats!



Its a quiet lot of research and speculation! (probably should be on Canada subforum at this point haha) Maybe ill post on my medical journey on and see what happens!

Thank you for your kind words, means a lot!

I applied to BC as an Albertan and matched. Basically anyone can apply but you score more points if your from BC or have connections because they want you to stay after. Most people who match to my program have pre-existing ties or families in BC already I noticed.

 

[TopNepNep]

I applied to BC as an Albertan and matched. Basically anyone can apply but you score more points if your from BC or have connections because they want you to stay after. Most people who match to my program have pre-existing ties or families in BC already I noticed.

Would you say matching to Alberta as AIMG is harder or matching to BC as an out of province applicant is harder?
This might depend on your matching rank if BC was higher in your rank. Just asking because some of my classmate are from Alberta and would it be worth it for them to apply as AIMG.