Worcestershire Acute Hospitals NHS Trust

Clinical Fellow F3 Acute Medicine

Information:

This job is now closed

Job summary

You will be working as an FY3 or equivalent grade supporting Acute Medicine at the Alexandra Hospital - "The Alex" in Redditch. The Hospital has a 49 bedded Acute Medical Unit comprising an Assessment Unit and Short Stay Unit alongside a 12 space Ambulatory Emergency Care Unit.

The role is mainly ward-based, and you will be working alongside 6 Acute Consultants, a senior middle grade doctor and 8 juniors who rotate between Medical Specialties and Acute Medicine and support the GIM rota.

Candidates should be available to start by December 2023.

The Alex is part of the Worcestershire Acute Hospitals NHS Trust and is located in the North East of the County near the border of South Warwickshire and Birmingham / Solihull. There are excellent road links with neighbouring areas for easy commuting. The hospital has 360 beds and a busy Emergency Department (ED) seeing circa 61,000 patients a year. It serves a local population of 200,000 but sees many more due to its proximity to other counties. There are a range of both medical and surgical specialties on site with a busy medical take of patients moving from the ED to the AMU.

There is a doctors mess, and a multi-disciplinary education centre on site with a library, teaching and study leave. Whilst these are not deanery posts, you will be supported to pursue postgraduate training and to participate in teaching sessions and Grand Rounds.

Main duties of the job

Your core working hours will be 08:30 16:30 Monday to Friday, working on either the Short Stay or Assessment Unit. You will undertake a range of duties to support patient treatment including:

attending consultant ward rounds

progressing actions arising

requesting investigations and reviewing results

making referrals to other specialties

prescribing

completing discharge summaries

discussing treatment with patients and their relatives / friends as appropriate

working closely with other doctors, nurses and other health care professionals working on the ward

completing relevant documentation and the electronic patient record

other duties relevant to your grade.

About us

Our purpose is simple - Putting Patients First. We are looking for exceptional colleagues who can help us achieve this.

Worcestershire Acute Hospitals NHS Trust is a large acute and specialised hospital trust that provides a range of local acute services to the residents of Worcestershire and more specialised services to a larger population in Herefordshire and beyond.

The Trust operates hospital-based services from three sites in Kidderminster, Redditch and Worcester

Our workforce is nearly 6,800 strong, and our caring staff are recognised as providing good and outstanding patient-centred care. You could be one of them.

We are committed to recruiting the best people to work with us to achieve our Vision - working in partnership to provide the best healthcare for our communities, leading and supporting our teams to move 4ward. Our 4ward behaviours, which we ask all staff to demonstrate, underpin our everyday work and remain firmly at the heart of all we do.

Our objectives are simple:

  • Best services for local people
  • Best experience of care and best outcomes for our patients
  • Best use of resources
  • Best people

Better never stops, and our Clinical Services Strategy provides a clear future vision for our Trust, our hospitals, our services and our role in the wider health and care system.

We are proud to have achieved Timewise accreditation - this means we are committed to embedding flexible working within our organisation as a flex positive employer.

Details

Date posted

21 August 2023

Pay scheme

Hospital medical and dental staff

Grade

Foundation Doctor

Salary

£43,923 a year Nodal 3

Contract

Fixed term

Duration

6 months

Working pattern

Full-time

Reference number

C9365-23-0771-1

Job locations

The Alexandra Hospital

Woodrow Drive

Redditch

Worcestershire

B98 7UB


Job description

Job responsibilities

POST SUMMARY:

  • Applications are invited for Foundation year 3 posts offered by the Worcestershire Acute Hospitals NHS Trust, based at the Alexandra Hospital, Redditch. These posts are for a period of 6 months with the potential to extend..

  • These posts are not Deanery posts. However, the posts are structured to provide a portfolio-based Postgraduate Training Programme similar to the Deanery model. The Trust is committed to providing the medical training content.

The posts are for 6 months on a 08:30 16:30 Monday to Friday basis. Opportunities are available to cover weekend shifts through a bank.

  • The successful candidates will be welcomed to join the weekly teaching sessions and Grand Rounds. In-house training will be provided for PACES/MRCP part II, and study leave will be available to help candidates prepare for the examinations.

  • Duties of the posts include care of acute medical admissions to hospital and short stay inpatients. Participation in audit and research is encouraged. Training will be supervised by a named consultant.

  • The typical candidate should have completed foundation year 1-2 training and are suitable for those with an interest in a career in medical specialities, or would like to sample a wider range of medical specialities prior to further training. Completion of the post should help prepare the candidate for further specialist training in the UK or abroad.

WORCESTERSHIRE GENERAL BACKGROUND

Worcestershire is a largely rural County, with four main towns, Bromsgrove, Kidderminster, Redditch and Worcester, lying between the Cotswolds, Welsh Border and Birmingham. There are four further substantial market towns of Malvern, Pershore, Evesham and Droitwich. Acute medical services are provided by two District General Hospitals, a Treatment Centre and a number of Community hospitals.

The major motorway network of the M42, M5 and M6, providing excellent communications, intersect the county. Local leisure facilities are well developed and the area has easy access to Birmingham/Solihull where the National Indoor Arena, International Convention Centre with the Birmingham Symphony Hall and the National Exhibition Centre are located. Stratford and the Royal Shakespeare Company are on the doorstep. Worcester City lying on the banks of the River Severn has the world famous cathedral, County Cricket Ground, Premiership Rugby and is home to the Royal Worcester Porcelain Factory. The Malvern Hills and the Wyre Forest are in the locality.

TRUST PROFILE

Worcestershire Acute Hospitals NHS Trust runs services from three main hospital sites: The Alexandra Hospital, Redditch; Kidderminster Hospital and Treatment Centre; and The Worcestershire Royal Hospital.

We also run some services and clinics at The Princess of Wales Hospital, Bromsgrove (outpatient clinics); Evesham Community Hospital (Burlingham Ward); Malvern Community Hospital (outpatient clinics); and Tenbury Community Hospital (outpatient clinics).

We have three main commissioners: Redditch and Bromsgrove Clinical Commissioning Group; South Worcestershire Clinical Commissioning Group; and Wyre Forest Clinical Commissioning Group.

We have an annual budget of £350million and service a population of more than 550,000 providing a wide range of surgical, medical and rehabilitation services. We have nearly 6,000 staff and provide services predominantly to the people of Worcestershire. However, patients do also come from further afield, most notably from Herefordshire, Dudley, South Staffordshire, Shropshire, Warwickshire and Birmingham. Every year we care for nearly 800,000 patients including 90,000 people who need operations, 130,000 people in A&E and 500,000 outpatients. More than 6,300 babies are born in our Trust every year.

ALEXANDRA HOSPITAL, REDDITCH

The Alexandra Hospital in Redditch opened in 1985. It serves a population of approximately 200,000 and has 360 beds. The hospital is the major centre for the countys urology service. The hospital has seven operating theatres, MRI and CT scanners and cancer unit status for breast, lung, urology, gynaecology and colorectal cancers. There is a multi-disciplinary education centre with library, teaching and study areas.

Our plan for the Alexandra Hospital is to increase the amount of planned elective activity carried out at the hospital, especially in orthopaedics.

KIDDERMINSTER TREATMENT CENTRE

Kidderminster Hospital houses Kidderminster Treatment Centre which offers outstanding clinical facilities and patient accommodation for a wide range of daycase, short stay and inpatient procedures. The nurse-led minor injuries service is open 24 hours a day and treats more than 2,000 patients every month. It can deal with a wide variety of injuries including simple fractures, soft tissue injuries, lacerations, bites, burns and scaled. Other facilities at the Kidderminster site include a full range of outpatient clinics including outpatient cancer treatment in the Millbrook Suite MRI and CT scanners and a renal dialysis unit. There is also a modern education centre with seminar rooms, IT suite, library and break out areas.

Our plan for Kidderminster is to increase the number of daycase, short stay and inpatient procedures performed and for it to become an elective centre for the Trust.

WORCESTERSHIRE ROYAL HOSPITAL

Worcestershire Royal Hospital is the latest of the Trusts three sites. The main hospital was built under the private finance initiative (PFI) and opened in 2002. It provides specialist services for the whole of Worcestershire including stroke services and cardiac stenting. The hospital has nine operating theatres including four laminar theatres. It has a level 2 neonatal intensive care unit and a cardiac catheterisation laboratory. The 24/7 Primary Percutaneous Coronary Intervention (PPCI) service began in October 2013. It has 500 beds and serves a population of more than 550,000.

The countys brand new, state-of-the-art Oncology Centre was officially opened by HRH the Princess Royal in April 2015. Developed in partnership with University Hospitals Coventry and Warwickshire, the £25 million Worcestershire Oncology Centre will enable 95 per cent of radiotherapy to be delivered within Worcestershire. For patients, their families and their carers, who previously had to travel to Coventry, Cheltenham or Wolverhampton for radiotherapy treatment, cancer services will be more accessible than ever, saving an estimated one million miles of travel every year.

Our plan for the Worcestershire Royal is for it to specialise in more complex and tertiary services for patients from across the county, giving them access to services that they would previously have had to travel out of county for. We have recently opened our state-of-the-art Worcestershire Oncology Centre, which will provide radiotherapy services in county for the first time. Other developments include a dedicated Breast Unit which opened in 2016.

Foundation year 3 POST

These posts are designed to offer experience and training to doctors who have completed foundation year 1-2 training and are suitable for those with an interest in a career in medical specialities, or would like to sample a wider range of medical specialities prior to further training.

Working as a foundation year 3 post in this Trust will combine exposure to acute unselected general medicine, with structured teaching to suit individual doctors.

F3 doctors will be allocated a consultant supervisor and will be welcomed to join the weekly teaching sessions and Grand Rounds. In-house training is provided for PACES/MRCP part II, and study leave will be available to help candidates attend courses to prepare for the examinations.

Undergraduate and Postgraduate Teaching.

The Trusts inpatient hospitals are Associate Teaching Hospitals with the University of Birmingham Medical School, and take part in undergraduate teaching of medical students in their third, fourth and final years. There is also an active postgraduate training programme co-produced with the West Midlands Postgraduate Deanery for CT1, CT2 and GP VTS training, as well as Specialist Registrar training in most specialties. These programmes include consultant supervision through consultants acting as clinical and educational supervisors, weekly protected teaching time, and a training portfolio logbook of clinical competencies and procedures. The Trust is already working closely with the University of Worcesters Institute of Health and Society and seeking ways of extending this collaboration.

DUTIES OF THE POST

General Duties - the details will differ in different Departments.

Inpatients consultant and registrar ward rounds, ward referrals.

Acute medicine on-call

Outpatients 1-2 clinics per week.

Observation and assisting the consultant or registrar with relevant procedures and investigations.

Attendance at multidisciplinary team meetings

Attendance at Grand Rounds and other Medical Meetings

Attendance at scheduled teaching sessions

Participation in audit projects.

Participation in Mortality & Morbidity case reviews.

TEACHING, AUDIT AND RESEARCH

The Consultants are keen to encourage audit and research projects. There is an active Clinical Audit Programme and audit meetings are held once in two months for a full afternoon. All Medical Departments take part in the audit projects regularly and the Fellow will be expected to contribute by undertaking and presenting audits.

Job description

Job responsibilities

POST SUMMARY:

  • Applications are invited for Foundation year 3 posts offered by the Worcestershire Acute Hospitals NHS Trust, based at the Alexandra Hospital, Redditch. These posts are for a period of 6 months with the potential to extend..

  • These posts are not Deanery posts. However, the posts are structured to provide a portfolio-based Postgraduate Training Programme similar to the Deanery model. The Trust is committed to providing the medical training content.

The posts are for 6 months on a 08:30 16:30 Monday to Friday basis. Opportunities are available to cover weekend shifts through a bank.

  • The successful candidates will be welcomed to join the weekly teaching sessions and Grand Rounds. In-house training will be provided for PACES/MRCP part II, and study leave will be available to help candidates prepare for the examinations.

  • Duties of the posts include care of acute medical admissions to hospital and short stay inpatients. Participation in audit and research is encouraged. Training will be supervised by a named consultant.

  • The typical candidate should have completed foundation year 1-2 training and are suitable for those with an interest in a career in medical specialities, or would like to sample a wider range of medical specialities prior to further training. Completion of the post should help prepare the candidate for further specialist training in the UK or abroad.

WORCESTERSHIRE GENERAL BACKGROUND

Worcestershire is a largely rural County, with four main towns, Bromsgrove, Kidderminster, Redditch and Worcester, lying between the Cotswolds, Welsh Border and Birmingham. There are four further substantial market towns of Malvern, Pershore, Evesham and Droitwich. Acute medical services are provided by two District General Hospitals, a Treatment Centre and a number of Community hospitals.

The major motorway network of the M42, M5 and M6, providing excellent communications, intersect the county. Local leisure facilities are well developed and the area has easy access to Birmingham/Solihull where the National Indoor Arena, International Convention Centre with the Birmingham Symphony Hall and the National Exhibition Centre are located. Stratford and the Royal Shakespeare Company are on the doorstep. Worcester City lying on the banks of the River Severn has the world famous cathedral, County Cricket Ground, Premiership Rugby and is home to the Royal Worcester Porcelain Factory. The Malvern Hills and the Wyre Forest are in the locality.

TRUST PROFILE

Worcestershire Acute Hospitals NHS Trust runs services from three main hospital sites: The Alexandra Hospital, Redditch; Kidderminster Hospital and Treatment Centre; and The Worcestershire Royal Hospital.

We also run some services and clinics at The Princess of Wales Hospital, Bromsgrove (outpatient clinics); Evesham Community Hospital (Burlingham Ward); Malvern Community Hospital (outpatient clinics); and Tenbury Community Hospital (outpatient clinics).

We have three main commissioners: Redditch and Bromsgrove Clinical Commissioning Group; South Worcestershire Clinical Commissioning Group; and Wyre Forest Clinical Commissioning Group.

We have an annual budget of £350million and service a population of more than 550,000 providing a wide range of surgical, medical and rehabilitation services. We have nearly 6,000 staff and provide services predominantly to the people of Worcestershire. However, patients do also come from further afield, most notably from Herefordshire, Dudley, South Staffordshire, Shropshire, Warwickshire and Birmingham. Every year we care for nearly 800,000 patients including 90,000 people who need operations, 130,000 people in A&E and 500,000 outpatients. More than 6,300 babies are born in our Trust every year.

ALEXANDRA HOSPITAL, REDDITCH

The Alexandra Hospital in Redditch opened in 1985. It serves a population of approximately 200,000 and has 360 beds. The hospital is the major centre for the countys urology service. The hospital has seven operating theatres, MRI and CT scanners and cancer unit status for breast, lung, urology, gynaecology and colorectal cancers. There is a multi-disciplinary education centre with library, teaching and study areas.

Our plan for the Alexandra Hospital is to increase the amount of planned elective activity carried out at the hospital, especially in orthopaedics.

KIDDERMINSTER TREATMENT CENTRE

Kidderminster Hospital houses Kidderminster Treatment Centre which offers outstanding clinical facilities and patient accommodation for a wide range of daycase, short stay and inpatient procedures. The nurse-led minor injuries service is open 24 hours a day and treats more than 2,000 patients every month. It can deal with a wide variety of injuries including simple fractures, soft tissue injuries, lacerations, bites, burns and scaled. Other facilities at the Kidderminster site include a full range of outpatient clinics including outpatient cancer treatment in the Millbrook Suite MRI and CT scanners and a renal dialysis unit. There is also a modern education centre with seminar rooms, IT suite, library and break out areas.

Our plan for Kidderminster is to increase the number of daycase, short stay and inpatient procedures performed and for it to become an elective centre for the Trust.

WORCESTERSHIRE ROYAL HOSPITAL

Worcestershire Royal Hospital is the latest of the Trusts three sites. The main hospital was built under the private finance initiative (PFI) and opened in 2002. It provides specialist services for the whole of Worcestershire including stroke services and cardiac stenting. The hospital has nine operating theatres including four laminar theatres. It has a level 2 neonatal intensive care unit and a cardiac catheterisation laboratory. The 24/7 Primary Percutaneous Coronary Intervention (PPCI) service began in October 2013. It has 500 beds and serves a population of more than 550,000.

The countys brand new, state-of-the-art Oncology Centre was officially opened by HRH the Princess Royal in April 2015. Developed in partnership with University Hospitals Coventry and Warwickshire, the £25 million Worcestershire Oncology Centre will enable 95 per cent of radiotherapy to be delivered within Worcestershire. For patients, their families and their carers, who previously had to travel to Coventry, Cheltenham or Wolverhampton for radiotherapy treatment, cancer services will be more accessible than ever, saving an estimated one million miles of travel every year.

Our plan for the Worcestershire Royal is for it to specialise in more complex and tertiary services for patients from across the county, giving them access to services that they would previously have had to travel out of county for. We have recently opened our state-of-the-art Worcestershire Oncology Centre, which will provide radiotherapy services in county for the first time. Other developments include a dedicated Breast Unit which opened in 2016.

Foundation year 3 POST

These posts are designed to offer experience and training to doctors who have completed foundation year 1-2 training and are suitable for those with an interest in a career in medical specialities, or would like to sample a wider range of medical specialities prior to further training.

Working as a foundation year 3 post in this Trust will combine exposure to acute unselected general medicine, with structured teaching to suit individual doctors.

F3 doctors will be allocated a consultant supervisor and will be welcomed to join the weekly teaching sessions and Grand Rounds. In-house training is provided for PACES/MRCP part II, and study leave will be available to help candidates attend courses to prepare for the examinations.

Undergraduate and Postgraduate Teaching.

The Trusts inpatient hospitals are Associate Teaching Hospitals with the University of Birmingham Medical School, and take part in undergraduate teaching of medical students in their third, fourth and final years. There is also an active postgraduate training programme co-produced with the West Midlands Postgraduate Deanery for CT1, CT2 and GP VTS training, as well as Specialist Registrar training in most specialties. These programmes include consultant supervision through consultants acting as clinical and educational supervisors, weekly protected teaching time, and a training portfolio logbook of clinical competencies and procedures. The Trust is already working closely with the University of Worcesters Institute of Health and Society and seeking ways of extending this collaboration.

DUTIES OF THE POST

General Duties - the details will differ in different Departments.

Inpatients consultant and registrar ward rounds, ward referrals.

Acute medicine on-call

Outpatients 1-2 clinics per week.

Observation and assisting the consultant or registrar with relevant procedures and investigations.

Attendance at multidisciplinary team meetings

Attendance at Grand Rounds and other Medical Meetings

Attendance at scheduled teaching sessions

Participation in audit projects.

Participation in Mortality & Morbidity case reviews.

TEACHING, AUDIT AND RESEARCH

The Consultants are keen to encourage audit and research projects. There is an active Clinical Audit Programme and audit meetings are held once in two months for a full afternoon. All Medical Departments take part in the audit projects regularly and the Fellow will be expected to contribute by undertaking and presenting audits.

Person Specification

Personal attributes

Essential

  • Diplomatic and tactful
  • Flexible approach to work duties
  • Ability to work in a team
  • Ability to work under pressure
  • Enquiring, critical approach to work
  • Ability to communicate effectively with patients, relatives, GPs, nurses and other agencies
  • Ability to organise and manage workload priorities

Desirable

  • Interest in research in medical education

Qualifications

Essential

  • Qualification that is registerable with the GMC for full registration i.e. MB BS or equivalent, and eligible for GMC registration at time of appointment
  • ALS

Desirable

  • MRCP Part 1
  • UK experience

Experience

Essential

  • At least 2 years full time or equivalent postgraduate training, at least 8 months of which will be in a General Medicine training programme or as a General Medicine FTSTA
  • Ability to offer expert clinical opinion on range of problems both emergency and elective within specialty and sufficient experience
  • Ability to take full and independent responsibility for clinical care of patients

Desirable

  • Experience of Audit

Teaching experience

Essential

  • Ability to teach clinical skills to medical, nursing staff and other disciplines
  • Experience of teaching clinical skills to undergraduates and postgraduates

Desirable

  • Ability to supervise postgraduate research

Other requirements

Essential

  • An understanding of the current NHS environment, particularly in relation to reforms, initiatives and issues
  • Workplace Health Clearance by time of appointment
  • Access to transport and ability to travel across hospital sites
  • Due to the nature of our work, all posts are deemed to require a satisfactory Enhanced Disclosure & Barring Service (DBS) Check. All posts working with children or vulnerable adults are required to have an Enhanced DBS checked including checking against DBS / ISA Vetting and Barring lists.
Person Specification

Personal attributes

Essential

  • Diplomatic and tactful
  • Flexible approach to work duties
  • Ability to work in a team
  • Ability to work under pressure
  • Enquiring, critical approach to work
  • Ability to communicate effectively with patients, relatives, GPs, nurses and other agencies
  • Ability to organise and manage workload priorities

Desirable

  • Interest in research in medical education

Qualifications

Essential

  • Qualification that is registerable with the GMC for full registration i.e. MB BS or equivalent, and eligible for GMC registration at time of appointment
  • ALS

Desirable

  • MRCP Part 1
  • UK experience

Experience

Essential

  • At least 2 years full time or equivalent postgraduate training, at least 8 months of which will be in a General Medicine training programme or as a General Medicine FTSTA
  • Ability to offer expert clinical opinion on range of problems both emergency and elective within specialty and sufficient experience
  • Ability to take full and independent responsibility for clinical care of patients

Desirable

  • Experience of Audit

Teaching experience

Essential

  • Ability to teach clinical skills to medical, nursing staff and other disciplines
  • Experience of teaching clinical skills to undergraduates and postgraduates

Desirable

  • Ability to supervise postgraduate research

Other requirements

Essential

  • An understanding of the current NHS environment, particularly in relation to reforms, initiatives and issues
  • Workplace Health Clearance by time of appointment
  • Access to transport and ability to travel across hospital sites
  • Due to the nature of our work, all posts are deemed to require a satisfactory Enhanced Disclosure & Barring Service (DBS) Check. All posts working with children or vulnerable adults are required to have an Enhanced DBS checked including checking against DBS / ISA Vetting and Barring lists.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Additional information

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Worcestershire Acute Hospitals NHS Trust

Address

The Alexandra Hospital

Woodrow Drive

Redditch

Worcestershire

B98 7UB


Employer's website

https://www.worcsacute.nhs.uk/ (Opens in a new tab)


Employer details

Employer name

Worcestershire Acute Hospitals NHS Trust

Address

The Alexandra Hospital

Woodrow Drive

Redditch

Worcestershire

B98 7UB


Employer's website

https://www.worcsacute.nhs.uk/ (Opens in a new tab)


Employer contact details

For questions about the job, contact:

Consultant in Acute Medicine

Dr M Saeed

muhammad.saeed4@nhs.net

01527503030

Details

Date posted

21 August 2023

Pay scheme

Hospital medical and dental staff

Grade

Foundation Doctor

Salary

£43,923 a year Nodal 3

Contract

Fixed term

Duration

6 months

Working pattern

Full-time

Reference number

C9365-23-0771-1

Job locations

The Alexandra Hospital

Woodrow Drive

Redditch

Worcestershire

B98 7UB


Supporting documents

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