Match Blog
How to Match Into Orthopedic Surgery Residency
Step-by-Step Guide for 2027 Applicants
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Matching into Orthopedic Surgery is one of the most competitive pathways in U.S. residency training, regardless of whether if you are a strong US graduate or an international medical graduate (IMG). But with the right combination of high academic performance, clinical excellence, and targeted preparation, matching into this rewarding and dynamic specialty is achievable. In this blog, we break down what orthopedic surgery residency involves and provide strategic tips to help you maximize your chances of matching.
Table of Contents
- Competitiveness of Orthopedic Surgery
- Key Components of a Strong Match Application
1. USMLE Step Exams
2. Clinical Experience in the U.S.
3. Research: Experience, Publications & Productivity
4. Letters of Recommendation (LoRs)
5. Personal Statement
6. ERAS Experiences
7. Application Strategy
8. Interview Preparation: Where the Match Is Won - Overview of Orthopedic Surgery
- Final Advice from Matched Ortho Applicants
- Final Thoughts
🧮 Competitiveness of Orthopedic Surgery
Orthopedic Surgery is a highly competitive field for all applicants, but especially for IMGs. According to the 2026 NRMP Match data:
| Applicant Type | Total Applicants | Matched | Match Rate |
|---|---|---|---|
| US MD Seniors | 1,129 | 765 | 67.8% |
| US DO Seniors | 283 | 121 | 42.8% |
| US IMGs | 36 | 5 | 13.9% |
| Non-US IMGs | 22 | 5 | 22.7% |
The match rate was calculated by dividing the number of matched applicants by the total number of applicants for each applicant type, then multiplying by 100 to express it as a percentage.
Source: NRMP
The table below highlights trends in Orthopedic Surgery Positions and how they were filled by different applicant groups over the past four years.
| Year | Positions Offered | Filled by U.S. MD Seniors | Filled by U.S. DO Seniors | Filled by U.S. IMGs | Filled by Non-U.S. IMGs |
|---|---|---|---|---|---|
| 2026 | 963 | 765 | 121 | 5 | 5 |
| 2025 | 929 | 724 | 131 | 8 | 14 |
| 2024 | 916 | 726 | 117 | 6 | 2 |
| 2023 | 899 | 690 | 119 | 8 | 4 |
📈 Key Components of a Strong Match Application
1. USMLE Step Exams
When it comes to residency applications, many programs use standardized exam scores as an initial screening tool. Step 1 historically held the most weight in this process but with its shift to a pass/fail scoring system, the spotlight has moved to Step 2 CK. That said, it’s still crucial to pass Step 1, as a failure can significantly hurt your chances of matching.
Why Step 2 CK Matters Now More Than Ever
Step 2 CK has become a crucial component of the evaluation process. While a high score doesn’t necessarily equate to better clinical skills or guarantee that someone will be a more competent physician, it does speak volumes about an applicant’s work ethic and determination. A strong Step 2 CK score shows:
- Commitment to excellence
- Dedication to the process
- Willingness to invest time and effort to succeed
The table below shows the average Step 2 CK scores for applicants who successfully matched in 2026. These scores offer a helpful benchmark for understanding how your performance compares to other matched candidates.
According to NRMP’s 2026 data:
| Applicant Type | Avg. Step 2 CK Score (Matched) |
|---|---|
| US MD Seniors | 259 |
| US DO Seniors | 256 |
| US IMGs | – |
| Non-US IMGs | – |
Source: NRMP 2026 Charting Outcomes
hile these averages provide a general overview by applicant type, Step 2 CK expectations can vary significantly by specialty. You can read our blog on the average scores by specialty here.
Step 3: An Often-Overlooked Opportunity
If your Step 2 CK score wasn’t as strong as you’d hoped, Step 3 offers a chance to turn things around. A solid performance on Step 3 can serve as evidence of resilience, growth, and your ability to bounce back and improve.
However, do not take the exam lightly. We’ve seen applicants attempt Step 3 hoping to boost their chances, only to fail ultimately hurting their application even more. If you decide to take Step 3 before matching, make sure you’re fully prepared to pass.
Tips to Succeed
✅ While not everyone is a naturally strong test taker, there are numerous resources available to help boost performance, including our personalized USMLE tutoring services, designed to help you break down complex topics, master high-yield concepts, and develop test-taking strategies. Start with a free session here.
You can check out our Biostatistics Course here.
2. Clinical Experience in the U.S.
Orthopedic Surgery demands hands-on experience, preferably in surgical or musculoskeletal-focused rotations. For IMGs, completing electives or externships in orthopedics at U.S. hospitals is absolutely imperative. We expand on that aspect on our USCE for IMGs blog here. The more U.S. clinical exposure you have, the more comfortable programs will feel about your readiness to function in their healthcare system.
Types of U.S. Clinical Experience
USCE comes in various forms, each offering a unique level of engagement and value:
- Electives (most meaningful): Completed before graduation, electives are considered the gold standard. These are hands-on experiences where you’re expected to participate actively in patient care interviewing, examining, presenting cases, and writing notes. Doing an Orthopedics sub-internship is the most valuable experience, but these opportunities can be harder to come by. Check the elective list on our website here.
- Externships (second most valuable): These are hands-on clinical experiences done after graduation. While not quite as weighted as electives, they still allow for direct patient interaction and demonstrate continued clinical involvement.
- Observerships (least impactful, but still important): These are not hands-on; you’re shadowing physicians and observing clinical care without direct involvement. While lower in impact, observerships still show initiative and exposure to the U.S. healthcare system.
Inpatient vs. Outpatient Experience
USCE can also be classified based on the setting:
- Inpatient: Experience in hospital wards provides exposure to acute management, teamwork with residents and attendings, and the fast pace of hospital medicine.
- Outpatient: Clinic experiences help demonstrate your ability to form longitudinal relationships, manage chronic conditions, and engage with patients in preventive care.
Both are meaningful, and what matters most is how you show up during these experiences.
Make the Most of Every Opportunity
No matter the type or setting, the value of USCE comes from your level of engagement. Being proactive can leave a lasting impression:
- Volunteer to present cases
- See more patients and take initiative
- Read about different diseases and ask questions
- Offer your thoughts on assessment and management plans
- Check in on patients in the afternoon and engage with the patient and their families. Compliments from patients and their families leave a lasting impression on the team.
- Try to help the team out, even with non-clinical tasks, like requesting outside hospital records. Being a good team player will be noticed and attendings very often ask residents what they think of visiting medical students.
These moments allow you to showcase your clinical reasoning and communication skills qualities that letter writers can highlight in your Letters of Recommendation (LORs). Strong LORs from U.S. physicians based on your performance in clinical settings can make a big difference in your ERAS application.
Residency Is a Clinical Job Start Practicing Now
At the end of the day, residency is a hands-on clinical job. You’ll be interacting with co-residents, attendings, and patients daily. USCE gives you the chance to practice those real-world skills, demonstrate your adaptability, and prove that you’re ready to contribute from day one.
So our advice? Do as much USCE as possible. Every experience adds to your confidence, credibility, and competitiveness.
📌 Need help finding clinical experience? Explore our USCE opportunities catalogue or contact us to discuss your needs.
3. Research: Experience, Publications & Productivity
In orthopedic surgery, where the competition is fierce and the number of qualified applicants far exceeds the available residency spots, an impressive research portfolio including publications, presentations, and academic productivity is not just an advantage but is slowly becoming a necessity. With Step 1 moving to pass/fail there are fewer opportunities for applicants (both IMGs and US graduates) to make their applications standout. As such, research experiences are becoming a mechanism to fill this vacuum. Unlike many other specialties, orthopedics places a strong emphasis on innovation and academic contribution, and program directors actively seek applicants who demonstrate a proven commitment to advancing the field. High research output signals intellectual rigor, dedication, and long-term interest in orthopedics qualities that resonate with academic programs aiming to train future leaders. In a field driven by technological advancement, surgical innovation, and evidence-based practice, research productivity sets top applicants apart and serves as a key metric of readiness for the demands of orthopedic residency.
How Much Research Do I Need to Do?
This is one of the most common questions we get from applicants interested in orthopedic surgery. Unfortunately, there’s no single answer that applies to everyone, it depends on your background, where you’re coming from, and how the rest of your application looks. That said, here are some general guidelines to help you set expectations:
For U.S. Medical Students:
Most U.S. graduates match into orthopedic surgery without dedicating 2–3 years exclusively to research. However, successful applicants usually have either:
- A dedicated 12-month research year (often between third and fourth year of medical school),
or - Several longitudinal research projects started early in medical school, particularly if they decided on orthopedics early on.
Many U.S. students combine clinical exposure with research by working on projects during clerkships or summers. The key is to produce meaningful output: abstracts, presentations, and publications that show commitment to orthopedics and academic productivity.
If you’re a U.S. medical student with an early interest in ortho, start research as soon as you can. It’s much easier to build momentum over time than to scramble last minute trying to catch up.
For International Medical Graduates (IMGs):
For IMGs, the bar for research is usually higher, both in terms of quantity and time commitment. Most successful IMGs spend 2–3 years in dedicated orthopedic research positions before applying. This serves multiple purposes:
- Building a competitive CV with publications, presentations, and academic projects.
- Developing strong relationships with U.S. orthopedic surgeons, which can lead to high-quality letters of recommendation, mentorship, and sometimes even interview opportunities.
- Learning the U.S. academic system, including how research teams operate, how to write abstracts, and how to present at conferences.
In many cases, the relationships you build during research are just as important as the research itself. Working closely with faculty allows you to prove your work ethic, communication skills, and commitment to orthopedics in ways that test scores alone can’t show.
If you’re an IMG, think of your research years as an investment not only in your CV but also in your network. Be proactive, stay productive, and use this time to create connections that can open doors when the Match cycle starts.
Need Help?
Our team offers personalized advising for orthopedic surgery applicants, including research planning, application strategy, and interview prep. Whether you’re a U.S. grad or an IMG, we’ll help you build the strongest possible application
Why Research Matters
Being involved in research shows more than academic curiosity. It reflects:
- Teamwork – Most research is collaborative. It shows that you can work effectively with others toward a shared goal.
- Hard work and productivity – Research requires long hours, attention to detail, and the ability to push through challenges.
- Adaptability and learning – Every research project introduces new methodologies, analytical tools, or clinical topics.
- Commitment to medicine – Your willingness to go beyond required clinical work and explore deeper questions shows true passion for the field.
These are all traits that align perfectly with the expectations of a resident especially in Orthopedics, where intellectual curiosity and lifelong learning are core values. Get access to the free lessons of our research course HERE.
Setting the Stage for Fellowship and Future Growth
Another major benefit of research is its potential to lay the foundation for future specialization. If you’re considering fellowship down the line, research in your area of interest can:
- Give you an early head start toward building a niche
- Help you network with residents, fellows, and faculty mentors
- Provide talking points during interviews that highlight your vision and career goals
Whether you’re interested in Sports Medicine, Spine Surgery, Pediatric Orthopedics, or another orthopedic subspecialty, early research involvement can lay the foundation for a stronger fellowship application and a smoother transition into advanced surgical training.
Any Role Counts It’s What You Make of it
Whether your title is research assistant, fellow, trainee, coordinator, or something else, what truly matters is your contribution and initiative. Be proactive:
- Get involved in multiple stages of the project (literature review, data analysis, writing, etc.)
- Submit abstracts to local and national conferences
- Aim for peer-reviewed publications
- Take ownership where appropriate and ask to present your work
- Learn statistical analysis (a great skill to have when doing research, learn more about statistics here).
Visibility and productivity are key. The more active you are, the more valuable your experience becomes not only for your CV but also for your professional growth.
Timeline
When planning your path to residency, it is essential to think ahead and establish a clear timeline for securing research opportunities. We strongly encourage candidates, especially those who have completed medical school and clinical experiences, to actively seek research positions during any available time.
Doing research during these periods adds significant value to your application, as discussed earlier. To make the most of this time and avoid gaps in your CV, keep the following tips in mind:
- Start early: For instance, if you know you will finish clinical rotations by the end of August, begin searching for research opportunities several months in advance ideally at the beginning of the year.
- Reach out to mentors and teams: Contact potential mentors or research teams early to express your interest and explore available opportunities starting in September.
- Show commitment: Plan to stay involved in the research position through the next academic cycle, typically until the end of June.
- Be transparent and professional: Clearly communicate your availability, goals, and willingness to commit when reaching out to potential research supervisors.
- Fill in free time wisely and stay active during the Match cycle: Use the months after your clinical experiences productively by engaging in research, strengthening your CV, and enhancing your residency application. Being involved in research at an institution during the Match cycle not only looks favorable on your application but also gives you meaningful experiences to discuss during your residency interviews.
📣 Many successful applicants recommend doing at least 6–12 months of research between graduation and Match if possible, especially if you want to match at academic programs.
But choosing the right mentor is key. That is why we made a whole course that teaches you how to find the best mentor at the best institutions to help you achieve your career goals. Get
access HERE.
Data on Research Productivity in the Match
The table below shows the average number of research experiences reported by matched applicants in the 2026 NRMP match data.
| Applicant Type | Median # of Abstracts | Median # of Presentations | Median # of Publications |
|---|---|---|---|
| US MD Seniors | 5.0 | 11.0 | 7.0 |
| US DO Seniors | 2.0 | 6.0 | 2.0 |
| US IMGs | – | – | – |
| Non-US IMGs | – | – | – |
In the NRMP data, the “mean number of abstracts, presentations, and publications” includes all scholarly work applicants reported on their ERAS application, including posters, oral presentations, and peer-reviewed articles.
Source: NRMP 2026 Charting Outcomes
Final Thoughts on Research
Research experience demonstrates much more than academic achievement. It’s a powerful reflection of your work ethic, intellectual curiosity, and dedication to orthopedic surgery. Whether you’re aiming to match into a community or academic program, your research background, especially when combined with clinical exposure, can elevate your application and open doors for future opportunities.
So wherever you are in your research journey: be proactive, be productive, and make it count.
4. Letters of Recommendation (LoRs)
Letters of Recommendation (LoRs) are among the most influential components of your residency application. Most Orthopedic Surgery programs require at least three letters, though some may ask for four and ERAS allows you to submit a maximum of four per program. These letters provide programs with an external assessment of your clinical performance, technical ability, and overall suitability for the demands of orthopedic residency, often playing a decisive role in interview selections.
Ideally, your LoRs should come from U.S.-based orthopedic surgeons who have worked with you directly in clinical settings, especially during sub-internships or away rotations. The most impactful letters are written by attendings who can speak specifically to your surgical skills, work ethic, teamwork, professionalism, and genuine interest in orthopedics. A generic or impersonal letter won’t carry nearly the same weight as one that offers detailed, first-hand insight into your strengths, dedication, and fit for the specialty.
That said, you can also consider asking a research mentor to write one of your letters especially if you’ve worked closely with them over time. A research mentor can provide a window into your non-clinical strengths like teamwork, intellectual curiosity, perseverance, attention to detail, and productivity. These qualities are just as important in residency and can round out your application. You can learn more about Letters of Recommendation for ERAS and Residency Applicants here.
No matter who you ask, the key is to choose letter writers who know you well and are likely to write a personalized, enthusiastic letter. A strong, detailed letter often gets mentioned during interviews faculty might say, “Your attending said you were one of the most dedicated students they’ve worked with” or “Your research mentor described how quickly you learned and took ownership of your work.” These direct quotes shape how programs view you, sometimes more than your scores or grades.
In short: choose wisely, build relationships early, and always aim for strong, personalized letters that speak to the kind of resident and future physician you’ll be.
5. Personal Statement
A strong personal statement can set you apart from other applicants with similar credentials by sharing your unique story, what drives you, the experiences that shaped you, and why you’re a great fit for the program.
Your personal statement is a valuable opportunity to:
- Show who you are beyond your accomplishments and CV.
- Your strengths and why a program should choose you.
- Share why you are passionate about orthopedic surgery.
- Highlight what you hope to achieve in your career
If you are interested in a certain area of Orthopedic Surgery, this would be a good place to mention this as it gives programs an idea of potential areas of interest.
Keep in mind:
Your personal statement can also be brought up during residency interviews. Interviewers may ask you about it in detail.
Use it as a tool to express your character, personality, and your fit for orthopedic surgery.
An excellent personal statement requires careful thought and attention to detail.
For more tips, in-depth guidance, you can read our Ultimate Guide to Crafting Your Residency Personal Statement. If you want examples of what an excellent Personal Statement should look like, sign up to our free match resources and get 20+ personal statement examples delivered to your inbox (sign up here).
Explore our Personal Statement Editing Service Here or bundle it with the Match Application Package for a full application review experience.
6. ERAS Experiences
Your ERAS CV (including Experiences and Publications) is a crucial part of your Match application and serves to highlight your unique skills and accomplishments.
When completing your ERAS application, it’s important to understand the different types of experiences you can list. These include:
- Clinical experiences (under education/training)
- Research experiences
- Volunteering experiences
- Leadership experiences (under professional organization)
- Work experiences
- Hobbies (under extracurricular activities/ clubs)
- Other experiences (military, teaching)
While clinical and research experiences are the main focus, adding a variety of other experiences can provide a more comprehensive view of your character, skill set, and prior achievements. You can also use these to highlight the unique qualities you bring to a residency program.
For example:
- If you were a teacher or had a prior career in education, this can show your teaching, communication, and mentoring skills.
- If you held a leadership role, it demonstrates your ability to manage teams and lead initiatives valuable qualities in any physician.
Be strategic:
- Prioritize quality over quantity.
- Highlight experiences that are meaningful, relevant, and showcase significant skills or challenges you have overcome.
- Choose experiences that demonstrate who you are as a person and as a future physician.
Before you fill your ERAS application, you MUST watch this video on how to fill the ERAS application step-by-step
You can also check out our detailed blog posts that break down each section of the application and the types of experiences you should include. Read HERE.
If you are looking for a full ERAS Application Template including samples of Experiences, Education, Geographic Preferences, Publications, and Personal/Biographic Information, sign up here!
Need expert 1-on-1 help perfecting your ERAS Application? Check out our ERAS Editing Service or Our Match Application Packages for comprehensive support.
7. Application Strategy
When it comes to applying for Orthopedic surgery residency, especially as an International Medical Graduate (IMG), two critical strategies can significantly increase your chances of matching: applying strategically and applying broadly.
🧠 Apply Strategically
Focus on programs that fit your specific application:
- Review program websites, social media, and current residents’ information to evaluate:
○ USMLE score expectations and cutoffs
○ U.S. clinical experience requirements
○ Research requirements (if any)
○ Year of graduation preferences
○ Number of IMGs in the program
○ Academic vs. community program
○ Whether they accept visa sponsorship (J1 or H1) - Use this information to:
○ Send your program signals wisely
○ Choose programs that align with your strengths
○ Focus on geographic regions you’re truly interested in
○ Considering not to limit your applications by geography, prestige, or other filters - This approach increases efficiency and improves interview yield
Learn more about signaling and applying to residency programs through ERAS
🌐 Apply Broadly
As an IMG, it’s important to recognize that competition is steep, and not all programs have the same level of openness to international applicants. For these reasons, casting a wide net is essential.
- Many successful IMGs apply to 100+ programs, especially if they have red flags or are applying to competitive specialties or don’t have a competitive application.
- There’s no magic number your target should be based on your application and match data
- The more you apply, the more likely you are to get interviews but be mindful of application costs, which can be significant.
▶️ Check out our video on how many programs to apply to based on the NRMP® and AAMC® data.
ALL-IN-ONE MATCH® 2026/2027 Application Resources.
Sign up here to get ERAS Application Template, 20+ Personal Statement Examples, Interview Prep, LOR, MSPE Resources & more, all from MATCH Experts – ALL FOR FREE!
8. Interview Preparation: Where the Match Is Won
Once you’ve secured interviews, the next phase is equally crucial: interview performance.
A strong application may get you through the door, but how you present yourself in interviews often determines your final rank. Programs are not only assessing your knowledge they’re asking: Would I want to work with this person for the upcoming years?
Why Interview Prep Is Essential
- It helps you communicate your story confidently and clearly
- You’ll be ready to answer both common and difficult questions (e.g., gaps in education, visa status, low scores)
- You’ll learn to highlight your strengths and experiences in a way that resonates with U.S. programs
- Practicing also helps reduce stress and lets your authentic personality shine through.
Start your interview preparation with our 200+ residency interview questions, and sign up to our interview prep resources to get sample answers to these questions (sign up here).
To support you through this crucial stage, we offer one-on-one interview preparation sessions through The Match Guy, led by experienced advisors who understand what programs are looking for. Our Interview Prep service can be tailored for orthopedic surgery applicants, where you’ll be matched with an orthopedic surgery Interview Preparation advisor. They are designed to simulate real residency interviews (mock interviews) and provide personalized feedback, helping you feel confident and well-prepared.
Overview of Orthopedic Surgery
Orthopedic Surgery is a specialty focused on the diagnosis, treatment, and prevention of disorders of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves. Orthopedic surgeons manage a wide range of conditions from acute fractures and sports injuries to degenerative diseases and congenital abnormalities often through both surgical and non-surgical means.
Training involves a 5-year categorical residency and may be followed by 1–2 years of fellowship training in a subspecialty such as sports medicine, spine surgery, orthopedic oncology, joint reconstruction, hand surgery, or pediatric orthopedics.
Orthopedic surgery offers a dynamic and technically demanding training experience that serves as the foundation for numerous specialized and high-impact career paths in surgery. Some of the key advantages include:
- Exposure to a Broad Range of Musculoskeletal Conditions:
Orthopedic training covers trauma, degenerative disease, tumors, infections, and congenital deformities. This diversity ensures constant intellectual and technical challenges, keeping every case unique and stimulating. - Balance of Inpatient, Outpatient, and Operative Work:
Residents gain experience in the operating room, inpatient consults, post-op management, and outpatient clinics. This combination helps trainees develop both surgical skill and longitudinal care perspective. - Restoration of Function and Quality of Life:
Orthopedic surgeons often help patients regain mobility, independence, and quality of life through joint reconstruction, fracture fixation, or minimally invasive procedures offering immediate, visible impact. - Primary Operator in Critical Moments:
In trauma settings or complex orthopedic emergencies, orthopedic surgeons are often the primary surgical team making key decisions and performing life- or limb-saving interventions. These moments demand precision, leadership, and calm under pressure. - Subspecialty Exposure Throughout Residency:
Orthopedic surgery training includes rotations through key subspecialties such as sports medicine, spine, hand, joint replacement, pediatric orthopedics, and trauma. This exposure helps residents identify their passion and prepare for potential fellowship training. - Collaborative Work Across Surgical and Medical Teams:
Orthopedic surgeons routinely work alongside radiologists, anesthesiologists, physiatrists, physical therapists, and trauma teams fostering strong interprofessional collaboration focused on comprehensive patient care. - Technical and Procedural Mastery:
From arthroscopic procedures and open reductions to joint reconstructions and spinal instrumentation, orthopedic surgery is rich with hands-on technical learning. Residents develop advanced operative skills that require precision, planning, and execution. - Pathways to Diverse Surgical Fellowships:
Orthopedic residency opens doors to a wide variety of surgical fellowships from high-acuity fields like orthopedic trauma and oncology to specialized areas like hand surgery or sports medicine. Each offers unique career opportunities and lifestyle options.
In sum, orthopedic surgery residency is a fast-paced, procedure-heavy training ground that prepares surgeons to restore mobility, relieve pain, and improve lives. Whether you’re drawn to complex reconstructions, high-stakes trauma care, or cutting-edge innovation in surgical technology, orthopedics offers a fulfilling and high-impact career where technical skill meets human resilience.
✅ Final Advice from Matched Ortho Applicants
- “Be relentless.”
“Ortho is not for the faint-hearted keep working until you match.”
– IMG matched at a Midwest academic program - “Master Step 2 CK.”
“Your exam score is your ticket to the door especially as an IMG.”
– IMG matched at a university program - “Start research early.”
“I had 25+ publications and that made a huge difference.”
– Non-US IMG, now a resident in New York - “Get U.S. ortho letters.”
“My best LoR was from a surgeon I rotated with who watched me present in the OR.”
– US IMG, matched at a hybrid program - “Apply smart.”
“Don’t only apply to big-name programs find IMG-friendly places.”
– IMG matched after 2 cycles
Final Thoughts
A strong application opens the door. Nailing your interviews walks you through it.
Together, these two strategies can be the difference between a good match cycle and a great one. So do your homework, prepare thoroughly, and don’t underestimate the power of being thoughtful, honest, and professional in every interaction.
And remember The Match Guy team is here to help you every step of the way. Check out our Match Guy Residency Match Application Package to access personalized interview preparation, expert human editing, one-on-one advising, and all the tools you need to maximize your chances of matching successfully.
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