Careers in Medicine

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Editor: Melissa Sue Hill
Date: 2016
Biology
From: Biology(Vol. 1. 2nd ed.)
Publisher: Gale, a Cengage Company
Document Type: Occupation overview
Pages: 13
Content Level: (Level 5)

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Careers in Medicine

Dentist

A dentist is a medical professional who cares for the oral health of their patients. Dentists administer prophylactic (preventative) care and corrective treatments for teeth and gums. Dentists in a general practice perform procedures such as cavity filling, root canals, gingivitis (gum disease) correction, and much more. Specialties in dentistry include orthodontics (structural correction), oral surgery, pediatric dentistry, endodontics (complex root canals and dental implants), oral surgery, periodontics (advanced gum care), and prosthodontics (reconstructive dentistry).

The most familiar work setting for a dentist is private practice. Dentists in private practice traditionally provide oral health services for families. However, dentists are also employed in various other situations. For example, many hospitals (especially those that specialize in long-term care, such as geriatric and psychiatric hospitals) employ dentists to attend to the oral health of their patients. In addition, public health agencies that organize relief efforts for inner cities, the rural poor, or developing nations employ dentists to provide dental care to people or groups that cannot normally afford it. Many insurance companies also employ dentists as consultants that help review and process dental claims.

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To become a dentist, one must attend four years of dental school after obtaining a bachelor's degree from an undergraduate college. To gain admittance into dental school, a strong high school and college background in biology, chemistry, math, and physics is required.

Full Text: 

Susan T. Rouse

Bibliography

American Dental Association. “Be a Dentist.” http://www.ada.org/en/education-careers/careers-in-dentistry/be-a-dentist

American Student Dental Association. http://www.asdanet.org/ .

Doctor, Family Practice

A family practice doctor is the primary health-care professional responsible for treating people for most conditions. Family physicians work in private offices, group practices, and hospitals, caring for every family member from before birth until the time of death. Under the U.S. health insurance system, most people go first to their family practice doctor for all complaints, from infections to chronic illnesses to preventive medicine.

Family practice doctors approach the treatment of the family as a unit, focusing on health promotion, disease prevention, and psychological issues affecting health as well as treatment of disease. Depending on the condition, treatment may include prescribing medicines; recommending lifestyle changes such as exercise and diet; or referring for other types of treatment, including surgery, physical therapy, or psychotherapy. The doctor works in partnership with other health-care professionals, including nurse practitioners, nurses, and medical assistants.

To become a family practice doctor, one must first earn a bachelor's degree (either a bachelor of arts or bachelor of science) from a four-year college and then earn a doctorate of medicine (MD) degree from a medical school. This usually takes four years and combines classes and clinical experience. After this, doctors undergo three years of postgraduate training, called internship and residency. During residency, they receive training in the full range of medical disciplines, including pediatrics, obstetrics/gynecology, internal medicine, preventive medicine, surgery, and psychiatry. Family practice doctors often choose this career because they enjoy participating in the comprehensive care of people of all ages, and they desire to help people attain and maintain good health.

Richard Robinson and Roxanne Jamroz Argie

Bibliography

American Academy of Family Physicians. http://www.aafp.org .

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Doctor, Specialist

A medical specialist focuses on diagnosis and treatment of a particular organ or body system, a specific patient population, or a particular procedure. Medical care of humans is a complicated task because of the many different organ systems that comprise the human body. Each stage of life presents various health issues that also need to be addressed. Moreover, males and females also have very different medical needs through puberty and adulthood. This complexity of life necessitates a high degree of specialization in the physicians that care for people's medical needs. There are many types of medical specialties.

General educational requirements for medical specialists All physicians, regardless of their ultimate specialization, must obtain a bachelor's degree from an undergraduate college and graduate from medical school (four years). During the last two years of medical school, students perform clinical rotations in which they are exposed to a wide variety of medical specialties. This provides broad training for all medical professionals and gives the students an opportunity to choose a specialty.

After medical school, all physicians are required to do a residency. The purpose of the residency is to provide specific, detailed training in the chosen specialty. The length of the residency is determined by the specialty. Physicians will oftentimes have a particular expertise within their specialized area. For example, most surgeons are subspecialized in the organ system on which they operate (neurosurgeons, cardiac surgeons, and orthopedic surgeons are examples). These subspecialties are obtained during a fellowship period that lasts one to two years after the residency is completed. It is not uncommon for a highly specialized doctor (such as a pediatric neurosurgeon) to invest ten years or more in their medical education after graduating from college.

Susan T. Rouse

Bibliography

American Board of Medical Specialties. http://www.abms.org/ .

Emergency Medical Technician

An emergency medical technician (EMT) is a person who delivers the initial medical treatment to persons in crisis situations. EMTs are traditionally part of the medical team that travels by ambulance or helicopter to the site of the emergency situation. The most common medical crises to which EMTs are called include injuries acquired during automobile accidents and roadway and home births, sudden myocardial infarctions (heart attacks), and wounds resulting from interpersonal violence (e.g., gun shot and stab wounds).

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EMTs must be trained and certified. There are five levels of EMT training, from first responders, who are certified in basic emergency medical care, to EMT-4 (paramedics), who are certified to administer drugs, read electrocardiograms, and use other advanced equipment in providing prehospital care. The training process is progressive, starting with EMT-1 (which includes first responder training), requiring approximately 120 hours of training, through the paramedic level and up to two years of training. Hospitals, trauma centers, private ambulance companies, and fire and police departments employ EMTs. In fact, many firefighters are also certified EMTs.

To be well-prepared for EMT training, a strong background in the sciences is important. High school courses such as biology, chemistry, mathematics, and physics are essential prerequisites for EMT training. A good driver's education class is also crucial because many EMTs are also ambulance drivers who must negotiate challenging roadway situations to quickly and safely reach the crisis scene.

A career in emergency medicine can be very challenging. EMTs must maintain the difficult balance between compassion and emotional fortitude. Strong leadership and interpersonal skills are a must for an EMT. However, despite the challenges, it is very rewarding to help people and save lives each day.

Susan T. Rouse

Bibliography

National Registry of Emergency Medical Technicians. https://www.nremt.org/ .

“Study Ranks Top 10 Locations for EMTs and Paramedics in the U.S.” EMSWorld.com , July 3, 2015.

Genetic Counselor

A genetic counselor is a medical professional who serves as a liaison between an individual or family and a physician or medical team. The counselor interprets genetic test results and provides information to help patients make medical or lifestyle choices on the basis of knowledge gained from genetic tests.

Genetic counselors are trained in genetics, statistics, and psychology, and they usually have master's degrees from genetic counseling programs. Nurses, social workers, physicians, and doctoral-level (PhD) geneticists also do genetic counseling. The job requires a combination of technical expertise and compassion—a genetic counselor must love working with people and be able to offer comfort under stressful circumstances.

During a typical session, the counselor asks many questions from which he or she constructs a pedigree, which is a family tree that depicts certain traits or illnesses. From this information, he or she can recognize or deduce the mode of inheritance (dominant or recessive, sex-linked, or Page 169  |  Top of Articleautosomal), predict which family members are likely to be affected, and suggest specific medical tests.

The first genetic counselors graduated from Sarah Lawrence College in Bronxville, New York, in 1971, against a backdrop of concern over such medical matters as test tube babies, heart transplants, and recombinant deoxyribonucleic acid technology. At that time, genetic testing for sickle cell disease and Tay-Sachs disease was a prelude to the more widespread testing of the twenty-first century.

Until the early twenty-first century, patients seeking genetic counseling either had family histories of rare, single-gene disorders or were at high risk of carrying a fetus with a chromosomal or congenital problem because of advanced maternal age or exposure to harmful substances (e.g., teratogens), respectively. With the sequencing of the human genome, the spectrum of conditions that a genetic counselor confronts is broadening considerably to include much more common disorders, such as cancers and cardiovascular disease, which reflect the input of several genes and the environment. Rather than offering definitive diagnoses based on detecting single abnormal genes, genetic information is more likely to take the form of elevated risk estimates.

Ricki Lewis

Bibliography

“Genetic Counselors.” In Career Information Center. 10th ed. Vol. 8, Health Science, edited by Kristin B. Mallegg and Joseph Palmisano, 114–116. Detroit: Macmillan Reference, 2014.

National Society of Genetic Counselors. http://www.nsgc.org/ .

Medical Assistant

A medical assistant is a health-care professional who provides administrative or clinical assistance to a doctor. Duties of the administrative medical assistant include general office responsibilities, such as answering the phone and making appointments, as well as more specialized skills, such as keeping medical records and processing insurance reimbursements. The clinical medical assistant may be responsible for obtaining a medical history from the patient, taking vital signs (temperature, blood pressure, and pulse), performing visual exams, obtaining specimens such as blood samples or throat swabs, or other medical procedures that assist in the diagnosis of a patient. All of these are done at the request of the physician, but they are usually performed without direct supervision. In smaller clinics or private doctor's offices, the medical assistant may perform both types of duties.

To become a medical assistant, one should take high school courses in science, mathematics, computer skills, and business. Medical assistant training programs are available at junior colleges, community colleges, and private vocational schools. Programs may last from seven months to Page 170  |  Top of Articletwo years, depending on the breadth of skills involved. Personal and professional skills essential to the medical assistant include attention to detail, desire to work with people, and a professional and friendly manner.

Richard Robinson

Bibliography

American Association of Medical Assistants. http://www.aama-ntl.org/ .

U.S. News. “Best Healthcare Jobs: Medical Assistant.” http://money.usnews.com/careers/best-jobs/medical-assistant .

Medical/Science Illustrator

Science and medical illustrators provide art for books; newspapers; magazines; advertisements; articles in scientific journals, online websites, and other electronic references; and museum, zoo, and legal exhibits. Illustrators may draw an illustration of an arrowhead dug from an archaeological site, a diagram showing how neurons in the brain transmit signals, or an animation of a chemical reaction. Illustrations may be artistic (e.g., an artist's conception of the surface of a faraway planet), realistic, or diagrammatic.

Everything that science and medical illustrators draw is meant to communicate scientific or medical ideas or facts. Some science illustrators specialize in natural history, drawing things such as a new species of fish or a coral habitat. Medical illustrators specialize in human anatomy, diseases, and surgical procedures. They may do anatomical drawings that help students and health professionals learn the structure of the human body, or they may make detailed drawings of how to perform a heart bypass operation.

The audience for an illustrator's work can be lay-people who know little science, the kind of people who wander into a museum on their lunch break; students; or highly specialized professionals. Illustration can be simple pen-and-ink line drawings, airbrush paintings, computer-generated graphics, cartoons, or even three-dimensional models.

Many science and medical illustrators begin by getting a bachelor's degree in biology or some other science. They may then spend one to two years studying medical illustration or science illustration in a graduate program at a university. Such students can launch their career by taking an internship or job at a place such as a magazine or art studio. Others get a degree in art and teach themselves science as they work. Still others are self-taught. If art has always been a hobby, then they may start out working with a researcher they know and then gradually find more work. High school students interested in science illustration should take as much math as possible in an effort to prepare for science classes in college.

Jennie Dusheck

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Bibliography

Association of Medical Illustrators. http://ami.org/ .

Guild of Natural Science Illustrators. http://www.gnsi.org/ .

Medical Illustration Sourcebook. http://www.medillsb.com/ .

Nurse

Nurses are health-care professionals with direct responsibility for patient care. Nurses work in hospitals, clinics, long-term care facilities, schools, corporations, and many other settings. In hospitals, nurses provide care under a treatment plan prescribed by doctors, but they often have considerable responsibility for managing the details of the patient's daily care. In other settings, nurses may be the first health-care professional seen by a patient and may be responsible for recommending treatment in conjunction with the doctor. Nurses combine medical expertise with strong interpersonal skills and a desire to help people.

To become a nurse, high school courses in math and science are required. Nurse training programs are offered at hospitals, junior colleges, community colleges, and four-year colleges. The degree of training offered by each differs, as does the advancement possible as a result. After graduation from the training program, the student must pass a state licensure exam to become a registered nurse (RN) and is then able to work as a nurse. Further education allows the RN to obtain a master's degree in nursing. This is required to become a nurse practitioner (a nurse who performs many of the same functions as a family practice doctor), a nurse-midwife (provides care to maternity patients), or several other nursing specialties.

Richard Robinson

Bibliography

American Nurses Association Career Center. http://careers.ana.org/ .

National Student Nurses' Association. http://www.nsna.org .

Nurse Practitioners

Nurse practitioners are registered professional nurses who have completed a graduate education program in advanced practice nursing. They provide many of the same services as physicians. A major focus for the nurse practitioner is the promotion of healthy lifestyles to prevent illness. Nurse practitioners can also diagnose and treat common minor health problems as well as chronic conditions, such as high blood pressure or diabetes. They order laboratory tests, prescribe medications, and prescribe various treatments. Studies have shown that they provide costeffective and high-quality care. Although some nurse practitioners Page 172  |  Top of Articlepractice in hospitals, most work in clinics. Many provide health care to those who may not otherwise have access to care, such as in rural areas, community clinics, shelters, schools, and other settings.

Nurse practitioners must complete a four-year bachelor's degree in nursing and must have experience working as an RN. The graduate nurse practitioner education program takes approximately two years to complete. Graduate study includes nursing coursework as well as advanced study in performing physical examinations, diagnosis, and treatment. The student also has hands-on education with a nurse practitioner and/or a physician preceptor in a clinic or other health-care facility.

Students can choose from several specialty areas of study. Some of these specialties include family nurse practitioner, adult nurse practitioner, geriatric nurse practitioner, pediatric nurse practitioner, and women's health-care nurse practitioner.

Students interested in becoming a nurse practitioner would benefit by taking high school sciences and the required college-level prerequisites for nursing school. Spending time with a nurse practitioner and working or volunteering in any type of health-care service organization is also suggested.

Nurse practitioners are quickly growing in numbers. In 1990, nurse practitioners numbered 28,600. In 2014, those numbers have increased to nearly 205,000.

Kevin Smith

Bibliography

American Academy of Nurse Practitioners. http://www.aanp.org .

“Family Nurse Practitioner Studies.” In Peterson's Graduate Programs in the Biological/Biomedical Sciences & Health-Related Medical

Professions 2015. 49th ed., 694. Albany, NY: Peterson's, 2015.

“Stopping the Stereotypes: Re-Defining the Role of Emergency Nurse Practitioners.” Premium Official News, August 14, 2015.

Nutritionist

Nutrition is the study of food, essential nutrients, and other substances in food and their effects on the body in relation to health and disease. It concerns how organisms eat, digest, absorb, use, and excrete the many components of food. The study of nutrition encompasses psychological and social perspectives as well as biochemical and physiological approaches.

Nutritionists work in many different settings. Public health nutritionists may focus on developing programs to improve the nutritional status of specific populations, such as expectant mothers or the elderly. Community nutritionists may counsel individuals how to improve their diets or develop educational materials on nutrition. These types of Page 173  |  Top of Articlenutritionists often work for governmental agencies. They usually have obtained a bachelor's degree in nutrition and often have advanced degrees, such as a master's degree in public health or science. There are also many opportunities in nutrition research, usually in a university or research institute. For example, nutritional epidemiologists study associations between nutrient intake and disease incidence in populations. Nutritional biochemists investigate how too little or too much of specific nutrients, both essential and nonessential, affect metabolic pathways and the development of various diseases. These positions require a bachelor of science (BS) in a biological science with a PhD in nutrition or a closely related field.

Dietitians have completed a BS in nutrition from an accredited program and completed an approved internship, as certified by the American Dietetics Association. Dietitians often work in hospitals or clinics providing nutritional services to patients. They also manage food service operations in hospitals, long-term care facilities, and universities.

Because nutrition is a biological science, high school courses in math and the sciences are necessary. Strong communication and computer skills are also extremely important. In college, nutrition degrees include courses in chemistry, physiology, and biochemistry, similar to other biological majors.

Daniel D. Gallahera

Bibliography

Academy of Nutrition and Dietetics. http://www.eatright.org .

The International & American Associations of Clinical Nutritionists http://www.iaacn.org .

Pharmaceutical and Medical Device Sales Representative

The people who tell others about new medicinal preparations usually work for pharmaceutical manufacturing or medical device companies as medical sales representatives. To keep informed about new products, pharmaceutical and device sales representatives are continuously learning as part of their jobs.

Pharmaceutical and device sales representatives talk to those who influence the prescription and sale of medicines and medical devices. Such people include those who write prescriptions (doctors, nurse practitioners, and dentists); the pharmacists who legally sell the preparations; the nurses, doctors, and surgeons that utilize medical devices; and the policy-makers who determine which drugs and devices are covered by health-management organizations and health insurance plans. Some are involved in advertisement of specific drug preparations and devices directly to consumers.

A four-year bachelor's degree (BS or BA) with a major in chemistry, microbiology, animal biology, or pharmacology is the usual minimum Page 174  |  Top of Articlepreparation for this career. A better general understanding of the actions of drug preparations is obtained through an entry-level pharmacy degree (which is now in most states a doctor of pharmacy [PharmD] degree), requiring six years after high school to complete. People with nonscience baccalaureate majors such as business or marketing will have the most “catching up” to do. In high school, a person interested in a pharmaceutical and device sales career should take college preparatory courses with a science and mathematics emphasis.

Margaret A. Weck

Bibliography

National Association of Pharmaceutical Sales Representatives. http://www.napsronline.org .

Riley, Pat. “An Interview with a Pharmaceutical Sales Recruiter.” Medical Service Society of San Diego. http://www.medicalservicesociety.org/article5.html .

Pharmacologist

A pharmacologist practices the science of pharmacology, which is the study of drug, hormone, and chemical actions on biological systems. A pharmacologist must have knowledge in the sources, chemical properties, biological effects, and therapeutic uses of drugs. The pharmacologist must be multidisciplinary with experience and/or knowledge in experimental techniques such as analytical chemistry, biochemistry, cellular and molecular biology, genetics, immunology, medicinal chemistry, microbiology, pathology, and physiology. Pharmacologists can be subcategorized as doing biologic, industrial, human, or regulatory research.

Pharmacologists perform studies to examine drug interactions and define the mechanism involved in producing these interactions. To determine the mechanism of action of a particular drug, the pharmacologist may perform experiments on cellular in vitro systems. However, to identify the physiological, biochemical, or immunological response, it is often necessary to perform the experiments in vivo experimental animal systems such as rats and mice (preclinical). Many pharmacologists consider toxicology to be an important part of pharmacologic research. Pharmacologists may perform this type of research in an academic (university) or industrial (drug company) environment.

Pharmacology training usually requires graduate degrees (MSc and PhD). Pharmacologists who study the therapeutic and toxic actions of drugs in humans are referred to as clinical pharmacologists. The clinical pharmacologist often has medical training (MD) with specialized training in the use of drugs in the treatment of disease. Clinical pharmacologists determine the correct routes of drug administration (e.g., oral or intravenous), assess their adverse effects, monitor drug levels, and establish therapies that prevent or treat overdoses as well as the consequences Page 175  |  Top of Articleof interactions with other drugs. Some pharmacologists are involved with the administration of the rules and regulations relating to the development of new drugs. The pharmacologist unlocks the mysteries of drug actions, discovers new therapies, and develops new medicinal products, which inevitably touch upon all human lives.

David S. Lester

Bibliography

Wayne State University. “Pharmacology Careers.” http://www.med.wayne.edu/pharmacology/careers.asp .

Physical Therapist and Occupational Therapist

Physical therapists and occupational therapists are health-care professionals who help people with a wide range of diseases, injuries, or disabilities maintain or improve their health and ability to perform everyday tasks. They assess a patient's overall condition, develop a treatment plan, help the patient carry out the plan, and determine if the plan is working.

Physical and occupational therapists work in hospitals, clinics, schools, long-term care homes, research institutions, and in private practice. Both professions can be physically demanding and require strong interpersonal skills and a solid background in biology, chemistry, physics, psychology, and mathematics. All students must complete at least a master's degree in their field. After graduation, students must pass a licensing exam to treat patients. Students interested in these fields can do volunteer work to learn more about the work and gain experience before committing to a full training program.

Physical therapists work with patients to relieve pain and improve joint mobility, balance, coordination, movement, and overall health. For example, they may help a person recovering from shoulder surgery regain normal range of motion, a stroke patient learn to walk again, or a spinal cord injury patient to become as independent as possible.

Physical therapists use many techniques and tools to accomplish their goals, including exercises, massage, hot and cold packs, ultrasound, electrical stimulation, and assistive devices (crutches, prostheses, and wheelchairs). Occupational therapists work with patients to improve their ability to perform activities associated with daily living or employment. For example, they may help a person who recently lost his vision learn to navigate his home; a developmentally disabled student participate in school; or a patient with head trauma learn to eat, dress, and bathe again. Occupational therapists use many tools to accomplish their goals, including assistive devices, computers, and various everyday objects.

John M. Ripper

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Bibliography

American Physical Therapy Association. “About Physical Therapist (PT) Careers.” http://www.apta.org/PTCareers/Overview/ .

Physician Assistant

A physician assistant (PA) career has been rated by U.S. News and World Report as one of the fastest growing and most desirable careers for the future. Job opportunities include work in clinics, care for patients in hospitals, and care for patients in nursing homes. Many of the PA job duties are similar to those of a doctor. PAs see patients, take a history, do a physical exam, make a diagnosis, and decide on the treatment needed. The differences between a physician and a PA are the amount of education required, the physician supervision, and the level of responsibility. Every PA needs to have a supervising physician—someone who oversees his or her work. The PA and physician work together as a team.

Most PA programs require an undergraduate degree in one of the sciences, such as biology or chemistry. Many PA programs require certain courses to get into a PA school, such as general biology, microbiology, general and organic chemistry, biochemistry, anatomy, physiology, psychology, and statistics. The education to be a PA lasts anywhere from two to three years after a minimum of three years of college. All PA programs award a certificate of completion at the end of the program. Some programs also award a degree along with the certificate.

Getting into PA school is challenging. As of 2014, there were 215 programs in the United States. Only 5% of applicants will be admitted to a PA program. To be considered, one needs to get good grades in college, at least consistent grades of a B. Volunteering and working in the health-care field, such as in a nursing home, increase one's chances of acceptance into a program. Many prospective students talk with PAs before starting a program so that they get a better idea of what PAs do on the job.

Dawn B. Ludwig

Bibliography

American Academy of Physician Assistants. http://www.aapa.org .

U.S. News. “Best Health Care Jobs: Physician Assistant.” http://money.usnews.com/careers/best-jobs/physician-assistant .

Veterinarian

Becoming a veterinarian is a challenging yet rewarding process. A veterinarian is someone who has earned a doctor of veterinary medicine or a veterinary medical doctor degree from an accredited college or university. The veterinary program consists of four years of a combination of lecture classes, practical laboratory work, and clinical experience.

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Many veterinary programs allow students to choose an area of emphasis (usually small animals, equine, food animals, exotic animals, or mixed), although this varies among programs. Although an undergraduate degree is not required to enter a veterinary program, the great majority of veterinary students have a degree, usually a BS in a biological science, and many may also have a master of science degree. Every veterinary program's entry requirements are different, but most include undergraduate courses in biology, chemistry, physics, mathematics, biochemistry, animal science, and animal nutrition. The high school student interested in pursuing a veterinary degree would be wise to take as many science and math courses as possible. Experience in handling animals is also a necessity for admission to a veterinary program, whether in a paid position or on a volunteer basis. Excellent grades are necessary: entrance into a veterinary program is very competitive because of the few veterinary programs in the United States.

Most veterinarians are employed in private practice, but this is not the only employment opportunity. Veterinarians are needed in government to serve on medical and agricultural committees, to inspect meat and meat products, and to work in laboratories. Colleges and universities hire veterinarians to teach undergraduate and graduate courses and to conduct research. Overseas veterinary mission and Peace Corps work are available. Large research and pharmaceutical companies often have veterinarians on their staffs. A veterinary degree is extremely versatile and useful, particularly when combined with an undergraduate degree in a biological science.

Amy L. Massengill

Bibliography

Association of American Veterinary Medical Colleges. “Careers in Veterinary Medicine.” http://aavmc.org/Students-Applicants-and-Advisors/Careers-in-Veterinary-Medicine.aspx .

Echaore-McDavid, Susan, and Richard A. McDavid. “Veterinarian.” In Career Opportunities in Agriculture, Food, and Natural Resources, 226–229. New York: Ferguson's, 2011.

Source Citation

Source Citation   (MLA 8th Edition)
Lewis, Ricki, et al. "Careers in Medicine." Biology, edited by Melissa Sue Hill, 2nd ed., vol. 1, Macmillan Reference USA, 2016, pp. 165-177. Gale Ebooks, https%3A%2F%2Flink.gale.com%2Fapps%2Fdoc%2FCX3629800076%2FGVRL%3Fu%3Dtel_a_uofmemflex%26sid%3DGVRL%26xid%3D487daa5d. Accessed 22 Oct. 2019.

Gale Document Number: GALE|CX3629800076

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