Physician Assistant Program - Quinnipiac University Academic Catalog

Program Contact: Jocelyn Depathy 203-582-7316

The Physician Assistant program, which leads to a Master of Health Science, educates qualified individuals to be highly skilled licensed healthcare providers who practice team-based medicine in collaboration with physicians, in a number of healthcare facilities ranging from private practices to tertiary care hospitals. This program fosters the development of compassionate and professional healthcare providers who embody the competencies of the PA profession. These competencies include medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, and systems-based practice. The PA program measures our students' attainment of our competencies using entrustable professional activities (EPAs) that correspond to the clinical and technical skills expected of new graduate PAs.

The vision of the Physician Assistant program at Quinnipiac University is to graduate physician assistants who are dedicated to providing quality healthcare by fostering teamwork, critical thinking skills, high ethical standards, and respect for diverse patient populations.

Quinnipiac is a member of the Physician Assistant Education Association (PAEA).

The Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) has granted Accreditation-Continued status to the Quinnipiac University Physician Assistant Program sponsored by Quinnipiac University. Accreditation-Continued is an accreditation status granted when a currently accredited program is in compliance with the ARC-PA Standards.

Accreditation remains in effect until the program closes or withdraws from the accreditation process or until accreditation is withdrawn for failure to comply with the Standards. The approximate date for the next validation review of the program by the ARC-PA will be July 2033. The review date is contingent upon continued compliance with the Accreditation Standards and ARC-PA policy.

The program’s accreditation history can be viewed on the ARC-PA website at https://www.arc-pa.org/accreditation-history-quinnipiac-university/.

MHS Physician Assistant Program of Study*

Plan of Study Grid
First Year
Summer Semester		Credits
PY 503	Principles of Interviewing	3
PY 507	Principles of Electrocardiography	1
PY 508	Diagnostic Methods I	2
PY 521	Human Anatomy	3
PY 521L	Human Anatomy Lab	2
PY 522	PA Success Skills	1
PY 550	Physiology and Pathophysiology for PA	5
	Credits	17
Fall Semester
PY 505	Clinical Pharmacology I	2
PY 506	Principles of Medicine	6
PY 514	Diagnostic Methods II	1
PY 518	Physical Diagnosis	3
PY 518L	Physical Diagnosis Lab	1
PY 520L	Clinical Decision Making	1
PY 572	Medical Microbiology and Infectious Diseases	3
	Credits	17
Spring Semester
PY 504	History, Roles and Responsibilities of the PA	1
PY 509	Principles of Obstetrics and Gynecology	3
PY 510	Principles of Pediatrics	3
PY 511	Principles of Surgery and Emergency Medicine	4
PY 512	Psychosocial Issues in Healthcare	2
PY 513	Behavioral Medicine	3
PY 516	Clinical Pharmacology II	2
	Credits	18
Second Year
Summer Semester
PY 526	Principles of Epidemiology	3
PY 548	Ethics in Healthcare Delivery 1	2
PY 553	Transition to the Clinical Year	1
PY 652	Medical Writing & Biostatistics for PA	3
	Credits	9
Clinical Rotations
PY 611	Clinical Residency I	3
PY 612	Clinical Residency II	3
PY 613	Clinical Residency III	3
PY 614	Clinical Residency IV	3
PY 615	Clinical Residency V	3
PY 616	Clinical Residency VI	3
PY 617	Clinical Residency VII	3
PY 618	Clinical Residency VIII	3
PY 619	Clinical Residency IX	3
	Credits	27
Third Year
Summer Semester
PY 608	Graduate Seminar	3
PY 676	Comprehensive Examination	2
PY 648	Ethics in Health Care Delivery II	1
	Credits	6
	Total Credits	94

*The curriculum for the Physician Assistant program is subject to modification as deemed necessary to maintain a high-quality educational experience and keep current with best practices in the profession.

In addition to the intensive classroom study during the first year, students are introduced to the clinical application of their training by being paired with a licensed healthcare professional one half day a week. This is designed to facilitate application of the skills and knowledge acquired in the classroom setting to the care of the patient.

PY 611-PY 619: All students must complete seven required core rotations (clinical residencies) and two elective rotations. The required core rotations are: emergency medicine, general surgery, inpatient internal medicine, primary care (family medicine and outpatient internal medicine), pediatrics, psychiatry, and women's health. Supplemental electives include a wide variety of medical, surgical and pediatric subspecialties. Students should expect that clinical rotations will often occur at facilities more than an hour travel distance from the university and may include out-of-state placement, requiring them to obtain temporary housing closer to the clinical site.

Requirements for Graduation

Upon successful completion of the 27-month Quinnipiac University Physician Assistant program, students are granted a Master of Health Science and a certificate of completion as a physician assistant. Students are expected to complete all requirements in 27 months. Students must meet all of the following requirements:

Satisfactory completion of the PA curriculum requirements (including academic, clinical, medical writing, clinical logging, professionalism and community service requirements).
Satisfactory completion of the PA program core competencies and essential learning outcomes; attaining the required level of entrustment for all core and non-core entrustable professional activities.
Satisfactory completion of all PA course requirements.
Satisfactory completion of the capstone comprehensive examination.
A cumulative GPA of at least 3.00/4.00.

Student Learning Outcomes - Program Competencies

Upon completion of the Physician Assistant program, students will demonstrate the following competencies:

Medical Knowledge: Demonstrate a knowledge of biomedical and clinical sciences and apply this knowledge to patient care in a variety of clinical setting as an entry-level practitioner.
Interpersonal and Communication Skills: Possess the ability to safely and effectively communicate with various populations, including but not limited to other healthcare providers, members of the healthcare team, patients and their families.
Patient Care: Be able to provide cost-effective, equitable, high-quality patient care in a variety of settings as an entry-level practitioner.
Professionalism: Demonstrate the attributes of a high-quality healthcare provider, and be able to apply an ethical framework in medical decision-making, practice evaluation, and their altruism to their profession, community and society.
Practice-Based Learning and Improvement: Be able to evaluate, assess and critically analyze their patient care practices.
Systems-Based Practice: Demonstrate an awareness and responsiveness to all aspects of the healthcare system.

The PA program measures the attainment of these competencies through entrustable professional activities (EPAs). Students must be entrusted at specific, predetermined levels for core and non-core EPAs.

Mission Statement

The mission of Quinnipiac University’s Physician Assistant program is to increase access to quality health care through the education and development of caring, knowledgeable and competent physician assistants who are dedicated to:

Clinical Competence
Professionalism
Interprofessionalism
Leadership
Community Engagement
Cultural Humility

Vision

Graduate physician assistants who are dedicated to providing quality healthcare by fostering teamwork, critical thinking skills, high ethical standards, and respect for diverse patient populations.

Core Values

The PA program core values reflect a commitment to the ethical concepts that guide the PA profession. They stand as the program’s pledge to the profession as well as the patients, families and communities with which the PA students engage.

These core values include:

Excellence—A commitment to teaching excellence and championing quality, patient-centered, evidence-based healthcare in an innovative and supportive learning environment that fosters the student’s personal effectiveness.

Accountability—Demonstrating responsibility to students, the university, patients, society and the PA profession utilizing a continuous process improvement system.

Integrity—Honesty and adherence to the highest standards of professional behavior and ethical conduct.

Teamwork and Collaboration—Building respectful partnerships within the university and the community to transform the healthcare system.

Advocacy and Equity—Seeking to eliminate disparities and barriers to effective, quality health care through patient advocacy and advocacy of the PA profession.

Intellectual Curiosity—Exhibiting self-reflection, intellectual curiosity and initiative, critical thinking and the enthusiastic pursuit of lifelong learning within a supportive environment that encourages research and scholarly work.

Wellness — Promoting an environment of personal health and wellness and mindfulness in the care of self and others.

Admission

The Quinnipiac University Physician Assistant program believes that excellence is inclusive and built upon equity. We recognize that all members of society deserve the best healthcare possible and this is most effectively provided by a diverse healthcare team. We are committed to admitting qualified individuals using a holistic evaluation. The program seeks students who possess intellectual capacity, personal maturity, communication and interpersonal skills.

The Physician Assistant program is a full-time program; there is no part-time status. The program does not accept transfer credits, advanced placement in the program, applications for challenge examinations or credits for experiential learning. The program does not accept graduates of foreign medical school or domestic medical school programs.

The Quinnipiac University Physician Assistant program has two admissions pathways: direct entry through the Entry-Level Master's Physician Assistant (ELMPA) program or application through the Centralized Application Service for Physician Assistants (CASPA).

Admission to the program is highly competitive. CASPA candidate applications are evaluated for the following factors: overall GPA, science GPA, prerequisite GPA, individual course grades, quality of academic program/load, commitment to organized sports and work, evidence of academic grit, several years of sustained high-level collegiate academic achievement or overcoming a major adversity followed by several semesters of sustained high-level collegiate academic achievement, direct patient care hours and experience, physician assistant shadowing, community service involvement, leadership activities, quality of narratives, letters of reference, performance on the Casper assessment, evidence of professional memberships and history of scholarly (published) activity.

Following this comprehensive application review, the most qualified candidates are invited for on-campus interviews and activities with program faculty, alumni and community partners. Those with the highest overall performance on the application and interviews are offered admission until the complete cohort of 54 students matriculates.

Interested students must possess, at a minimum:

A bachelor’s degree from a regionally accredited institution in the United States or a nationally recognized institution
An overall GPA of at least 3.20 (includes all undergraduate and graduate coursework)
An overall science GPA of at least 3.20 (includes all undergraduate and graduate science coursework)
A combined GPA of at least 3.20 on the following required prerequisites:
- Four semesters of courses in biology (credits must be in mammalian or human biology), including one semester of microbiology and two semesters of human anatomy and physiology. All these courses must include labs.
- Three semesters of courses in chemistry, including one semester of organic chemistry (with lab) or biochemistry
- One semester of pre-calculus, calculus or statistics
- All prerequisites must be completed at a regionally accredited institution in the United States or nationally recognized institution in Canada within ten years of the date of application
- Prerequisite labs must be completed through an on-campus course (not online)
  - COVID exception (Prerequisite labs that were changed to an online format and completed between the start of Spring 2020 and the end of Fall 2021 as a result of the COVID-19 pandemic will be accepted. Online labs prior to Spring 2020 or after Fall 2021 will not be accepted.)
A C or higher in all prerequisite courses. Applicants with prerequisite course grades of D or F in any of the prerequisite course options are not considered, even if the courses were repeated. In addition, applicants with more than one semester of withdrawals in science or prerequisite courses are not considered.
All academic prerequisites must be completed prior to September 1 of the year of application.
A minimum of 2,000 hours of direct patient care experience in the United States or Canadian healthcare system. The program values the exposure of direct, patient-facing, hands-on healthcare careers rather than those that lack physical contact with patients. Examples of hands-on experiences that we consider toward the minimum 2,000 hours include: EMT/paramedic, certified nurse’s aide, medical assistant, patient care assistant, orthopedic technician, athletic trainer, radiology technologist, respiratory therapist, registered/licensed practical nurse, licensed clinical social worker, surgical technician, pharmacy technician, military medic, physical therapist/aide, occupational therapist/aide, dental assistant, and phlebotomy technician. Examples of experiences that we do not recognize toward this include: lab technician, patient transport technician, massage therapist, personal trainer, medical secretary, life coach, lifeguard and patient sitter. Scribe or clinical research coordinator positions that offer a majority of hands-on patient activities, like those assigned to a medical assistant, do count; scribe and coordinator positions only permitting observation and record-keeping do not.
Scores from the Acuity Insights Situational Judgement Test (Casper). The Acuity Insights Situational Judgment Test (Casper) is only offered on certain dates. Applicants may submit the CASPA application prior to taking the Casper exam. It is the applicant's responsibility to ensure the Casper test is completed prior to the September 1 application deadline. Applicants may contact Acuity Insights, CASPA or the Office of Graduate Admissions for more information. Repeat applicants must take a new test each year.
Scores from the Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) if the applicant received a bachelor’s degree from a non-English speaking country
Scores from Graduate Record Examination are not required

Entry-Level Master's Physician Assistant Program

Quinnipiac has an undergraduate direct entry program whose students have different requirements for entry into the MHS in Physician Assistant program.
- Entry-Level Master's Physician Assistant (ELMPA) students are required to document 1,000 hours of direct patient care experience before they matriculate into the graduate program.
- Most ELMPA students are not second-career applicants like the CASPA applicants and are less likely to have certifications such as radiologic technologist, registered nurse or paramedic; as a result, the program considers a broader range of allowed direct patient care experiences for ELMPA students. Examples of these allowed direct patient care experiences can be found on that program's admissions page.
- ELMPA students all meet the minimum course prerequisites but are required to complete more higher-level courses than CASPA applicants. More information about the course schedule can be found on that program's curriculum page.
- To enter the graduate PA program, ELMPA students must meet all progression standards and ELMPA curricular requirements.
- In their senior spring semester, ELMPA students must complete an application and participate in interviews of the same format as CASPA applicants; they must also take the same situational judgment test. Their applications are reviewed with a similar rubric as for CASPA applicants, but the results of this process for these ELMPA students are formative and do not influence their admission into the graduate program. ELMPA students who complete all of the ELMPA program requirements have a guaranteed seat in the graduate program.
- Our faculty participates in the admissions interviews of high school seniors who are applying for entry into the ELMPA program.
Our graduate PA program has 54 seats available each year and approximately one-half of those spots are reserved for ELMPA program graduates (2024 - 25; 2025 - 25; 2026 - 28).

The Quinnipiac Physician Assistant program participates in the Central Application Service for Physician Assistants (CASPA). Go to caspa.liaisoncas.com for more information regarding the application process and fees. All applications, transcripts, references and other supporting materials are submitted directly to CASPA.

PA Program Technical Standards

The Physician Assistant program is a rigorous and intense program that places specific requirements and demands on the students enrolled in the program. The PA certificate/master of health science degree signifies that the holder is prepared for entry into the practice of medicine. It follows that the graduate PA student must have the skills and knowledge to function in a broad variety of clinical situations and to render a wide spectrum of patient care. The technical standards set forth by the physician assistant program establish the essential qualities considered necessary for students admitted to this program to achieve the knowledge, skills and competencies of the physician assistant profession as well as to meet the expectations of the program’s accrediting agency:

Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA)

3325 Paddocks Parkway, Suite 345
Suwanee, Georgia 30024
Phone: 770-476-1224
Fax: 470-253-8271

All students entering the graduate Physician Assistant program at Quinnipiac University must be able to meet the established abilities and expectations of the PA program technical standards. Students must possess ability, aptitude and skills in the following areas: observation, communication, motor, intellectual-conceptual-integrative, behavioral, social and physical. PA students must be able to meet the requirements and worker attributes of a physician assistant as defined by the Bureau of Labor and Statistics, U.S. Department of Labor/Employment and Training Administration’s Occupational Information network (O*NET) Handbook. In the event a student is unable to fulfill these technical standards, they will not be admitted or may be dismissed from the program.

Students matriculating into the PA program are required to verify they understand and meet the technical standards. Verification of understanding includes the student reading, thoroughly reviewing with their medical provider, signing and returning a copy of the Technical Standards Agreement to the program prior to arrival on campus in the summer semester.

A listing of the technical standards for the PA program can be found on the program’s website. Both the student and medical provider must sign the document and return it to the PA program prior to the start of class.

Modifications

The curricular and other requirements for the professional courses in the program are subject to modification as deemed necessary to maintain a high-quality educational experience and keep current with best practices in the profession.

Additional Program Costs

The Physician Assistant program requires some expenses that go beyond standard university tuition and fees. Most of these costs can be included in your financial aid requests and awards. The following items are “miscellaneous” components of the Quinnipiac University Physician Assistant Program. Please note that these items have been budgeted for as part of the estimated budget for the program, which is submitted to the federal government. It is from this estimated budget that federal student loans are determined. The program would like to remind students of these miscellaneous costs and fees since they are not listed as a specific line item, but included with other items in your proposed QU PA program budget.

Clinical/Fieldwork Education Travel – Students are responsible for all expenses (e.g., gas, parking, maintenance) related to transportation to get to a fieldwork site. This includes private transportation, public transportation and air travel as necessary. Cost: variable Please see the program's website for estimated costs.
Academic and Experiential Software Package Cost (Exxat-Prism & Exxat-Approve https://exxat.com/) - Students enrolled in the PA program are required to purchase access software that manage experiential learning processes management of student health requirements (physical exams, vaccinations, etc.). Exxat-PRISM offers various software tools that manage clinical/fieldwork tracking and data. Exxat-PRISM is a one-time cost of $150 for the duration of a student's program for all clinical/fieldwork activities and assessment software. Exxat-APPROVE is a tool for background checks, scheduling drug screening tests, and uploading all required documentation (i.e. background checks, immunization records and physicals). The Exxat-APPROVE module has a cost of $50 while in the program.
Background Check & Drug Screen - The PA program requires a criminal background check and drug screening before a student is placed at an experiential learning site. In addition, students may be required to obtain a drug screen prior to entry into the pre-clinical experience. The university has procedures to assist students in obtaining such screenings. Students must review university policies regarding background checks and drug screening.

The cost of the background check and drug screen is the responsibility of each individual student; additionally, certain clinical/fieldwork sites may require an additional check(s) prior to the student rotating at their specific site. Additional details and costs can be found on the School of Health Sciences page.
Immunizations / Health Ins – Consistent with the School of Health Sciences policy, all students must have a full battery of immunizations and, in some cases, titer affirmation of immunity for common diseases including but not limited to: MMR, HepB, varicella, polio, TDAP, TB, COVID and influenza. These must be documented prior to the start of clinical experiences and must be maintained until graduation. Cost: variable (please check with your insurance carrier). Students must have health insurance throughout their time at the program and must show proof of healthcare coverage. Health/medical insurance is offered through the university’s insurance agent; students may enroll or opt out of this coverage. Details are sent to students upon acceptance into the program.
Liability Insurance – All students have liability insurance coverage through the university, free of charge, while performing required pre-clinical, clinical and program-sanctioned community service event. Students may choose to purchase additional coverage at their own expense.
Professional Memberships - The Quinnipiac PA program requires all its students to join the Connecticut Academy of Physician Assistants and the American Academy of Physician Assistants. The work of both organizations has made the PA profession what it is today and both continue to advocate for improvements in PA practice and patient care. The cost of both memberships has been factored into student budgets and financial aid packages.
Copying Costs - Tuition and fees at Quinnipiac University do not include copying costs. The program provides electronic copies of the PA Program Student Handbook, Clinical Rotation Handbook and course syllabi. In addition, numerous lectures/notes and other resources are posted on the program's learning management system. If the student desires a printed copy of any program resources it is their responsibility to incur the associated costs. The estimated cost of photocopying/printing is $0.07 per page B/W; $0.12 per page color.
Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) - BLS certification is required by the program in order to attend pre-clinical experiences in the second semester. ACLS is required by the program prior to entering the clinical phase of a student’s training. Students must have both BLS and ACLS certification that is valid through the end of their second year (the clinical year). Students may choose to attend training set up by the QU PA program or a self-arranged training as long as it meets the requirements as outlined by the QU PA program. The total estimated costs for these programs are approximately $100. This cost is figured into the overall estimated PA program budget and is NOT included in the student tuition and fees. The course is offered on site, at the university and is taught by certified instructors. Once in the program, all students must provide documentation of successful completion of BLS and ACLS by a specified due date or they cannot go to or continue in clinical rotations. Students do not need to provide proof of BLS and ACLS certification upon entering the program.
Certification Examination Costs - Upon successful the completion of the program (after graduation), students will be eligible to register for the Physician Assistant National Certifying Exam (PANCE), administered through the National Commission on Certification of Physician Assistants (NCCPA). Students may register for this during the final months of the program and are responsible for the registration fees associated with the exam.
Other Costs - Students that have a delayed graduation (“late finishers”) may incur additional costs and fees.
There may be other costs associated with the Graduate PA program. Information regarding tuition and fees can be found on the program’s website.

* All prices as of May 1, 2026, and subject to change**

Accreditation

Accreditation remains in effect until the program closes or withdraws from the accreditation process or until accreditation is withdrawn for failure to comply with the Standards. The approximate date for the next validation review of the program by the ARC-PA will be July 2033. The review date is contingent upon continued compliance with the Accreditation Standards and ARC-PA policy.

The program’s accreditation history can be viewed on the ARC-PA website at https://www.arc-pa.org/accreditation-history-quinnipiac-university/.

Complete Academic Standards, Progression and Program Completion Policies

ACADEMIC STANDARD POLICY
Students enrolled in graduate studies at Quinnipiac University are required to maintain Academic Good Standing. The university policy for academic good standing is outlined in University Policies. In addition, the PA program has the following requirements:

Students in the Quinnipiac University Physician Assistant Graduate Program are expected to maintain a GPA of 3.00/4.00 or above, and to pass every class with a final grade of B or better (3.00). At the end of each semester, the Department Chair/Program Director will review all grades and identify students who do not meet academic criteria requirements as follows:

Failure to achieve or maintain a cumulative grade point average of 3.00
Failure to achieve a semester grade point average of 3.00
Failure to demonstrate competency in clinical skills
A course grade of B- or lower
Failure of a course with a grade of D or F

Deceleration, Withdrawal, and Dismissal Policies

DECELERATION POLICY

ARC-PA defines deceleration as “the loss of a student from the entering cohort, who remains matriculated in the physician assistant program.” The QU PA Program may decelerate students due to leaves of absence, suspension, overturn of a dismissal or other academic reasons. Students who decelerate for academic reasons must meet regularly with a QU PA Academic Success coach in their first semester back after deceleration and are automatically placed on probation for the semester that they return. Students who decelerate must complete a personal academic success plan to ensure their success upon re-matriculation. The plan will be specific to the needs of the individual student. Deceleration will lead to delayed graduation and may require that the student enrolls in and is financially responsible for additional courses.

WITHDRAWAL AND DISMISSAL FROM THE PA PROGRAM POLICY

Withdrawal

Students considering withdrawal from the Physician Assistant Program should meet with their academic advisor or the department chair to explore the available alternatives. If withdrawal is the student’s final decision, it is recommended that they meet with a Dean’s Team member at the School of Health Sciences, the Dean of Graduate Student Affairs, and the Director of Graduate Financial Aid.

Honorable release is granted when all financial obligations to Quinnipiac University have been met. The refund policy is available through One Stop Student Administrative Services.

A student receiving aid for education for the Veterans Administration must consult with the Registrar and comply with Veterans Administration regulations. A student holding a Stafford Loan or Nursing Student Loan must have an interview in the financial aid office to ensure a clear understanding of repayment obligations. For details, see the One Stop Student Administrative Services website information.

If a student plans to withdraw and later is suspended, dismissed, placed on warning for unsatisfactory academic performance (including academic integrity sanctions), or suspended or expelled as the result of a judicial decision, the sanctions take precedence over the withdrawal and stand as a matter of record. Any academic warning becomes operative if the student is readmitted to the university.

All students who are withdrawn or dismissed from the PA program must follow a set procedure as detailed below which complies with Quinnipiac University policy:

The student will be withdrawn from all courses/clinical rotations in progress. If the student leaves the program while in their clinical year of training, they will be withdrawn from the clinical rotation in progress. Any failed rotations or rotations incomplete due to failures will be considered failed courses and the student will receive a grade of “F” and will not be withdrawn from the course.

Withdrawal from the Physician Assistant graduate program must be done in writing (with a date and student’s signature) with a copy to the Department Chair/Program Director and the Dean of the School of Health Sciences.

Note: Except in the case of deceleration, withdrawal from a course is tantamount to withdrawal from the program; therefore, the student MUST meet with the Department Chair/Program Director.

Any student requesting readmission will be considered a new applicant to the program and will be required to complete the program application process as a new applicant through CASPA and may be required to repeat coursework. Reapplication does not guarantee readmission to the Physician Assistant graduate program. After careful review of the students’ previous academic record and the request for readmission, a decision will be made. Students may be required to repeat selected coursework or meet new requirements of the Physician Assistant graduate program that became effective after the student’s withdrawal. A decision will also be rendered as to what program coursework will be considered for credit as completed.

Dismissal

A student may be dismissed from the Physician Assistant graduate program for failure to meet academic and/or professional performance requirements as well as infractions of the policies, procedures, technical standards, competencies and regulations. Dismissed students may not reapply for admission. Dismissal may occur in the didactic or clinical year. Grievance of dismissal may be made through the appeal process outlined in this handbook and in the current QU Catalog, QU Graduate Student Handbook and on the Quinnipiac University website.