Welcome to the Obstetrics and Gynecology Residency Program

Training excellent physicians who will go on to achieve success and become outstanding leaders

Welcome to the Obstetrics & Gynecology Residency Program

Dear Residency Candidate:

 

Welcome to The University of Texas Rio Grande Valley (UTRGV) Obstetrics and Gynecology Residency Program at Doctors Hospital Renaissance Hospital (DHR). We are dedicated to providing you with a world-class residency education in a setting that is friendly, warm, and supportive. Our residency program is dedicated to training excellent physicians who will go on to achieve success and become leaders in a variety of careers within general obstetrics and gynecology and its sub-specialties. Let me share with you some of the unique aspects of UTRGV-DHR and our residency program. 

 

The University of Texas Rio Grande Valley and Doctors Hospital at Renaissance are ideally situated in the Rio Grande Valley of South Texas, an area rich with cultural and recreational activities for adults and children of all ages. This setting allows us to attract top-notch faculty dedicated to the mission of teaching residents and medical students evidence-based, patient-centered care. We strongly believe that teaching the “Doctors of Tomorrow” is a special calling that must be approached with caring and dedication.

 

We provide all residents with individualized training and mentoring so that they can pursue their highest aspirations as physicians, whether in general obstetrics and gynecology or through additional training in fellowship programs. The core rotations will provide extensive experience in all aspects of our specialty at DHR from obstetrics to gynecology malignancy, and everything in-between.  At the DHR Women’s Health Center, residents participate in the full scope of ambulatory Ob/Gyn services augmented by regular sessions on the patient-doctor relationship, clinical examination skills and evidence-based medicine. The inpatient services at DHR provide a wealth of opportunity in all aspects of obstetrics and surgical gynecology. Residents care for all patients on th teaching service and also participate in the care of private patients enabling them to see a variety of approaches in the OR and on Labor & Delivery.

 

Strong research opportunities supplement our residents’ educational experience. All trainees are encouraged to pursue scholarly activities, and faculty members involved in research are eager for resident participation. Residents are supported to publish and present their research projects. There are also numerous opportunities to become involved in research projects at or quality improvement projects with a focus on community engagement.

 

Finally, as a program, we feel strongly connected to the community we serve. Our goal is to have residents reach out in many ways to serve beyond the walls of the hospital. As the program grows residents will participate in a number of community activities including presenting at health fairs, providing care at community based clinics, and joining faculty in community presentations on women’s health.

 

Thank you for taking the time to look at the UTRGV Obstetrics and Gynecology-DHR Residency Program. We are a new program in a region of Texas that provides numerous learners unique opportunities to become an outstanding Ob/Gyn physician. Our program trains residents to provide care they would want their families to have:  compassionate, comprehensive, high quality and cutting edge.  We feel that we offer a superb training experience and hope that you will consider us as the way to foster your love, passion and excitement for obstetrics and gynecology.

 

Sincerely,

Tony Ogburn, M.D.

Program Chair and Program Director

Residency Program Leadership

Tony Ogburn, MD

Professor and Program Chair, UTRGV

 

Dr. Tony Ogburn is the professor and chair of The University of Texas Rio Grande Valley (UTRGV) Department of Obstetrics and Gynecology. He was previously a professor in the Department of Obstetrics at the University of New Mexico (UNM) where he was on faculty since 1997. He was also the chief medical officer at the University of New Mexico-Sandoval Regional Medical Center. He attended medical school at the University of Florida and completed his residency in OB-GYN at the University of California-Irvine. Following his residency he worked for the Indian Health Service in Gallup, New Mexico for six years. He served in a number of educational leadership roles at UNM including residency program director and assistant dean of Graduate Medical Education. He continues with an active clinical practice with a focus in general gynecology and family planning. He has been involved on the national level including serving as Chair of the CREOG Council, an oral board examiner, and various ACOG committees.

Efraim Vela, MD

Clinical Assistant Professor and Assistant Program Director

 

Dr. Vela graduated medical school from the Meharry Medical College in Nashville Tennessee in 1980. He went on to complete an internship at UTMB in Galveston Texas in 1986. Dr. Vela joined the faculty as a Clinical Professor and Assistant Program Director in 2014. He is certified by the American Board of Obstetrics and Gynecology.

 

Jennifer Salcedo, MD

Program Director/Associate Professor

 

Dr. Jennifer Salcedo is Associate Professor and Program Director in the Department of Obstetrics and Gynecology at the University of Texas Rio Grande Valley (UTRGV). She was previously an Associate Professor in the Division of Family Planning, Department of Obstetrics, Gynecology &Women’s Health, at the University of Hawaii where she served as an Associate Program Director and Director of the Kenneth J. Ryan Residency Training Program in Abortion & Family Planning. There she also held adjunct faculty appointments in the Office of Public Health Studies and the Department of Biomedical Sciences. Dr. Salcedo received her medical degree and MPH at Northwestern University, completed residency training at the University of California, Irvine, and finished a fellowship in family planning at the University of California, Los Angeles. During fellowship, she received an MPP through UCLA’s Luskin School of Public Affairs, with a concentration in health. She has held leadership positions in the American College of Obstetricians & Gynecologists, American Society of Reproductive Medicine, and the North American Society for Pediatric and Adolescent Gynecology. Dr. Salcedo’s research interests include emergency contraception, health care systems improvement, and medical education. She is certified by the American Board of Obstetrics and Gynecology.

Liliana Padilla-Williams, MD

Clinical Assistant Professor

 

Dr. Padilla-Williams received her M.D. in 2005 from University of Texas Health Science Center in Houston, Texas. She completed her residency at the Louisiana State University in Shreveport, Louisiana in 2009. She received numerous awards including best teaching resident, outstanding third year resident in ambulatory care and the resident research award. Dr. Padilla-Williams has been part of our team since 2014 as a Clinical Professor. She is certified by the American Board of Obstetrics and Gynecology

Roberto Prieto-Harris, MD

Clinical Assistant Professor

 

Dr. Rivas grew up in the border city of El Paso, TX. He completed an undergraduate degree in community health education at New Mexico State University followed by graduate level training in epidemiology and biostatistics at the University Of Texas School Of Public Health. He has had the opportunity to work in research and public health at MD Anderson Cancer Center and the Texas Department of State Health Services. After completing a medical degree at Texas A&M School of Medicine and a residency in obstetrics & gynecology at the University of New Mexico, he joined UT RGV to continue his passion of helping underserved populations as well as teaching residents and medical students.

 

Saul Rivas, MD, MSPH

Clinical Assistant Professor

 

medical schools in Mexico City, where he graduated with honors. He moved to Philadelphia, PA, where he completed his residency training in Obstetrics and Gynecology at Albert Einstein Medical Center. During this time, he received numerous awards including best first year resident, best teaching resident and ended residency as chief administrative resident. In 2007, he moved to the Rio Grande Valley. During this short time, he has accomplished certification by the American Board of Obstetrics and Gynecology, and was appointed as Professor of Obstetrics and Gynecology at the University of Texas Medical Science Center in San Antonio. In 2010 he was chosen by his medical students as the best teaching junior attending. He is certified by the American Board of Obstetrics and Gynecology.

 

Hazem Kanaan, DO., FACOOG

Diplomat American Board of Obesity Medicine

Clinical Assistant Professor

 

Dr. Kanaan completed his undergraduate degree in Biochemistry at Kennesaw State University in Georgia and graduated with Cum-Laude Honors in 2005. He then was accepted at West Virginia Osteopathic School of Medicine for his medical doctoral degree in 2009, then had his Obstetrics and Gynecology residency training in Michigan at Henry Ford Health System at Wyandotte Hospital in 2013. During his residency training he was awarded the “Teaching Resident of the Year Award” in three out of four years of training. Then in the summer of 2013 Dr. Kanaan moved to Rio Grande Valley for work and in a short time he completed his board certification in Obstetrics and Gynecology; thereafter, he completed his fellowship specialty training in Obesity and Metabolic Disease Medicine in 2016. Dr. Kanaan was appointed as Clinical Assistant Professor with University of Texas-RGV in 2016. He is currently double board certified in Obstetrics and Gynecology and in Obesity and Metabolic Disease Medicine.

 

Kyle Biggs, DO

Clinical Assistant Professor

 

Originally from the Midwest, Dr.Biggs has made his home in the southwestern United States for the past 15 years

After undergraduate college and medical school in Phoenix, Arizona, Dr. Biggs moved to the west Texas town of El Paso for residency training in Obstetrics and Gynecology. Dr. Biggs' interest in Latino culture and proximity to Mexico during his education and training has given him the gift of the Spanish language which he enjoys using daily.

 

Dr. Biggs was drawn to UT-RGV both for the opportunity to provide care for an underserved population as well as the privilege to educate the next generation of America's physicians. His research interests include cultural adaptation, specifically of Hispanic-Americans, and it's impact on health outcomes and healthcare delivery.

 

In his free time, Dr. Biggs enjoys reading, endurance sports and live music.

Denise De Los Santos, MD

Clinical Assistant Professor

 

Dr. De Los Santos was born and raised in the Rio Grande Valley. She went to PSJA North High School and was accepted into the Medical School Early Acceptance Program, which allowed her to matriculate to the University of Texas Health Science Center at San Antonio at age 20 after 3 years of undergraduate education at the University of Texas Pan American. She graduated with an undergraduate degree from UTPA with a Bachelor’s degree in Biology and minor in Chemistry, and UTHSCSA with her Doctorate in Medicine. After completing an OB/GYN residency at New York Downtown Hospital in Manhattan and Danbury Hospital in Danbury, CT, she worked at a private practice in Columbia, MO, where her husband is a resident in anesthesiology.

 

Dr. De Los Santos is excited to be back home to help the next generation of RGV physicians. Teaching has been important to her, as she was a teaching assistant and lab assistant in organic chemistry in undergraduate school as well as a teaching assistant in Neuroscience in medical school.

Dr. Laura Faye Gephart, MD MBA FACOG

Assistant Professor

 

Dr. Laura Faye Gephart MD MBA FACOG received her undergraduate degrees in Spanish and Neurobiology, Physiology and Behavior from the University of California, Davis and her MD from Loma Linda University. She also earned her MBA from Loma Linda University while teaching elementary school in Desert Hot Springs. After her internship in Washington DC, she completed Obstetrics and Gynecology residency at University of South Florida in Tampa followed by Female Pelvic Medicine and Reconstructive Surgery fellowship at Baylor Scott & White Health in Temple, Texas.

 

A board certified OBGyn with fellowship training in FPMRS, Dr. Gephart treats women suffering from urinary and fecal incontinence, pelvic organ prolapse, defecatory and urinary dysfunction, recurrent UTI, and bladder pain syndrome. She advocates for patients and health system reform on the state and national level. Dr. Gephart is passionate about her patients, clinical research, medical education and legislative advocacy. As an Assistant Professor at UTRGV, Dr. Gephart helps educate and groom the next generation of OBGyn doctors for the Rio Grande Valley.

Lyuba Levine, MD

Clinical Professor & Chief, Gyn Oncology

 

Dr. Lyuba Levine is an obstetrician-gynecologist in Galveston, Texas and is affiliated with multiple hospitals in the area, including Memorial Hermann Baptist Hospital and University of Texas Medical Branch Hospitals. She received her medical degree from St. George's University School of Medicine and has been in practice between 11-20 years. Dr. Levine accepts several types of health insurance, listed below. She is one of 14 doctors at Memorial Hermann Baptist Hospital and one of 43 at University of Texas Medical Branch Hospitals who specialize in Obstetrics & Gynecology.

Cherie J. Johnson, MD,. F.A.C.O.G

Clinical Assistant Professor

 

Dr. Johnson has 25 years’ experience in Maternal Fetal Medicine (MFM) care and is board-certified in OB/GYN as well as MFM. She completed her medical school at Thomas Jefferson in Philadelphia, residency in OB/GYN at Christiana Hospital- a Jefferson affiliate performing about 6000 deliveries per year. Fellowship at University of California and currently she is pursuing he Masters at USC with 25 physicians from around the world. She is bilingual and loves to care for the high-risk OB mothers of our region.

 

 

 

Kedak Baltajian, MD

Clinical Assistant Professor

 

Dr. Baltajian received her medical degree from University of Balamand, Lebanon, completed her residency in OB/GYN at the Brooklyn Hospital Center in Brooklyn, NY and continued her fellowship in Maternal Fetal Medicine (MFM) at Beth Israel Deaconess Medical Center, Boston, MA.  She has been a faculty member in Boston, MA for 9 years. Dr. Baltajian has been part of numerous lectures that were conducted to her fellow residents, clinical fellows, and research fellows (post-docs). Dr. Kedak Baltajian moved to the Rio Grande Valley to join the DHR Center for Maternal Fetal Medicine at Doctors Hospital at Renaissance and has joined our team as a Clinical Assistant Professional for the OB/GYN Residency Program.

 

 

 

 

Cristela Hernandez, M.D. FACOG

Clinical Assistant Professor

 

Dr. Hernandez was born and raised in Edinburg, TX before attending Yale University, where she received her bachelor’s degree in Psychobiology. She obtained her medical degree from Harvard Medical School in Boston, Massachusetts. Dr. Hernandez completed an internship, residency training, and fellowship training at UT Southwestern Medical Center at Dallas and Parkland Memorial Hospital. She is currently an associate professor with the University Of Texas Rio Grande Valley School Of Medicine, educating students in Endocrinology and Female Reproduction.

 

 

 

 

Henry E. Ruiz, MD

Clinical Professor

 

Dr. Henry Ruiz is an urologist in Edinburg, Texas and is affiliated with Doctors Hospital at Renaissance. He received his medical degree from Icahn School of Medicine at Mount Sinai and has been in practice for 26 years. Dr. Ruiz joined our team in 2015 as our Clinical Professor. He completed a fellowship in FPMRS and is board certified in Urology and FPRMS. He also speaks multiple languages, including Spanish.

 

 

 

 

 

Robert S. Schenken, MD

Professor UTHSCSA

 

Dr. Schenken assumed the position of Chairman in 2002. He holds the rank of Professor and the Humana Foundation Distinguished Chair in Obstetrics and Gynecology. Dr. Schenken completed medical school at Baylor College of Medicine in 1977 and concluded his residency training at The University of Texas Health Science Center at San Antonio. He completed a fellowship in Reproductive Endocrinology at the National Institutes of Health, Pregnancy Research Branch, in 1982. Dr. Schenken was the Chief of the Division of Reproductive Endocrinology and Infertility from 1986 until 2002. He is certified by the American Board of Obstetrics and Gynecology in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. He was President of the American Society for Reproductive Medicine in 2005 and currently serves as a director of The American Board of Obstetrics and Gynecology and under the Residency Research Committee for Obstetrics and Gynecology.

Randall Robinson, MD

Adjunct Clinical Professor

 

Dr. Robinson joined the Department of Obstetrics and Gynecology and Reproductive Endocrinology Division in 2011. He received his A.B (Arte Baccareleuratis) and M.D. degrees from the University of Missouri and completed his Obstetrics and Gynecology residency at Madigan Army Medical Center, Tacoma, WA in 1992 and a Fellowship in Reproductive Endocrinology and Infertility at Harvard Medical School, Brigham and Women’s Hospital, Boston, MA in 1996. He previously served on active duty in the US Army Medical Corps and retired at the rank of Colonel after more than 26 years of service. He served as both the Chairman and Residency Program Director of Obstetrics and Gynecology at the San Antonio Military Medical Center and the San Antonio Uniformed Services Health Education Consortium. He is board certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. Dr. Robinson currently serves as Vice-Chairman of the Council on Resident Education in Obstetrics and Gynecology. He is a board examiner for the American Board of Obstetrics and Gynecology and is the Army Section Chair of the Armed Forces District of the American College of Obstetricians and Gynecologists.

Maritza R. Jimenez, M.S.

Program Coordinator- OB/GYN

 

Maritza R. Jimenez was born and raised in the Rio Grande Valley where she completed both her undergrad and undergraduate degree in Rehabilitation Counseling at the University of Texas Pan American in Edinburg, TX. She has worked hand in hand with variety of non-profit organizations from Communities In Schools of Hidalgo County, Border Health Office- Diabetes Registry, and the College Assistant Migrant Program. Ms. Jimenez enjoys giving back to her community by participating in the Junior League of McAllen, Inc., American Cancer Society- Cattle Baron Ball Committee, and the Rio Grande Valley Empowerment Zone.

 

When she is not working or planning her wedding, she enjoys spending time with her fiancé, family and friends.

 

 Ms. Jimenez is extremely thrilled to be part of the collaboration of Doctors Hospital at Renaissance (DHR) and the University of Texas Rio Grande Valley (UTRGV); and foresees many more ground breaking events here in the Rio-Plex Region.

How to Apply

 

Applicants must be eligible for licensure in the State of Texas. If there are any questions regarding this, inquiries should be made directly to the Texas Medical Board. The Department participates in the National Resident Matching Program (NRMP) and the Electronic Residency Application System (ERAS). Only applications submitted through the ERAS will be considered. Applicants must also register with the National Residency Matching Program. The application deadline is January.

 

The following documents should be submitted through ERAS:

 

  • Common Application Form
  • Curriculum Vitae (CV)
  • Personal Statement
  • Medical School Transcripts
  • USMLE (United States Medical Licensing Exam) Transcripts
  • Three Letters of Recommendation
  • Dean’s Letter
  • Wallet-sized Color Photo
  • Valid ECFMG certification for international medical graduates

 

  • Applicants must be eligible for employment in the US on 1 July of the year of Match.

 

**Please Note: UTRGV requires that IMG’s be a U.S. citizen or a permanent resident in order to engage in graduate medical education. For more information, contact the Office of International Services at  1-888-888-4026 or international@utrgv.edu.

 

Interviews are by invitation only and are a prerequisite for admission. Our interview season extends from November through December and will be held on Wednesdays. We schedule approximately 48 interviews for four (4) positions each year.

 

Please direct all correspondence and inquiries to:

 

Obstetrics and Gynecology Residency Program

University of Texas Rio Grande Valley – Doctors Hospital at Renaissance

2821 Michaelangelo Dr. Suite 400

Edinburg, Texas 78539

Phone: 956-362-3594

Residency Program Coordinator: Maritza R. Jimenez

mar.jimenez@dhr-rgv.com

Program Description

 

OUTLINE OF PROGRAM

Obstetrics and gynecology training at the University of Texas Rio Grande Valley, is four years of clinically oriented graduate medical education focused on reproductive health care and ambulatory primary health care for women, including health maintenance, disease prevention, diagnostic treatment, consultation and referral.

Year 1

4 months

Obstetrics

2 months

Clinic

2 months

Gynecology

1 months

Night Float

1 months

Ultrasound

2 months

Family Medicine

Year 2

3 months

Gynecology/REI

3 months

Clinic

3 months

Maternal Fetal Medicine

1 months

Oncology

2 months

Night Float

1 months

Research

3 months

Night Float

2 months

Urogynecology

3 months

 Obstetrics

1 months

MD Anderson

2 months

Oncology

1 months

Gynecology

Year 3

Year 4 of training will consist of targeted learning objectives in the Obstetrics and Gynecology rotations.  Elective rotations will be balanced and tailored to meet the educational objectives of each resident and along with the needs of the community and the surrounding regions. This will allow residents to explore opportunities for enhanced training with specific populations aligned with their future practice goals.

Training Facilities

Obstetrics and Gynecology Center

The Obstetrics and Gynecology Center is located in the Medical Tower on the Doctors Hospital at Renaissance (DHR) Health System 80-acre campus. The center includes 12 exam rooms with 2 procedure rooms and a dedicated ultrasound suite. The clinic is designed as a patient-centered medical home and serves as the focal point for the education of residents during their training and it is the venue for their practice of continuity.

Women's Hospital at Renaissance

Women’s Hospital at Renaissance is the teaching site for our residents. Women’s Hospital at Renaissance has 7 operating rooms, 63 NICU beds, 24 labor and delivery suites, and 12 antepartum beds. Doctors Hospital at Renaissance (DHR) is a physician-owned health system that offers some of the most comprehensive medical care on the U.S. Southern Border. One of the largest physician-owned facilities in the United States, DHR serves the 1.2 million residents of the Rio Grande Valley. From general acute care services and graduate medical education to individually-tailored wellness and preventative health programs, at DHR over 700 physicians and more than 1,200 nurses dedicate themselves to offering a full continuum of care in over 70 different sub-specialties.  Continually expanding and growing to meet the needs of the community and the patients it serves, DHR is a national best practice model minority-serving health system that is committed to providing the highest quality learning experience for students.

Contract, Salary, and Benefits

 

Residents at DHR are employees of the UT  Rio Grande Valley UTRGV is the sponsoring institution for the residency program. Benefits are established through the UT System Office of Employee Benefits. Benefits begin on the first official day of residency/fellowship.

 

RESIDENT CONTRACT click here to view a copy (PDF)

Residents are required to sign an annual Graduate Medical Education (GME) Agreement establishing the terms and conditions for participation in the GME program's facilities or other participating institution facilities.

 

CURRENT SALARIES (effective July 2016- June 2017)*

UTRGV employees are paid once a month on the 1st of the month.

 

PGY-I:  $51,300.00

PGY-II: $52,800.00

PGY-III: $54,400.00

PGY-IV: $56,100.00

 

*PLEASE NOTE: The current salaries for UTRGV residents are provided as reference.

________________________________________

 

ANNUAL EDUCATION ALLOWANCE

Residents are eligible for the following amounts each year for continuing medical education and study materials.

 

PGY-I: $400.00

PGY-II: $1000

PGY-III: $1000

PGY-IV: $

 

Other Benefits

 

STEP 3- Resident taken during their intern year will be eligible for reimbursement with a passing score.

ABOG Written exam- will be reimbursed

IPADS and Cell phones will be provided

 

Additionally, residents are encouraged to participate in scholarly work during residency.  If presenting at a national conference, expenses will be covered by the department.

 

PERMIT [details]

• TMB PIT Permit application fee reimbursed

 

MAJOR BENEFITS [details]

• Health Insurance

• Dental Insurance

• Vision Insurance

• Life Insurance

• Disability Insurance

• Professional Liability Insurance

 

MANDATORY RETIREMENT [details]

• All eligible employees of The University of Texas System are automatically enrolled in the Teacher Retirement System (TRS) of Texas on their first day of employment. For FY15, employees contribute 6.7% of monthly pay to TRS. The institution contributes 6.8%.

• At the time of orientation, residents will also be given a one time opportunity to enroll in the Optional Retirement Program (ORP) instead of TRS. For ORP, employees contribute 6.65%. The institution contributes 8.5%. Learn more about ORP, [here].

 

VACATION

• PGY1 year-10 days paid leave; cannot be carried over.

• PGY2 year and above-15 days paid leave; cannot be carried over

 

PERSONAL LEAVE

• Residents receive 3 personal days per year.

Family and Medical Leave

 All years-residents are eligible for up to twelve (12) weeks unpaid leave for birth or adoption of a child or care of a seriously ill family member’s personal serious health condition. The FMLA provides leave to care for a new-born child or a child placed in the employee’s home for adoption or foster care; to care for an employee’s parent, spouse, son or daughter with a personal serious health condition; or for a serious personal health condition which prevents the employee from performing his/her job.

 

MATERNITY or PATERNITY LEAVE [details]

• Residents are eligible for up to twelve (12) weeks unpaid leave under the Parental Leave policy.

 

EMPLOYEE ASSISTANT PROGRAM (UTEAP) [details]

• The UTEAP provides an Employee Assistance Program (EAP) for all UTRGV employees, faculty, staff members and their families.  Through the EAP, you, your spouse or live-in partner, and eligible dependent children can access free, convenient and confidential services. The EAP offers a variety of services including counseling sessions with a licensed mental health professional, legal and financial resources, and WorkLife referrals.

 

 

Contact Information

 

Please direct all correspondence and inquiries to:

 

Maritza R. Jimenez

Program Coordinator - Obstetrics & Gynecology

 

Obstetrics and Gynecology Residency Program

University of Texas Rio Grande Valley – Doctors Hospital at Renaissance

 

2821 Michelangelo Dr. Suite 400

Edinburg, Texas 78539

Phone: 956-362-3590 / FAX: 956-362-3598

Email: mar.jimenez@dhr-rgv.com

5501 S. McColl Rd. Edinburg Texas 78539 | (956) 362-8677 | 956-DOCTORS

Copyright © 2015 Doctors Hospital at Renaissance. All Rights Reserved

 

Doctors Hospital at Renaissance proudly meets the federal definition of a “physician-owned hospital” (42 CFR § 489.3). As required by law, a list of the hospital’s physician owners and investors is available at www.dhr-rgv.com. DHR, Ltd. and its affiliated entities comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex.