04(10): Being world champion of the finale of a global challenge that was held in London, and sightseeing in the city

Background & Introduction

**Scroll to the bottom of this post for a tl;dr summary if you’d rather not read the details!**

In perhaps the first quarter of 2021, I encountered a fellow Singaporean medical student’s retweet on Twitter. The retweet promoted an online event, specifically a global competition for medical students, that had been organized by one of the world’s pre-eminent academic publishing companies – Elsevier. The event was entitled “ClinicalKey Student Global Challenge (CKSGC)”. In addition to publishing an entire array of journals, which is the core business of what Elsevier does, Elsevier has also ventured into other areas, and has developed products which facilitate medical education for medical students, doctors, and researchers.

In an article I had gotten published in SMA News in July 2021, I talked about how I had used the ‘Complete Anatomy’ app for iOS as a primary learning resource for anatomy. The ‘Complete Anatomy’ app had been developed and successfully marketed with the help of Elsevier, and this app is just one of many innovative products that Elsevier has developed. ClinicalKey, like Complete Anatomy, is an innovative product and constitutes a clinical resource for medical students and doctors that had been developed by Elsevier. CKSGC is essentially a marketing campaign for the ClinicalKey product.

A few weeks after that medical student’s retweet, my medical school sent an email to its current students: telling us of the existence of a competition for medical students. As it turned out, this was the same event which that same medical student had promoted. Given that I had now heard about this competition from two independent sources, I couldn’t help but feel that I was on to something legitimate and that I needed to check this out to satiate my curiosity.

Some of you may be wondering who that fellow Singaporean medical student is. Well, at least at the time the retweet was posted, he was a student. He is now a junior doctor (given that he was a member of the class of 2021 at NTU LKCSoM). This person is none other than Aaron Goh. Aaron and I are similar in that he was born in the same year as me and as such, we had taken our final high school-equivalent exams in the same year. He didn’t do the GCE ‘A’ Level though. He was an alumnus of Anglo-Chinese School (Independent), better known as ACS(I) locally, and he had done the International Baccalaureate Diploma Programme. We had actually connected with each other on Twitter back then (this was way before I permanently deleted my Twitter account) due to our shared interest in ophthalmology.

To the best of our knowledge, we were the only two students from Singapore who were engaging with medical students, doctors, and researchers from all around the world (though mainly from North America) on ophthalmology-related stuff on social media.

But perhaps most notable is the fact that he had actually participated in CKSGC’s inaugural run in 2019. I’ll give the details soon, but in essence, Aaron had cleared the initial stages of the global challenge, and was a finalist, which meant that he earned the right to participate in the global finale which was held in London in 2019. He ended up going on to be a member of the winning team (named “Happy Red Blood Cells”; presumably due to the colour of the scrubs they were issued for the event) of the entire global challenge, So, it was also an interesting coincidence that for the second run of the event (the finale of this second run was supposed to be held in November 2021; however, it was postponed due to the unforeseen developments in the COVID-19 pandemic) which I participated in, my team was issued scrubs of the same colour – fuchsia. We also coincidentally named our team after a type of cell (though the previous winners’ team name had no influence on our decision to name our team after a type of cell). However, instead of naming our team after erythrocytes, we called ourselves “The Astrocytes”. Like Aaron’s team, our team then went on to win the global challenge.

What exactly is Elsevier CKSGC ’21 and how were the 16 finale participants selected?

The structure of the Elsevier CKSGC is as follows: four question rounds (Rounds 1-4), one video submission round (Round 5), and the finale where finalists, Elsevier staff, and panel of content experts come together at some location in the world where Elsevier has a major presence.

How it works for the initial question rounds is that to be eligible for the next round, you need to either score full marks on the current round, or score at least 10% more than your previous round’s score. Each round has 25 questions which vary in difficulty level and are written in the style of USMLE (United States Medical Licensing Examination) questions. As you might imagine, the latter criterion is easier to achieve than the former. Each round needs to be completed within 40 minutes. According to the official rules, everyone clears Round 1 successfully and advance to take Round 2 by default.

The four question rounds commenced on 17 April 2021, and lasted for four weeks. When each new round commenced each week, the questions went live for three days, and students were able to access results and additional learning materials as they progressed.

People who clear round 3 successfully are known as quarter-finalists. People who clear round 4 successfully are known as semi-finalists.

For the relatively low proportion of students who clear all four question rounds, they would get the opportunity to undergo a video round, where these semi-finalists would submit a four-minute video recording of themselves in which they would answer three questions on the topic of leadership in medicine. All the semi-finalists who submit their videos would have their videos reviewed by an expert panel.

For the Elsevier CKSGC ’21, the expert panel consists of, in no particular order, Dr Ted O’Connell, Dr Ryan Pedigo, Dr Hao-Hua Wu. It may consist of other people that I’m not aware of, but these are the people whom I know for sure are on the panel.

In each video, CKSGC participants need to provide their responses to three questions pertaining to leadership in a medical scenario. Each member of the expert panel judges each participant’s response to the questions, giving a numeric score for each prompt. The mean of all the panel members’ assigned numeric scores for the prompt is then calculated. Lastly, a candidate’s final ‘numeric score’ for the video round is determined via some form of average of the average numeric scores obtained for each of the three prompts. Participants are ranked in order of their final ‘numeric score’ for the video, and the top students with the highest scores would be selected as finalists.

In total, 15 finalists were chosen from among the pool of 7,500+ medical students from 100+ countries who had participated in the Elsevier CKSGC ’21. A similar challenge that was specific to India had been held, and the winner for that country-specific challenge was Ms Mitul Suhane. She had won the Grand Prize of the ClinicalKey Student India National Challenge 2021. Though she hadn’t participated in the CKSGC to become a finalist in the traditional manner, the fact that she was the Grand Prize winner of her country-specific challenge meant that she received a ‘Golden Ticket’ and this automatically qualified her for the CKSGC finals. As such, with the inclusion of Mitul, there would be 16 participants for the Elsevier CKSGC ’21 finale.

London – Day 1 of 5 – 21 April 2022 – Thursday

I departed Singapore on 20 April 2022, 2330 hrs and arrived in London at Heathrow Airport on 21 April 2022, 0555 hrs. It was great. Thursday was a day to ease in into things. Elsevier had actually allowed me to fly in to London one day earlier than most other participants given that I was coming from Singapore via a long 14-hour flight, given that the first official component for the finale would be the meet-and-greet at a bar that would occur at 2:45 pm on 22 April 2022.

I was picked up by a driver from Heathrow Airport and fetched to Travelodge London City. During non-peak hours, the journey would take around 30 mins. However, at the time we actually made the journey, the roads were congested and the navigation app predicted that we would take over 1.5 hours to get there. As it turned out, when I tried to give my details to the counter at the lobby of Travelodge London City, I realised that I had arrived at the wrong Travelodge branch. However, by the time I went outside of the Travelodge building to notify the driver in an attempt to get him to drive me to the correct location, I realised that he already vanished. The correct Travelodge branch was an 18-min walk away. Although I was advised to just book a cab there (I was promised reimbursement) by the point of contact, I figured that I’d just walk the distance. It was good exercise anyway. I didn’t have much stuff with me too. All I had to carry was just my simple carry-on bag and my check-in luggage that weighed about 8 kg.

When I reached the correct Travelodge, it was still too early for checking into my room (the standard check-in time was 3 pm). So, I decided to deposit my luggage with the counter and headed off for lunch at Dishoom Shoreditch, which had been recommended by someone who had been to London and enjoyed the food there. At Dishoom, I ordered the Garlic Naan + Mutton Pepper Fry (which came with three types of spices as seen in the saucers in the image below) + Chocolate Chai (which to my pleasant surprise, is refillable).

For the rest of the afternoon, all I did was sightseeing. I didn’t use public transport and instead got around purely on foot and ended up walking 20k steps (according to the ‘Health’ app on iOS).

For this first day, I visited some landmarks. The first place I decided to head to Tower Hill, followed by Tower of London. Then, I saw the beautiful Tower Bridge, which I learnt was not London Bridge!

I saw the actual London Bridge later that day, and found it quite underwhelming. It’s the former bridge that’s more iconic! We can only blame the popular nursery rhyme (‘London Bridge is Falling Down’) for this highly prevalent misconception. Later on, I visited the ‘All Hallows By The Tower’ church, the oldest church in the ‘City of London’.

I signed in the church’s visitor book on 21 April 2022, Thursday. Be sure to also do so if you’re gonna visit London too!

I then walked to St. Paul’s Cathedral, the venue of the wedding of Prince Charles and the late Princess Diana. They had gotten married in St. Paul’s instead of the more traditional Westminster Abbey because the former could accommodate a greater number of guests that they wished to invite. Isn’t the dome of the church simply magnificent?

Once I was done visiting St. Paul’s, I walked back to the vicinity of London Bridge. Look at the following photograph – a panaromic shot of London Bridge with The Shard (tallest building in the UK, standing at just above 300 m) in the background. Wouldn’t you agree that it’s underwhelming compared to Tower Bridge?

It was at point that I decided that I had done enough and that I wanted to rest for the day. So, I made my way back to Travelodge London Central City Road. I passed by the Bank of England along the way. I had dinner at Travelodge, and took the rest of the night off.

London – Day 2 of 5 – 22 April 2022 – Friday

I woke up early. I had a buffet breakfast at my accommodation, and began my morning walk to King’s Cross Station (3 km away). I mostly walked along City Road, and passed a number of notable locations. Early on in my journey, I passed by the residence of John Wesley. Wesley was the leader of the Methodist movement, which ultimately gave rise to the Methodist denomination of Christianity. In fact, the largest and oldest Methodist church in Singapore is named after him: Wesley Methodist Church. Futher along my way on City Road, I soon encountered Moorfields Eye Hospital.

It would be a dream come true if I could work or conduct research here in some capacity in the future given my current interest in ophthalmology. Moorfields Eye Hospital, together with the UCL Institute of Ophthalmology, is the oldest and largest centre for ophthalmic treatment, teaching, and research in Europe. According to the hospital’s Wikipedia article page, the hospital will apparently be relocating to a new location near King’s Cross railway station and that the present building has been sold to private developers.

Dr Vivian Balakrishnan, Singapore’s Minister for Foreign Affairs since 2015, had worked here from 1993 to 1995 as a senior ophthalmology registrar, where he had subspecialised in paediatric ophthalmology. It was after he completed his stint here that he returned to Singapore and was appointed a consultant ophthalmologist at SNEC and NUH. Many well-known people in ophthalmology are associated with Moorfields in one way or another. Another example I can cite is that of the late Dr Robert Marcus Gunn, who had worked as a house officer at Moorfields. He was a Scottish ophthalmologist after whom the eponymous Marcus Gunn pupil (a clinical sign that may be seen in patients with multiple sclerosis or severe retinal disease) is termed.

Soon, I arrived at the famous London King’s Cross station.

London’s King’s Cross station is one of the busiest train stations in the whole of the UK, and is also well-known for being the filming location of the first of the Harry Potter movie series, where the ‘Platform 9 3/4″ had been featured. Adjacent to King’s Cross is St. Pancras International Station (see the following image), the London terminus for the international high-speed railway service to continental Europe.

I walked a bit within St. Pancras International Station and found two public pianos. I tried playing both of them but unfortunately, the keys’ action on both pianos were in a pretty terrible state. It’s this way probably due to the lack of maintainance and the fact that it is subject to the wide variation in temperature and humidity on all days throughout the year. The fact that London has four seasons does not help at all.

Soon, I left St. Pancras and headed to the nearby British Library.

Then, I walked to Great Ormond Street Hospital (formerly known as the Hospital for Sick Children). One of the reasons I had decided to visit this place was that my mentor (who has had a significant impact and influence on my life) had undergone specialty training here many decades ago. The hospital is closely associated with University College London (UCL) and in partnership with the UCL Great Ormond Street Institute of Child Health, which is adjacent to it, is the largest centre for research and postgraduate teaching in children’s health in Europe. Think of it as the Moorfields of the paediatric realm.

From what I had seen at the entrance of the hospital, I learnt a number of things: 1) that Elizabeth II had visited the hospital in 2002 to commemorate the hospital’s 150th anniversary as part of the Golden Jubilee celebration of her accession (she was coronated in 1952 after all).

NB: As a brief summary to those who aren’t familiar with the concepts of jubilees, a golden jubilee is a celebration of a 50th anniversary. Silver, ruby, diamond, sapphire, and platinum jubilees correspond to 25th, 40th, 60th, 65th, and 70th anniversaries respectively. Elizabeth II is the first British monarch to have had a sapphire and platinum jubilee.

Moreover, did you know that Sir James Barrie, the novelist and playwright best known for the creation of Peter Pan, actually donated the copyright of Peter Pan to the hospital? It is thus not totally surprising that Peter Pan-related statues can be found at the hospital entrance.

After this, I walked to the British Museum, the world’s oldest national public museum. It was established in 1753, 23 years prior to the ratification of the US Declaration of Independence.

Following the stop at the British Museum, I walked to Piccadilly Circus (this hyperlinked website mistakenly writes that the statue that surmounts the Shaftesbury Memorial Fountain is that of Eros, when the statue is actually that of Anteros). Here is a photograph is of me at the fountain. Piccadilly Circus is basically the London-equivalent of Times Square. Pretty cool.

After Piccadilly Circus, I walked to nearby Trafalgar Square, a public square in central London.

This is a photograph of me and Nelson’s column in the background. Constructed in the 1840s, the column is a monument in Trafalgar Square to commemorate Admiral Horatio Nelson, who died at the Battle of Trafalgar in 1805.

Also within Trafalgar square is the National Gallery that was founded in 1824. Majestic, isn’t it?

After this, I decided to walk towards Buckingham Palace and had a photo taken at Admiralty Arch. Its construction had been commissioned by Edward VII in memory of his mother, Queen Victoria. The Latin inscription says: In the tenth year of King Edward VII, to Queen Victoria, from most grateful citizens, 1910.

Then, as I was en-route to Buckingham Palace, I spectated the Changing of Guard which was happening.

The photograph is that of me and both Buckingham Palace and Victoria Memorial in the background.

Look at the crowd! I’m sure it was worse than this pre-COVID. And this isn’t even the peak period! And this was on a Friday – not even a weekend!

After Buckingham Palace, I walked all the way to Westminster Cathedral.

One of the things I appreciate about having learnt basic Latin previously is that I can make out random neat inscriptions. The inscription reads: Lord Jesus, King and Redeemer: by your blood, save us! Do you see the Latin word ‘sanguinem’ there? It’s whence we get our English words ‘sanguine’ and ‘exsanguinate’.

It’s important not to confuse Westminster Cathedral with Westminster Abbey. One church is Roman Catholic, and the other is Anglican! After the former, I walked to the latter. Westminster Abbey is one of the UK’s most notable religious buildings and the traditional place of coronation and a burial site for English and British monarchs. Since the coronation of William the Conqueror in 1066, all subsequent monarchs have had their coronation at Westminster Abbey.

After Westminster Abbey, I walked towards Elizabeth Tower (commonly known to the general public as ‘Big Ben’). In my readings, I learnt that the tower had actually been originally named simply as ‘Clock Tower’ and had been renamed ‘Elizabeth Tower’ in 2012 as part of the Queen’s Diamond Jubilee Celebrations (do you remember that little mini tip on jubilees I gave earlier? hahaha). Strictly speaking, the term ‘Big Ben’ is a nickname for the large central bell at the top of the tower that chimes on the hour. Big Ben is surrounded by four smaller bells which chime every 15 minutes.

I was very fortunate to be visiting London in end-April 2022 as the renovation for Elizabeth Tower is almost complete. For the past five years, it has actually been undergoing significant maintainance, which meant that for most of the past five years, a significant proportion of the exterior of the building, and the clock mechanism was shrouded in scaffolding. Thus, I am grateful for the present opportunity to view the entirety of Elizabeth Tower in all its splendour. To protect the hearing of the on-site workers and for practicality’s sake, the routine chiming of the bells has also been halted except on special events such as New Year’s Eve.

It’s such an iconic symbol of London, and I would argue that it’s even more well known than Tower Bridge. Show anyone an image of Elizabeth Tower, and he’ll know it’s London.

Here’s me crossing Westminster Bridge and having a photograph of me and Elizabeth Tower taken from another angle.

From Westminster Bridge, one can see the London Eye.

This was my last stop on my sightseeing journey for Friday morning. I had walked so much (25k steps on the whole of Friday according to my ‘Health’ app; I hadn’t used any form of public transport in the UK by this point as I had not been issued my Oyster card with 10 pounds of stored value by the Elsevier staff). After this, I headed to a nearby Japanese restaurant where I enjoyed delicious Osaka street food at OKAN South Bank. Specifically, I opted to partake of the ‘Okan Special Okonomiyaki’.

After the main course, I decided to have the Matcha Basque Cheesecake for dessert. It was absolutely delicious and satiating – both the main course and the dessert.

Finally, it was time to attend the first official event of the leadership summit, the main reason I had come to London. It was a meet-and-greet session at a pub – Smiths of Smithsfield. The following photo is that of me and the other participants in the finale.

What a great day this was. Simply unforgettable.

London – Day 3 of 5 – 23 April 2022 – Saturday

The participants and I walked from our accommodation to Elsevier’s London office at 125 London Wall. Here is a photograph of us checking in at the lobby of the office.

They had prepared for us a wonderful breakfast. Incredible.

Just look at that wall. How often is it the case that one’s name can be found on a wall?

After breakfast, we had an ice-breaker activity, followed by a short break, where we were all offered decadent chocolate and vanilla cupcakes. There were other miscellaneous activities, and the day ended with an ‘Amazing Race’ where each group of four would go to various landmarks within London based on certain clues…

At the end of the Amazing Race, my team walked the Millennium Bridge (as seen in this photo). Straight ahead in the photo is St. Paul’s Cathedral. Millennium Bridge is so named because it opened in June 2020. According to its Wikipedia article, “Londoners nicknamed it the “Wobbly Bridge” after pedestrians experienced an alarming swaying motion on its opening day. The bridge was closed later that day and, after two days of limited access, it was closed again for almost two years so that modifications and repairs could be made to keep the bridge stable and stop the swaying motion. It reopened in February 2002

My team didn’t win the Amazing Race. Nevertheless, I still had a highly enjoyable time in the evening as all gathered back at a pub. As someone who abstains from alcohol, I would either only consume cold water or apple juice at most. I did help myself to the canapes, the fries, and other food though. Absolutely sumptuous dinner.

London – Day 4 of 5 – 24 April 2022 – Sunday

This was the day of the finale. Exciting. Early in the morning, we were transported by bus to a location somewhat far away – the University of Greenwich! Please note how ‘Greenwich’ is pronounced. Many people pronounce it wrongly!

In the following photograph, the scrubs I am wearing were issued by the Elsevier team. Each team of four had its own corresponding colour of scrubs. My team happened to be assigned scrubs of the fuchsia colour. And yes, look how large that wall is. It’s just incredible.

This is my team of four (we named our team “The Astrocytes” because of some of the team members’ interest in neurology and how we “reach for the stars”).

This photograph is that of me and Aaron (the person from whom I had first heard about this event):

After the finale, we were transported back to London where we had an early dinner at a pub. This was where it was announced that my team had won the finale.

I was pretty ecstatic as I wasn’t expecting the win at all. In fact, just making it to London on a fully-sponsored trip had already fully exceeded my expectations. Anyway, allow me to share some of the few photographs that I had taken.

The following is that of me talking to Dhruv Tuteja (a medical student from India) and George Garratt (a medical student from the UK; he’s studying at the University of Leicester).

A photo of George and I. I enjoyed talking to him a lot throughout on this trip.

This is Mitul Suhane. She’s a medical student from AIIMS (All India Institutes of Medical Sciences) Raipur, one of the top medical schools in India. She topped the entire Elsevier CK Student National Challenge in India in 2020.

A photo of Dhruv, George, Mitul, and I:

Lastly, I managed to have a photo taken of me and Dr. Hao-Hua Wu, a final year orthopaedic surgery resident at UCSF, and one of the members of the expert panel that had assessed the video submissions (if you remember what I had said earlier). He had gone to Penn (an Ivy League school) for medical school. Really brilliant person. It was actually on this fateful Sunday afternoon/evening, from talking to him, that I learnt more about the book publishing process and his journey of co-authoring multiple books. In fact, he’s currently working on coauthoring a book on leadership in medicine with this year’s ClinicalKey mentors: Aaron and Maria (another person who was on the same team as Aaron in CKSGC ’19).

On that evening, I met with my parents for dinner at a Vietnamese restaurant. And yes, my parents were in London at that point. They had arrived in London a day after I did and departed a day after I did.

London – Day 5 of 5 – 25 April 2022 – Monday

Well, all good things come to an end. Finally, the day had come for me to depart London.

For lunch, I went to Flat Iron (a dining venue that had been recommended to me by someone who had been to London some years back), a steakhouse near my lodging. I took a direct bus there with my parents because they simply refuse to walk there! I had lunch with my parents, and I must say that I enjoyed the experience a lot. Over there, I ordered the ‘Flat Iron Steak’, not that there were many alternatives LOL.

What made the dining experience unique was that at the conclusion of our meal, we were handed these mini metal cleaver trinkets, similar to the ones that you would play with at a game of Monopoly. I’ll leave you to read for yourself how it works in the following image.

The ice cream was amazing! The original plan was actually to head to a ‘Greedy Goat Ice Cream‘ shop, an independent stall within Borough Market that sells ice cream made with goat’s milk. Well, as it turned out, Greedy Goat was closed on that Monday. It all worked out in the end.

After the ice cream, I got the opportunity to further experience the London public transport system for what it is. Having been born and raised in Singapore, I was quick to notice many aspects of the underground rail system that were pretty lacklustre compared to what I was accustomed to. However, it would not be totally fair to criticise the London rail system because it is after all the world’s oldest rail network. They have had to modernise and work from infrastructure that is pretty old. On the other hand, in the city-state, we have had the opportunity to learn from the mistakes made by other countries and construct a world-class transport system in the modern era with the assistance of the latest technology. This reminds me of the opening paragraphs of Francis Scott Fitzgerald‘s magnum opus, The Great Gatsby, where the narrator recounts the advice that he had been given by his father: that whenever he feels like criticising anyone, he should remember all the people in the world that haven’t had the advantages he has had.

Eventually, I boarded an arranged transport vehicle (along with a fellow member of “The Astrocytes” who also had to be at the airport at around the same time as me) opposite Travelodge at 4:30 pm. My flight’s departure from Heathrow was scheduled to occur at 8:50 pm.

We both sat in the rear passenger seats and had an enjoyable 1.5-hour conversation as we travelled to the airport. This was the final photograph I took in London. After this photo, we parted ways as she headed to Terminal Three while I remained in Terminal Two.

My short stay in London has been a highly memorable one, and I will certainly cherish all that I’ve learnt and experienced here for the remainder of my life!

Nic
2 May 2022


Tl;dr – A summary of my 5D4N experience in London

I had chanced upon information on an event entitled “Elsevier ClinicalKey Student Global Challenge” that was being promoted on Twitter by a friend. A few weeks later, I received an email from my medical school which informed its medical students of the existence of that same event. So, given that I had obtained information about the event from two independent sources, I decided to satiate my curiosity by visiting the event’s website. The event was essentially a competition amongst current medical students from all around the globe. The first run had occurred in 2019, and is expected to run annually. However, last year’s run was the second run instead of the third because the 2020 run was suspended in view of the pandemic. I decided to participate in the competition, and made it through all four multiple-choice-question rounds, and successfully cleared the video round, which earned me a ticket to the world finale, which would be held in London in April 2022. The finale took place over a weekend. There were four teams consisting of four people each. My team was named “The Astrocytes” given some of our team members’ interest in neurology and how we ‘reach for the stars’. Our team turned out to be champions!

I had departed Singapore on 20 April at 2330 hours, arrived in London on 21 April at 0600 hours. I then departed London on 25 April at 2050 hours, and arrived in Singapore on 26 April at 1655 hours. In addition to the official leadership summit that had occurred over the weekend, I did some sightseeing as it was my first time in the UK. I visited many famous attractions and had an enjoyable time. In sum, the Elsevier CKSGC 2021 provided me the opportunity to network with many brilliant medical students, mentors, and doctors from all around the world. They shared stories of their incredible journeys and their insights, which I deeply appreciate. To say that some of their stories was inspiring is such a sheer understatement. They make me want to become the most successful person I can be, a person who can be a significant positive influence in whatever domain he finds himself in.

This has been an incredibly fulfilling experience, and I hope to stay in touch with the people I met at this leadership summit, even as we go about attaining professional success in our separate ways.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s