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-Medicine: Still an Art?—James Best
-353
-Lecture
-22nd Gordon Arthur Ransome Oration: Is Medicine Still an Art?*
-James Best, 1
-MD (Melb.), FRACP, FRCPath
-Distinguished guests and colleagues in medicine, I am
-deeply honoured to have been invited to deliver this 22nd
-oration in honour of Sir Gordon Arthur Ransome, and also
-humbled  when  I  peruse  the  list  of  outstanding  previous
-orators.
-I  took  up  my  position  here  as  Dean  of  the  Lee  Kong
-Chian School of Medicine exactly a year ago, in time to
-welcome  just  the  second  cohort  of  medical  students  to
-Singapore’s newest medical school. Soon after I arrived, I
-was addressing a group of high school students interested
-in studying medicine. I emphasised that medicine is both
-an art and a science. After my address, one of the students
-came up to me and asked, “What do you mean that medicine
-is both an art and a science?”
-I was sure he was not questioning whether medicine is
-a science, but I am not sure my answer convinced him—
-perhaps  because  this  proposition  was  self-evident  at  the
-time when I learnt the practice of medicine and so I have
-not thought very carefully about it in the current era. So
-choosing this topic has given me the opportunity to consider
-this proposition anew and to share with you this evening
-my thoughts about whether medicine is still an art.
-Now I mentioned that I have been living in Singapore
-for only one year but I am not a stranger to Singapore. In
-fact my ﬁ rst visit here, and to Kuala Lumpur on the same
-trip—the ﬁ rst time I left Australia—was in 1963, the same
-year as this Congress was ﬁ rst held. My grandfather brought
-me here to meet his Singaporean friends. Singapore made
-a deep impression on me and I have been here many times
-since. So it is a particular pleasure to speak at the Singapore-
-Malaysia Congress of Medicine over 50 years after my ﬁ rst
-visit to both the island and the peninsula.
-Medicine  Has  Evolved  Since  the  Era  of  Hippocrates
-and Voltaire
-Medicine has long been described as an art. “Life is short,
-the art long, opportunity ﬂ eeting, experience treacherous,
-judgment difﬁ cult” wrote Hippocrates. Voltaire was being
-frivolous when he wrote “Medicine is the art of amusing
-the patient while nature cures the disease” and more serious
-when he wrote “Nothing is more estimable than a physician
-who,  having  studied  nature  from  his  youth,  knows  the
-properties of the human body, the diseases which assail it,
-the remedies which will beneﬁ t it, exercises his art with
-caution, and pays equal attention to the rich and the poor”.
-But we are over 2000 years on from the time of Hippocrates
-and more than 200 years on from the time of Voltaire. Has
-the scientiﬁ c era changed medicine irrevocably from an art to
-a science? Has that other common medical aphorism—“cure
-sometimes, relieve often, comfort always”—been overtaken
-by advances in diagnostic and therapeutic medicine?
-Certainly engineering and technology have brought great
-advances to medicine over the past 40 to 50 years. I choose
-this interval as the likely lifetime in medical practice and
-coincident  with  my  own.  Over  the  past  40  to  50  years,
-dramatic developments in imaging techniques have allowed
-us to see inside the body, particularly the brain, with both
-structural and functional analysis. Surgery has advanced,
-with  laparoscopic  techniques  and  robotic  surgery.  The
-prevention  and  treatment  of  cardiovascular  disease  has
-changed dramatically, with angioplasty and reﬁ nement of
-coronary  artery  bypass  surgery.  In  vitro  fertilisation  has
-brought  the  joys,  and  the  tribulations,  of  parenthood  to
-many families. In my own ﬁ eld of diabetes, we now have
-miniaturised insulin infusion pumps and continuous glucose
-monitoring devices, enabling a more physiological match
-between insulin and glucose levels.
-Advances in therapeutics have been equally impressive.
-Study  of  the  genetic  and  molecular  basis  of  cellular
-function  in  health  and  disease  has  led  to  many  new
-therapies. Inhibitors of the enzyme HMG-CoA reductase
-in  the  cholesterol  synthesis  pathway—statins—have
-revolutionised  the  prevention  and  treatment  of  coronary
-heart disease. We have entered the era of designer drugs,
-targeted  at  cellular  signaling  pathways  and  based  on
-1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
-Address for Correspondence: Prof James Best, Lee Kong Chian School of Medicine, Novena Campus, 11 Mandalay Road, Singapore 308232.
-Email: jamesbest@ntu.edu.sg
-*Delivered on 31 July 2015 at the 49th Singapore-Malaysia Congress of Medicine 2015
-Annals Academy of Medicine
- Medicine: Still an Art?—James Best
-354
-laboratory results mean that the computer screen is or will
-soon be our constant companion during the consultation.
-As we all know, our patients can and do access medical
-information on the internet, as well as from family, friends
-and neighbours, who also get information form the internet.
-And  our  patients  can  also  seek  treatment  through  the
-internet.  Computerised  cognitive  behavioural  therapy  is
-available online for help with anxiety, stress, depression,
-phobias and obsessive compulsive disorders. Systematic
-analysis of studies in this area has demonstrated the utility
-of this approach.
-So  what  are  the  consequences  of  the  explosion  of
-technology  and  scientiﬁ c  discovery  for  the  practice  of
-medicine and the role of the doctor? Science and technology
-of medicine is at its most advanced in the US, of course,
-and  so  perhaps  we  should  look  there  for  the  answer  to
-what lies ahead. Dr Abraham Verghese, physician-author
-and Professor for the Theory and Practice of Medicine at
-Stanford University Medical School says, “I joke, but only
-half joke, that if you show up in an American hospital missing
-a ﬁ nger, no one will believe you until they get a CAT scan,
-MRI and orthopedic consult”. So using one’s judgment and
-common sense is still part of the art of medicine, in both
-diagnosis and treatment. Much of medicine continues to
-involve  complexity  and  uncertainty,  so  there  remains  a
-place for clinical reasoning despite the ubiquity of clinical
-guidelines and decision support systems.
-What  Constitutes  the Art  of  Medicine  and  Is  It  Still
-Required?
-But  what  other  elements  of  medical  practice  remain
-relevant  and  constitute  the  art  of  medicine?  They  are
-contained  in  the  many  strands  that  make  up  the  bond
-between doctor and patient. The basis of the doctor-patient
-relationship is trust—and trust is engendered in ways that
-include active listening, empathy, compassion and physical
-contact.
-That is not easy. As Kafka wrote in his short book, ‘A
-Country Doctor’: “To write prescriptions is easy; to come to
-an understanding with people is hard.” That is the essence of
-clinical medicine: to come to an understanding with people
-and with that understanding to accompany them on their
-medical journey. No matter how sophisticated diagnosis and
-therapy becomes, patients will still appreciate someone they
-trust accompanying them on that journey. What comfort
-can  a  computer  provide?  Even  if  it  does  have  artiﬁ cial
-intelligence and even if it can simulate the human touch,
-it will still be just that—artiﬁ cial and simulated.
-Even with the scientiﬁ c advances over the past 40 to 50
-years, I would contend that this kind of relationship with
-our patients is just as important as it ever was. With more
-knowledge  of  molecular  structures.  For  example,  the
-tyrosine kinase inhibitor, imatinib is dramatically effective
-in several cancers, including chronic myeloid leukaemia
-and gastrointestinal stromal tumour. Biological therapies
-have been developed, such as antibodies designed to block
-the function of the inﬂ ammatory molecule TNFα, which
-have proven very effective in the treatment of rheumatoid
-arthritis and useful in other inﬂ ammatory diseases such as
-ulcerative colitis and psoriasis. Another antibody therapy,
-solanezumab, binds to β amyloid proteins and was reported
-only last week to slow progression of dementia. Stem cell
-therapies are starting to show real promise in the treatment
-of macular degeneration and Parkinson’s disease.
-Laboratory research has also led to an understanding of
-how some existing therapies work. Only recently have we
-known that metformin, ﬁ rstline therapy in the treatment
-of type 2 diabetes for over 50 years, activates the enzyme
-AMP-kinase, which is also activated by exercise. The holy
-grail of research in this area is to develop a therapy which
-is the pharmaceutical equivalent of physical exercise. We
-have also learned that insulin stimulates uptake of glucose
-by muscle tissue through activating transfer of a speciﬁ c
-glucose  transporter  protein—a  sugar  shuttle—from  an
-inactive intracellular site to insert itself in the cell membrane.
-At the same time, particularly in the use of pharmacological
-treatments, medicine has moved from relying too much on
-treacherous experience and difﬁ cult judgment to the use
-of  systematised  evidence  based  on  well  conducted  and
-unbiased clinical trials. One of the great pioneers in this
-area of medicine, David Sackett, died on May 13 this year
-and has left a huge legacy based on judicious application
-of knowledge. For what use is new knowledge if it is not
-used appropriately? It can be considered an art to apply the
-scientiﬁ c basis of medicine wisely and effectively.
-The Era of Precision Medicine
-Now—62  years  after  Watson  and  Crick  reported  the
-structure  of  DNA  and  12  years  after  the  ﬁ rst  human
-genome was sequenced—we stand on the threshold of an
-era named precision medicine. In this proposed model of
-medical care, diagnosis, prognosis and treatment will be
-based on genome analysis—genomics, protein analysis—
-proteomics and metabolite analysis—metabolomics, from
-each individual. This mega-data or big data will be collated
-to predict response and so to individualise therapy.
-Of course this approach relies on high level computing,
-which  is  also  changing  the  nature  of  medical  practice.
-Although it is argued that medicine has been much slower
-to utilise computing technology than other industries such
-as the commercial and engineering ﬁ elds, the advent of the
-electronic medical record and digitisation of imaging and
-September 2015, Vol. 44 No. 9
-355
-Medicine: Still an Art?—James Best
-chronic  disease  and  in  Singapore  an  ageing  population,
-complex illnesses such as diabetes require a strong bond
-between doctor and patient to achieve good outcomes. We
-are far from curative treatments for kidney, liver, lung or
-heart failure, despite the advances in stem cell research.
-Neurodegenerative diseases and musculoskeletal disorders
-are  major  burdens  with  only  modest  advances  in  most
-areas. Mental illness remains a major cause of morbidity
-and  progress  in  the  therapeutic  management  of  major
-psychiatric disorders over the past 40 to 50 years has been
-incremental but not dramatic.
-In cancer treatment there have been signiﬁ cant advances in
-some areas, but cancers of lung, pancreas, breast, ovary and
-prostate are still major causes of mortality and the promise
-of  precise  therapies  based  on  the  genetic  and  molecular
-analysis of individual cancers remains just a promise.
-I do, of course, share the excitement at the discoveries that
-have enhanced our knowledge of the pathophysiological
-basis  of  human  disease  and  I  can  envision  the  amazing
-progress  likely  to  occur  over  the  next  50  years  in  the
-treatment, and hopefully in the prevention, of many of the
-diseases I have mentioned. But I do not foresee medicine
-becoming totally mechanised and even if there are effective
-treatments for all illnesses, they will still need to be managed
-by caring clinicians with empathy and compassion. Just
-as insulin was expected to be a cure for diabetes 94 years
-ago,  I  expect  that  many  of  the  so-called  cures  that  will
-be discovered in the future, will in fact, be imperfect and
-complex therapies.
-Management of Patients with Terminal Illness in the
-Era of Precision Medicine
-One concern about the advent of precision medicine is
-that  we  could,  as  a  profession,  focus  almost  entirely  on
-technical treatment of the disease process and lose our view
-of the whole person, our patient. This danger of applying
-scientiﬁ cally sound therapies in circumstances which are
-futile  already  occurs  frequently  in  the  management  of
-patients with cancer.
-In  his  book  ‘Being  Mortal’,  Harvard  Medical  School
-surgeon Atul  Gawande  writes  “The  simple  view  is  that
-medicine exists to ﬁ ght death and disease, and that is, of
-course,  its  most  basic  task.  But  the  enemy  has  superior
-forces. Eventually, it wins. And in a war that you cannot
-win, you don’t want a general who ﬁ ghts to the point of
-total annihilation.” Treatment that is burdensome—both in
-terms of major side effects and cost—and essentially futile
-in that it may prolong life by only a few months is already
-prevalent in the so-called battle against cancer.
-worthwhile  outcomes.  At  the  same  time,  there  will  be
-many other therapies that have only incremental beneﬁ t,
-extending life by a few months at great cost to all concerned.
-Helping our patients and their families to choose wisely in
-this situation will require great art.
-Sir Murray Brennan, a New Zealand born and educated
-surgical oncologist, who was Chairman of the Department
-of  Surgery  at  Memorial  Sloan  Kettering  Cancer  Center
-in New York for over 20 years, spoke at a symposium I
-attended earlier this year on ‘Affordable Cancer Care.’ He
-spoke about the extensive practice of futile and burdensome
-surgery in cancer care because doctors lose sight of what
-is good for their patients.
-And he contrasted the ways that doctors can care for their
-patients when the decision is made that aggressive treatment
-of the disease is no longer warranted. An all too common
-approach is to say, “There is nothing more I can do for you”
-and to pass the patient on for palliative care management.
-His recommended approach is to say, “I do not think there
-is any further beneﬁ t to be gained from more surgery. But
-I will continue to care for you and make sure you receive
-the best possible treatment.” I believe that is the kind of
-doctor you and I would like to have caring for us.
-So let us make sure that use of the new treatments that
-will become available as the precision medicine wave rolls
-in, is matched by a renewed focus on patient-centred care,
-balancing the science with the art of medicine. Let us afford
-our patients a good death when the time comes, with all
-the care that modern medicine can provide, but avoiding
-futile and invasive treatments that rob them of dignity and
-precious last moments with their loved ones.
-The  Rewards  from  Medicine  as  a  Caring  Profession
-and its Teaching
-While  doctors  who  are  skilled  in  the  art  of  medicine
-provide great beneﬁ t to their patients, we should not forget
-the rewards we receive as clinicians from practising the
-art of medicine. Robert M Solomon, medical graduate of
-University of Singapore and bishop of the Methodist Church
-in Singapore believes that “the quality of the doctor-patient
-relationship…is guided by the best of human virtues such
-as altruism, compassion and the desire to alleviate human
-suffering.” Isn’t that what has drawn us to medicine as a
-career—the opportunity to share in the lives of others and
-to lighten their burden in times of trouble? Doesn’t that
-give meaning to our lives—or at least to our working lives?
-As the American poet and essayist Ralph Waldo Emerson
-said: “To know even one life has breathed easier because
-you have lived. This is to have succeeded.”
-In  the  precision  medicine  age,  we  will  undoubtedly
-see major advances in cancer therapy with dramatic and
-So  if  it  is  important  for  doctors  to  practise  the  art  of
-medicine well into the future, how should we be equipping
-Annals Academy of Medicine
- Medicine: Still an Art?—James Best
-356
-of the College of Physicians, which in turn, derives from
-the writings of his students and colleagues, some of whom
-have spoken of him at earlier orations in his honour. He is
-described as kind and softly spoken. He was always ready
-to answer any cry for help from patients, staff or colleagues.
-When  he  was  with  a  patient,  he  was  transported  into  a
-world where only the patient mattered—and his patients
-knew that. He believed that a doctor is placed in a special
-position to gain the patient’s trust and that a doctor needs to
-be a student of human nature.  He was a master of clinical
-diagnosis and an enthusiastic and effective teacher, fondly
-remembered by his students.
-I want to emphasise here that Gordon Arthur Ransome
-loved teaching, as did William Osler. In fact Osler said: “I
-desire no other epitaph—no hurry about it, I may say—than
-the statement that I taught medical students in the wards,
-as  I  regard  this  as  by  far  the  most  useful  and  important
-work I have been called upon to do.” I am sure Ransome
-knew this Oslerian saying and he himself was notorious for
-becoming so engaged in teaching his medical students that
-they complained he would often keep them through their
-lunch period. He believed that students should study history
-and philosophy—and I am sure he would have approved
-of the introduction of the study of the humanities into the
-modern medical curriculum.
-As  Dean  of  a  medical  school,  I  cannot  pass  up  the
-opportunity  to  recommend  teaching  as  another  way  to
-maintain our currency in the art and science of medicine, as
-well as to give back to the profession which has nurtured us.
-I mentioned earlier the practice of reciting the Hippocratic
-Oath at entry to medical school or after graduation. It is
-usually  a  modern  version  such  as  that  endorsed  by  the
-World Medical Association. Another interpretation that I
-particularly like was written in 1964 by the Dean of Tufts
-University  medical  school,  Dr  Louis  Lasagna.  The  ﬁ rst
-promise  in  this  version  is:  “I  will  respect  the  hard-won
-scientiﬁ c gains of those physicians in whose steps I walk,
-and  gladly  share  such  knowledge  as  is  mine  with  those
-who are to follow.” And there is another promise that is
-relevant to my topic this evening: “I will remember that
-there is art to medicine as well as science, and that warmth,
-sympathy and understanding may outweigh the surgeon’s
-knife or the chemist’s drug.”
-Clearly,  Gordon  Arthur  Ransome  epitomised  the  art
-of medicine and we can learn much from his example of
-selﬂ essness  and  devotion  to  his  patients.  Of  course,  the
-world and its ways have changed since he practised medicine
-here  in  Singapore.  The  gender  balance  of  the  medical
-profession has changed and the importance of family and
-other commitments outside of medicine are acknowledged
-more readily. We are also challenged by changes that can
-distance us from our patients, like the computer terminal, the
-our medical students to learn the art? Again Dr Verghese
-from Stanford: “What we need in medical schools is not
-to teach empathy, as much as to preserve it—the process
-of learning huge volumes of information about disease, of
-learning a specialised language, can ironically make one
-lose sight of the patient one came to serve; empathy can
-be replaced by cynicism.”
-Of course we do attempt now to select students in part
-on  the  basis  of  their  empathic  skills,  but  that  is  a  very
-inexact science. At least we demonstrate that we think it
-is important. Encouraging our students to learn from their
-patients and from other health professionals is part of the
-modern curriculum for instilling a sense of empathy and
-compassion. We can also teach about professionalism and
-ethical  responsibility.  The  development  of  professional
-identity is aided in many medical schools by white coat
-ceremonies  and  recitation  of  the  Hippocratic  Oath  on
-entry to medical school. Over 100 years ago William Osler
-urged us to treat medical students as our junior colleagues,
-surely an important way for them to develop that sense of
-belonging to our profession.
-Innovative programmes in the humanities and medicine
-use art, literature and poetry to explain the human condition
-and to help our students come to an understanding of human
-nature and the effect of illness on the individual. In fact,
-it is not just students who can beneﬁ t from a study of the
-humanities. William Osler read non-medical classics from
-10 to 11 every evening—and just as we keep ourselves up to
-date with medical literature, we can refresh our commitment
-to the art of medicine in this way.
-With all of these efforts to develop our students as caring
-professionals, it is the role model that doctors provide to
-our students that probably has the most impact. Learning
-by example, just as children tend to emulate their parents’
-behaviour, is called the hidden curriculum. That means we
-all have a responsibility to demonstrate the art of medicine
-when we are being observed and to practise it even when
-we are not being observed. Because genuine empathy and
-compassion are not qualities that can be turned on and off
-like a tap.
-What Can We Learn and Emulate from Gordon Arthur
-Ransome?
-In  his  collection  of  aphorisms  called  ‘Aequanimitas’,
-William Osler wrote “the stories of the lives of the masters
-of medicine do much to stimulate our ambition and rouse
-our sympathies.” So what can we learn from that master of
-medicine and ﬁ rst master of the Academy, Gordon Arthur
-Ransome, that will stimulate our ambition to practise the
-art of medicine?
-I draw on his entry in Munk’s Roll of the lives of members
-September 2015, Vol. 44 No. 9
-357
-Medicine: Still an Art?—James Best
-mask and gloves that are now part of the medical uniform
-in many settings. But it is the ethos, the spirit of his legacy
-that we want to emulate and pass on in turn to the future
-members of the medical profession.
-with another aphorism from ‘Aequanimitas’: “The practice
-of medicine is an art, not a trade; a calling, not a business;
-a  calling  in  which  your  heart  will  be  exercised  equally
-with your head.”
-Gordon  Arthur  Ransome  valued  medical  history  and
-medical books and was a devotee of the works of William
-Osler. So it is ﬁ tting to conclude the oration in his honour
-Thank you for this singular honour of addressing you
-this evening.
-Annals Academy of Medicine

+THE INTERNATIONAL
+STUDENT HANDBOOK
+Southern Methodist University | 2025-2026
+L E T T E R   F R O M   T H E   I S S S   D I R E C T O R
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+What's Inside?
+Get to Know Your New Home
+Life in Dallas, Texas .................................................. 5
+Q&A with International Mustangs ........................ 6
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+Our Favorite SMU Traditions ................................. 8
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+ Student Success and Useful Information
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+4
+Life in Dallas, Texas
+POPULATION: Dallas is the 9th largest city in the US and the third largest in Texas
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+I  generally  like  to  hang  out  with  my  friends.  We  binge
+watch  shows,  play  poker,  and  have  dinner  parties.
+Sometimes  I  try  to  emulate  a  new  recipe  that  I  came
+across  during  the  course  of  the  week  and  test  it  on  my
+friends. If the weather is not unforgiving, we play soccer
+near my apartment complex. I also try to get done with my
+errands  such  as  laundry,  grocery  runs,  meal  prep  and  if
+time permits, I go record player shopping.
+I  love  trying  new  restaurants!  Dallas  is  filled  with  places
+from  different  cuisines  and  cultures.  I  also  have  a
+membership to the Arboretum, which is a botanical garden
+that  you  can  walk  around  to  see  the  different  flowers;
+there is also events and cool picnic spots there. Lastly, the
+Farmer’s  Market  is  my  favorite  place  to  go  on  the
+weekends for breakfast and shops.
+What helped you make friends at SMU?
+I  reached  out  to  a  lot  of  people  at  SMU  on  LinkedIn
+before I came, the ones that responded connected me to
+the  other  students  who  had  reached  out  to  them  as  well.
+So, I had a good mix of a network that was new and old to
+SMU.  The  people  I  met  at  the  Orientation  and  Welcome
+Party  are  still  my  best  buddies.  I  made  a  lotta  friends  at
+events and also while working at ISSS.
+To me, at first it was hard to make friends because I was
+so nervous and still adapting to the culture here. But once
+I  joined  different  organizations  on  campus  -  International
+Leadership  Program  and  the  Brazilian  and  Portuguese
+Speakers Association - I was able to meet the people that
+became my support group. I also gained the confidence to
+meet other people at events on campus and at the library.
+What's your favorite restaurant in the area?
+I honestly wish I could select one, but Dallas is such a
+heavenlike place for people who like diverse cuisines. I
+have tried so many new cuisines here such as Thai,
+Pakistani, Iraqi, Italian, French and Tex-Mex. If I had to, I
+think I would put it between Deccan Grill or Olivella’s. The
+Former because it reminds me of home, and the Latter
+because I think they make the best pizza in the world.
+I enjoy trying different restaurants but here are some of
+my favorites: Delucca Gaucho Pizza is an all you can eat
+Brazilian pizza for a really affordable price. Hibiki Sushi
+and Vidora (Tex-Mex food) are both at Deep Ellum, a spot
+in Dallas with a bunch of restaurants and local shops.
+Honey Berry Pancakes is awesome for breakfast and has
+a huge menu - their Nutella pancake is amazing!
+What helped if you felt homesick?
+Luckily,  I  haven’t  felt  homesick  because  I  never  really
+isolated  myself  from  people.  Making  new  friends  is  hard,
+but if you just try a little to ask people around campus or
+events  about  their  degree  or  where  they  come  from,  I’m
+sure  that  will  go  a  long  way  in  helping  you  feel  more  at
+home. Because every time you see that person on campus,
+you  have  someone  to  talk  to,  share  experiences  with,  and
+maybe  go  out  with  them.  It  takes  time,  some  will  want  to,
+some  won’t.  But  that  doesn’t  mean  you  stop  trying  to
+socialize.
+I  regularly  call  and  Facetime  my  family  and  friends.  The
+distance  is  harder  during  special  occasions  like  birthdays
+and  holidays,  but  it  made  me  more  appreciative  of  the
+present and helped me learn to enjoy the little things. I also
+made my own chosen family here, they helped me through
+tough times and celebrated every milestone with me! Some
+of  my  friends  are  from  Brazil  as  well,  so  it  helped  a  lot
+with homesickness. Now, I have two places to call home and
+I am so grateful for that.
+6
+#YouAreWelcomeHere
+Get Involved!
+Getting involved on campus is a great way to get connected to the SMU community!
+There are over 200 student organizations at SMU including academic, athletic,
+cultural, and interest groups! Some of these organizations include...
+International Leadership Program
+K-pop Club
+Intramurals Sport Clubs
+Indian Student Association
+Virtual Reality Club
+Asian Council
+Esports Club
+Outdoor Adventures
+Discover all the organizations at SMU at Connect.SMU.edu
+Check out the SMU International Student & Scholar Services
+Channel for our #YouAreWelcomeHere video.
+7
+Our favorite
+SMU Traditions
+“We don’t tailgate, we boulevard”
+is one of the most common
+phrases that comes up when
+talking about SMU tradition. A day
+or two before each football game,
+beautiful white tents are put up all
+along the Boulevard and the lawn
+in front of Dallas Hall. Then, three
+hours before the game, SMU
+students, faculty, alumni and
+friends come out to enjoy food
+and games on the Boulevard.
+At the beginning of each school
+year there are many events to
+enjoy and make new friends.
+Usually there is also a chance to
+get free food too! The New Student
+Welcome Party hosted by ISSS has
+always been a good one!
+Homecoming is always a big tradition at SMU.
+There is banner making, window painting,
+Peruna painting and float building. Then there is
+also the much-anticipated Homecoming court in
+which each organization nominates a candidate
+for homecoming queen and king. The week builds
+up to the Homecoming parade to showcase the
+floats students have worked on.
+The Celebration of Lights! Every year in
+December thousands of lights are displayed on
+Dallas Hall and it’s surrounding area. SMU
+students come out to sing , listen to groups
+perform and hear President Turner read The
+Christmas Story. The finale of the night is
+always the lighting of the Christmas tree,
+Dallas Hall and the surrounding trees with
+more than 100,000 twinkling lights that
+helps everyone feel the holiday spirit.
+8
+W E L C O M E   N E W
+S T U D E N T S !
+Here's what to expect from now until your arrival in Dallas, Texas.
+1
+Pre-Arrival
+Pay close attention to your SMU email address inbox. The ISSS office and
+other  campus  offices  will  be  reaching  out  to  you  with  important
+information. We will also have webinars available to help you get ready for
+your arrival and life at SMU.
+Immigration Compliance Course &
+Government Document Check-In
+2
+All  F-1  or  J-1  visa  holders  are  required  to  complete  the  Immigration
+Compliance  Course.  Then,  you  must  complete
+the  mandatory
+goverment document check-in once you arrive at SMU.
+3
+Campus Welcome
+We  are  looking  forward  to  welcoming  you  to  the  SMU  community.  We'll
+host  opportunities  for  you  to  develop  new  friendships,  become  familiar
+with  U.S./Texas  culture  and  help  prepare  for  the  next  stage  of  your
+professional life. These include; Orientation, Welcome Party, and More!
+You are welcome here.
+For details visit the ISSS website and review "New Student Information"
+9
+S T E P S   T O   R E C E I V E
+Y O U R   S M U   I - 2 0
+In order to receive your SMU I20 please follow the steps below. Contact your admitting
+department directly for instructions on how to submit the required documents.
+STEP 1: Have a photocopy of valid passport ready
+STEP 2: Prepare financial documents
+Funds available must meet or exceed cost for 1 year of student expenses
+Dated no more than 6 months prior to submission
+Printed on bank or financial institution letterhead
+Must be printed in English
+Includes account holder name and account information
+Financial Commitment Form - this will only apply if funds are not personal funds
+Funds must be liquid without restrictions
+Student Loans
+Student loan applications are not accepted.  Approved loans with a dollar amount will be accepted.
+Financial Documentation not accepted:
+Stocks or Bonds, Life Insurance, Property or Land, Proof of Employment or Tax Documents
+For more information about the estimated tuition, fees and other expenses for your program please visit the Estimated
+Expenses for I-20 page on the International Student and Scholar Services website.
+STEP 3: If requesting an F-2 Dependent Visa
+The F-2 dependent visa is a nonimmigrant visa which allows dependent spouses and children (unmarried,
+under 21 years old) of F-1 student visa holders to enter into the U.S. The following is required if your
+dependents will apply for an F2 visa and travel to the U.S. with you:
+Photocopy of Valid Passport for all dependents
+Photocopy of Marriage Certificate (translated in English) for dependent spouse
+Copy of Birth Certificate (translated in English) for dependent children
+F1 must provide additional funds for each dependent
+STEP 4: Receiving your I-20 Form
+Form I-20's are sent to students via SMU email. Students should monitor their SMU email address for their I-20
+document. Students should then print and sign their I-20 in ink.
+10
+G E T T I N G   R E A D Y   F O R
+Y O U R   A R R I V A L
+Request an I-20
+Verify information on I-20/DS2019 is accurate. If you see any errors contact  ISSS
+immediately at isss@smu.edu
+Pay SEVIS fee *
+Apply for New Visa, F or J *
+Prepare for your visa interview and take the following documents with you:
+SEVIS Fee Receipt
+Letter of Admission
+Form I-20/DS-2019
+Passport
+Proof of funding and/or educational sponsorship documents reflected on
+I-20/DS-2019
+Check your SMU email regularly for updates related to class registration,
+orientation and notices from campus departments
+Register for health insurance & complete immunizations to ensure there are no
+holds on your account. You can register through my.SMU.edu. For more information
+visit the SMU Health Center website.
+Complete the International Student Compliance Course
+Plan for housing and an SMU meal plan if required
+Book your flight and plan travel to campus. Be sure to enter the U.S. with your F-1
+or J-1 student visa; do not enter the U.S. with a tourist visa. You are allowed to enter
+U.S. up to 30 days prior to program start date listed on I-20/DS-2019
+Prepare for payment of tuition for more information visit the SMU Bursars Office
+website and view the section about "Paying Tuition as an International Student"
+Video tutorial is available on ISSS website under "New Student Information"
+11
+A guide from students, for students
+How to Pack for SMU
+Packing for a long trip can be stressful and that's okay. We're here to help.
+Top 4 Packing Tips
+1.
+2.
+3.
+4.
+Bring Just the Essentials
+A lot of items can be purchased locally upon arrival and saves room in your suitcase.
+Plan Ahead
+Get to know what the weather is like in Dallas to plan your clothes accordingly.
+Bring a Few Sentimentals
+Have a few pictures or small momentos that remind you of home.
+Don't Forget Anything
+Make a packing list and check it twice. Include what you plan to buy here in the states!
+12
+Packing Must Haves
+How to Pack for SMU
+Must-have items:
+Wallet & Money
+Passport
+Printed Compliance
+Course
+Important
+Documents
+Medical &
+Immunization
+Records
+Emergency
+Contact
+Clothing and Accessories
+Clothes
+Glasses
+Shoes
+Under Clothes
+Small Towels
+Recommended
+Electronics &
+Chargers
+Bring just the essentials
+A lot of items, such as shampoo, towels, etc. can be purchased locally.
+Medicine
+Hygiene
+Products
+Snacks
+Universal
+Adapter
+Protective
+Lotions
+Check out the SMU International Student & Scholar Services
+Channel for our packing video.
+13
+O N C E   Y O U ' V E
+A R R I V E D   I N   T H E   U . S .
+We hope you had safe travels!
+Continue checking your SMU email regularly. You will be receiving updates related
+to expectations upon arrival and other important information.
+Update your U.S. residence address and U.S. phone number in your My.SMU
+account. Department of Homeland Security requires you to update your U.S. local
+address and phone number within 10 days of any change.
+Manage holds on your account if you have any remaining  to register for classes if
+still needing to do so. To view, access your Student Center from your My.SMU
+account and holds will be listed at the top of the right hand side of the screen.
+Ensure that you have completed the International Student Compliance Course
+on SMU Canvas smu.instructure.com. Log-in with SMU ID number and password.
+*video tutorial is available on ISSS website under "New Student Information"
+Complete Mandatory Document Check-In. Link is available on the ISSS website
+under Students Tab > “New Student Information” > Mandatory Government Check-in
+Review SMU shuttle, parking services and transportation options at
+parking.smu.edu
+Pay your tuition and fees through the Bursar’s Office
+https://www.smu.edu/EnrollmentServices/Bursar
+14
+International Student &
+Scholar Services Office
+No matter where you are across the globe, the International Student and Scholar
+Services (ISSS) team is here to support you. ISSS provides services to help you
+maintain your immigration status and promote your success here at SMU. Stay
+up to date via our website www.smu.edu/enrollmentservices/international.
+Laura Lee Blanton Building, Suite 101
+6185 Airline Rd, Dallas, TX 75205
+214-768-4475
+isss@smu.edu
+ISSS Document Pick-Up Hours:
+Monday - Friday:
+9:00 AM - 4:00 PM
+Wednesdays:
+10:00 AM - 4:00 PM
+ISSS Advising Hours:
+Meet with an advisor on Zoom or in-person
+Monday to Thursday:
+Virtual: 9:00 AM -11:00 AM
+In-person: 2:00 - 4:00 PM
+Follow us:
+@smuinternational
+@smuintlservices
+SMU International Student
+and Scholar Services
+15
+T R A N S P O R T A T I O N   I N
+T H E   U . S .
+Concerned about how you are going to get around when you
+come to Dallas? Don't worry- there are a lot of options!
+On-Campus
+Off-Campus
+Walk
+Most students walk to class.  Just make sure you
+leave with enough time to make it to class! Google
+Maps works great in the area and on campus.
+Bikes
+When going to a university, lots of students may
+bring a bicycle for transportation around campus.
+SMU provides various areas to keep your bikes,
+just bring your lock.
+Look into purchasing a bike at popular stores such
+as Walmart, Target, Dick's Sporting Goods, or
+Academy Outdoors!
+Tapride
+If you find yourself feeling uncomfortable walking
+alone after a long night in the library, call a safe
+ride using the app Tapride. An SMU security officer
+will pick you up in a golf cart and take you
+wherever you need on campus.
+Pro Tip: It's a good idea to consider how far
+away your classes are from each other when
+selecting them, especially since most classes
+are 10 minutes apart
+Ride Share Services
+The  most  popular  option  for  transportation  around
+Dallas are ride sharing services such as Uber and Lyft.
+Just  download  the  apps  and  input  your  destination!
+Always make sure the license plate matches.
+DART
+The Dallas Area Rapid Transit service is a railway that
+travels around the Dallas area including to the airport
+and NorthPark Mall. Conveniently, across the street
+from SMU campus is a DART station! SMU students
+are eligible for a free SMU DART transit pass by
+enrolling through the Parking and ID Card Services
+Office with a valid U.S. phone number. DART is
+typically much cheaper than ride sharing options.
+Pro Tip: While the DART is typically safe it
+would be smart to travel with a friend and
+avoid riding the DART late at night.
+SMU Express
+The SMU Express is a DART operated bus that goes
+on campus and makes stops at nearby apartments,
+shopping centers and resturaunts.
+For more information visit  the SMU Parking and ID
+Services Office website.
+Transportation from the airport upon arrival in the U.S.
+Most students use ride sharing options such as Uber or Lyft for their commute
+from the airport to campus, but others may use DART.
+16
+U.S. LAWS & SAFETY
+Did You Know?
+Emergency Blue Lights
+There are over 55 emergency Blue Light phones across
+SMU's Campus, typically placed outside or in parking
+garages. If you are in danger, find the nearest blue light
+phone, press the emergency button, and you will be
+connected with the police department and an officer will be
+dispatched.
+SMU Alerts
+In the case of a campus wide safety threat, SMU will send
+out alerts through the Emergency Notification System (ENS)
+to alert everyone on campus that there is a threat. Alerts
+will also be posted on all official SMU social media sites,
+emailed, and in buildings alarms will sound.
+Seatbelts
+In the U.S. it is required��to wear a seatbelt in a vehicle,
+regardless of whether you are driving or not.
+Drinking and Driving
+In the U.S. it is not permitted to operate a vehicle under the
+influence of alcohol. If you do, you will jeopardize your
+student visa status.
+Alcohol on Campus
+Alcohol is not permitted in any public area on SMU's campus
+including the residence halls regardless of your age.
+Legal Ages
+in the U.S.
+Drinking Age: 21+
+Tobacco Age: 21+
+Smoking on
+Campus
+Smoking is prohibited
+within twenty-five (25)
+feet of any entrance to
+buildings on campus.
+Learn more on SMU's Risk Management website
+17
+EMERGENCIES AT SMU:
+KNOW WHAT TO DO
+In the case of an on-campus emergency, alarms will sound across campus
+buildings with audio instructions on what to do. Students will also get an
+emergency alert to their emails and phones with updates on the situation.
+Learn more at SMU's Risk Management website
+18
+HEALTH
+AND WELLNESS
+Office of the Chaplain
+& Religious Life
+Inspiring the Expression of Religious
+Faith and Discourse in the University
+The Office of the Chaplain works to
+ensure that SMU is a place that
+welcomes religious diversity while
+offering student support.
+https://www.smu.edu/studentaffairs/religious-
+life
+Dr. Bob Smith
+ Health Center
+The health center is an on
+campus clinic that provides
+students with access to medical,
+counseling, and dental services.
+Also, the heath center has a
+pharmacy and offers student
+health insurance.
+https://www.smu.edu/studentaffairs/h
+ealth-center
+Dedman Center for
+Lifetime Sports
+The recreation center offers a
+free-weight and cardio gym as
+well as basketball, volleyball,
+and tennis courts. You will also
+find indoor and outdoor pools
+and countless fitness classes
+including spin and yoga!
+Check out the SMU International Student & Scholar Service
+Channel for our mental health video.
+19
+ACHIEVING ACADEMIC
+SUCESS AT SMU
+Altshuler Learning
+Enhancement Center (A-LEC)
+The ALEC offers free peer tutoring, writing
+center, academic counselors, and academic
+success workshops to undergraduates.
+smu.edu/alec
+Disability Accommodation and
+Success Strategies (DASS)
+The DASS office advocates, assists, and
+accommodates students with physical or
+learning disabilities. DASS also provides
+mentoring, self-advocacy, time management,
+and other success strategies to aide in the
+academic success of students with
+disabilities.
+https://www.smu.edu/provost/saes/academi
+c-support/disability-accommodations
+ESL (English Second Language)
+The Department of Intensive English
+Program partners with the
+ISSS Office regarding free classes for
+students who are having
+academic difficulties due to the English
+language.
+ smu.edu/Dedman/Resources/Students/ESL
+Fondren Library
+Online Databases
+Fondren offers an extensive online library
+database to aide students in their research.
+Study Spaces
+Need a quiet place to study? Reserve a
+private study room in the library or go to the
+Centennial Reading Room, otherwise,
+Fondren library offers many places for you
+and your friends to study!
+Research Support
+Need help navigating research, finding
+scholarly sources, or creating citations?
+Fondren library offers support both online
+and in-person in these areas.
+smu.edu/libraries/fondren
+Pro Tip: Don't forget to go to your professors office
+hours with any questions about lectures, due dates,
+grades, or anything at all. Professors are there to
+help you so make sure you take advantage!
+20
+Understanding SMU's
+Honor Code
+WHAT IS ACADEMIC DISHONESTY?
+SMU's Student Handbook defines academic dishonesty in five different ways...
+1.
+2.
+3.
+4.
+5.
+ Academic Sabotage. Intentionally taking any action which negatively
+affects the academic work of another student.
+ Cheating. Intentionally using or attempting to use unauthorized
+materials, information, or study aids in any academic exercise.
+ Fabrication. Intentional and unauthorized falsification or invention of
+any information related in an academic exercise.
+ Facilitating Academic Dishonesty. Intentionally or knowingly helping
+or attempting to to help another to violate any provision of the Honor
+Code.
+ Plagiarism. Intentionally or knowingly representing the words or ideas
+of another as one’s own in any academic exercise.
+Note: This includes ghostwriters.
+WHAT ARE POSSIBLE SANCTIONS?
+1.
+2.
+3.
+4.
+5.
+6.
+Informal Warning. Not a part of the student's formal conduct record.
+Formal Conduct Warning. Part of the student's formal conduct record.
+Conduct Probation. A warning that is
+Deferred Suspension
+Suspension
+Expulsion
+To learn more about Academic Dishonesty and Conduct Proceedings, please view the SMU
+Student Handbook at smu.edu/StudentAffairs/officeofthedeanofstudents/StudentHandbook
+21
+STUDENT TIPS
+FOR CLASS
+REGISTRATION
+Sohyun 'Jun',
+Accounting
+1
+Review All Your Options
+University course catalog, major track, ratemyprofessor.com
+If you have decided your major, browse through the university
+course catalog and major track to learn about your required courses. If not, you still have plenty of
+time to discover your interests and passions by taking advantage of all the diverse classes that
+SMU has to offer. I personally like to check out the course overview on the university course
+catalog and instructors reviews on the ratemyprofessor website.
+2
+Make Your Own Schedule
+“Wunderlist”, “Class Timetable”, "Coursicle"
+As an undergraduate I usually enroll in 4 to 6 classes and try to evenly spread them out over the
+week. Remember that as international students we are required to enroll full-time every fall and
+spring semester. If possible, try to have a day off from a school to dedicate for your work,
+internship, exam prep and more. You can utilize apps like Wunderlist and Class Timetable that will
+help you visualize your college schedule.
+3
+4
+5
+Talk To Your Academic Advisor
+This will vary depending on your academic level and department
+New undergraduate students will be able to schedule an appointment with an academic advisor
+from the University Advising Center (UAC) for assistance with class selection and registration. New
+graduate students have a difference process based on the academic department. Something I
+found helpful when deciding between classes was to contact the instructor of the class to ask if
+you can be added or just simply for class information. You can always find instructors contact
+information on the SMU faculty website.
+Be Strategic Selecting Classes
+Excel templates for college courses
+Create an excel file to keep track of a list of courses you need to take at SMU per semester at a
+glance. While still making sure to keep a balanced life, I worked on getting the core classes and
+University Curriculum (UC) credits out of the way as soon as possible. Note: undergraduates there
+are classes that meet 2-4 UC requirements - keep an eye out for these, they are a timesaver!
+Complete all Requirements Needed to Complete Class Registration
+Set a reminder for the time/date you can register for classes
+Make sure to put classes in the cart to make the registration process smooth and fast. Remember
+that before you can register, you will need to complete the Immigration Compliance Course on
+SMU Canvas. Then upon arrival at SMU, attend the Mandatory Government Document Check-in to
+remain in good visa status. Register in advance for the document-check-in on the ISSS website.
+22
+JOB PREP AND
+ EMPLOYMENT
+at SMU
+Job Preparation
+SMU's Hegi Career Development
+Center offers career fairs and
+other career resources including
+resume building, cover letter
+writing, job research tips,
+interview tips, career counseling,
+and even professional headshots!
+Learn more at smu.edu/StudentAffairs
+12twenty is an employment
+search engine that connects
+students to potential off-campus
+employers and on-campus job
+opportunities.
+https://www.smu.edu/studentaffairs/hegi
+-career-center/twelve-twenty/students
+On-Campus Employment
+International students may get an
+on-campus job
+Note: F-1 and J-1 visa holders
+are not eligible for federal work
+study positions.
+Students who obtain employment
+are REQUIRED to visit the ISSS
+Office and get permission BEFORE
+you begin your job for
+authorization.
+Off-Campus Employment
+Students who have maintained
+their status for one academic year
+are eligible to apply for Curricular
+Practical Training (CPT) or Optional
+Practical Training (OPT) which
+allows them to work off-campus.
+Learn more at
+smu.edu/EnrollmentServices/international
+Pro Tip: Meet with a Hegi Career
+Center advisor to create a U.S. style
+resume and form a strong career plan!
+23
+The Market in Hughes-Trigg Student Center
+Mon - Thu  9:00AM - 8:00PM
+Fri 9:00AM - 4:00PM
+Sat 9:00AM - 4:00PM
+Sun 2:00PM - 6:00PM
+Arnold Dining Hall
+Breakfast
+Mon - Fri
+7:00AM - 10:30AM
+Dinner
+Mon - Thu.
+5:00PM - 9:00PM
+Brunch
+Sat - Sun
+9:30AM - 2:00PM
+Dinner
+Fri. and Sat.
+5:00PM - 7:00PM
+Lunch
+Mon - Sun
+11:00AM - 2:00PM
+Dinner
+Sunday
+5:00PM - 8:00PM
+Umphrey Lee Dining Hall
+Breakfast
+Mon - Fri
+7:00AM - 10:30AM
+Sat - Sun
+9:30AM - 2:00PM
+Lunch
+Mon - Fri
+11:00AM - 2:00PM
+Dinner
+Mon - Fri, Sun
+5:00PM - 8:00PM
+Saturday
+5:00PM - 7:00PM
+Other On-Campus Dining Options
+Starbucks  - Fondren Library
+Lawyer's Inn - Law School Quad
+TeaCo - Law School Quad
+Chick-Fil-A - Hughes-Trigg Student Center
+Panera - Hughes-Trigg Student Center
+Sushic - Hughes-Trigg Student Center
+ShakeSmart - Dedman Center for Lifetime Sports
+Mac’s Place - McAlvaney Commons
+Sclafani's Bagels and Sandwiches- Cox School Of Business
+For more information and the most up to date hours visit: smu.campusdish.com/ 24
+s
+e
+i
+t
+i
+l
+i
+c
+a
+F
+g
+n
+n
+D
+i
+i
+s
+u
+p
+m
+a
+C
+-
+n
+O
+Eating
+Vegetarian at SMU
+In Dallas
+Being vegetarian can feel daunting in situations when
+it seems hard to find options to fill one’s appetite.
+However, the proximity of SMU to downtown Dallas
+provides students with a greater variety of choices.
+Every corner gives rise to a new discovery of small
+restaurants with unique styles and food. Right across
+the North East dorms there is the Sinder Plaza which
+is a common place for students to hangout while
+studying or to visit restaurants or ice cream shops.
+If one wants to go further off campus, there is an
+abundance of opportunities to explore new and
+wonderful flavors on the weekends by planning an
+adventure with your friends to downtown Dallas
+using the DART (Dallas Transit) which is free for all
+SMU students
+At SMU: Dining Halls
+Umphrey Lee
+The brownies at the Vegan Dessert Section at Umph
+are  delicacies  and  if  you  are  an  SMU  student  the
+Umph  cookies  have  a  fame  of  their  own.  If  you
+consume dairy products and have a sweet tooth, the
+Umph Dessert Section is a blessing.
+Another  captivating  feature  is  the  make-your-own
+sandwich  and  salad  area  at  Umph,  it  provides  you
+with the flexibility to choose your own ingredients to
+make your own veggie salad or sandwich.
+Arnold
+Arnold, has their own make-your-taco section which
+again, could be made vegetarian with only a red bean
+paste filling.
+Arnold also has a Mongolian grill station where
+students can make their own grill with rice or
+noodles hence, vegetarians have the ability to
+personalize their food.
+Other Options on Campus
+ Something notable about Mac’s place is that it
+offers Beyond Meat style burgers for us vegetarian
+lovers. Another favorite are the salads here! Though
+they are made available in the menu with meat it
+could be replaced while you are placing your order.
+ A vegetarian or vegan is in for a treat at the Food
+Market! There is a whole section dedicated to vegan
+versions of food. It ranges from vegan ice creams to
+vegan oven cooked food and biscuits. It is my haven.
+We also have restaurants on campus which are
+Chick-fil-a , Lawyer’s Inn and Cinco Taco. While at
+Chick-fil-a there are not many vegetarian options, it is
+a go-to for french fries. The potato tots at Lawyer’s
+Inn are my vegetarian choice.
+Tips from Upperclassmen
+ Tread with Caution! It might be hard to
+differentiate between the meat option and
+vegetarian options sometimes, so when in doubt
+check with the staff and double check yourself!
+ Double Check! Check before consuming boiled
+or cooked vegetables since sometimes in the
+cooking process butter is added.
+Take Advantage! If you're at the SMU dining
+halls, there are a variety of fruit options available
+to take and it is a healthy snack between meals
+and classes to keep around. So grab a fruit on
+your way out!
+Dedeepya 'Deepu'
+Chinnam
+Business, Economics, and
+Statistics
+25
+Ethnic Grocers and
+Resturaunts
+African
+European
+Latin
+Maru Grocers
+8353 Park Ln Dallas, TX
+75231
+Affribean Market
+ 2717 E Belt Line Rd Apt 109,
+Carrollton, TX
+9724160701
+Desta Ethipoian
+12101 Greenville Ave Ste
+105 Dallas, TX 75243
+Asian
+Hong Kong Market
+9780 Walnut St Dallas, TX
+75243
+Thai Oriental Food
+Store
+5615 Sears St Dallas, TX
+75206
+Patel Brothers
+8150 Walton Blvd Irving, TX
+75063
+Gui-Rock Korean BBQ
+2625 Old Denton Rd Ste 700
+Carrollton, TX 75007
+Royal Thai
+5500 Greenville Ave Ste 608
+Dallas, TX 75206
+Cafe Madrid
+4501 Travis St Dallas, TX
+75205
+Bavarian Grill
+221 W Parker Rd Ste 527
+Plano, TX 75023
+Wooden Spoon
+Scandinavian Shop
+1617 K Ave Plano, TX 75074
+Middle
+Eastern
+Cafe Istanbul
+7300 Lone Star Dr Ste 160
+C Plano, TX 75024
+Ali Baba Mediterranean
+Grill
+2103 N Central Expy
+Richardson, TX 75080
+Jasmine Market & Café
+820 S Sherman St, Richardson, TX
+75081
+9724374522
+Haji Foods Market & Deli
+4621 W Park Blvd Ste 108
+Plano, TX 75093
+El Rio Grande Latin
+Market
+5308 Maple Ave Dallas, TX
+75235
+Fiesta Mart
+5334 Ross Ave Dallas, TX
+75206
+Nazca Kitchen
+8041 Walnut Hill Ln Ste 854
+Dallas, TX 75231
+La Michoacana Meat
+Market
+6770 Greenville Ave, Dallas, TX
+75231
+For more
+information and
+reviews of Dallas
+Restaurants,
+please visit: Yelp,
+Zomato, or Guide
+Live
+26
+Post Office
+SMU has a conveniently located mail center in
+Hughes-Trigg Student Center where you can
+send letters and if you live on-campus you can
+pick-up packages. The on-campus post office
+also offers international shipping and mailing
+supplies such as envelopes, stamps, and boxes.
+Front Counter Hours
+Monday - Friday
+8:00 AM - 4:30 PM
+Mail PIck Up
+Monday - Friday
+8:00 AM - 5:30 PM
+Saturday
+11:00 AM - 2:00 PM
+For questions email postoffice@smu.edu or call 214-768-4450.
+Copy Center
+The copy center, located next to the Post
+Office in Hughes-Trigg student Center,
+prints posters, yard signs, booklets,
+resumes, and projects.
+Copy Services
+Monday - Friday
+8:00 AM - 5:00 PM
+For questions or job
+submissions email
+copycentral@smu.edu or
+call 214-768-7901
+Learn more at the SMU Mail and Copy Center website.
+27
+s
+e
+i
+t
+i
+l
+i
+c
+a
+F
+l
+i
+a
+M
+s
+u
+p
+m
+a
+C
+-
+n
+O
+Banking in the U.S.
+Below is a list of major banks near the SMU campus:
+28
+Phones in the U.S.
+Information about some companies that offer local phone
+service in the DFW area is provided below.
+Research more options on Google!
+29
+Important Contact Information
+United States Emergency
+Phone Number:
+911
+Campus Police:
+214-768-3333
+Campus Police
+(Non-Emergency):
+214-768-3388
+International Student
+& Scholar Services:
+214-768-4475
+isss@smu.edu
+ISSS Document Pick-Up Hours:
+Monday to Friday:
+9:00 AM - 4:00 PM
+Wednesdays: 10:00 AM - 4:00 PM
+ISSS Virtual Advising Hours:
+Monday to Thursday:
+Virtual: 9:00 AM -11:00 AM
+In-person: 2:00 PM - 4:00 PM
+SMU IT Help Desk:
+214-768-4357
+help@smu.edu
+help.smu.edu
+Bob Smith Health Center:
+Medical Services:
+214-768-2141
+Nurse Advice:
+214-768-3194
+Pharmacy:
+214-768-2149
+Counseling Services:
+214-768-2277
+Health Education:
+214-768-2393
+Violence Prevention and
+Support Services:
+214-768-4512
+SMU General Helpline:
+214-768-2000
+What's the difference between U.S. emergency number and the
+campus police?
+Campus police are real police officers that deal specifically with campus
+safety. They monitor and patrol campus 24 hours a day to ensure SMU is
+a safe place! Call the campus police when there is an incident on-
+campus.
+Learn more (including how to report an incident) at smu.edu/BusinessFinance/Police 30
+The ISSS office is looking forward to
+welcoming you to SMU. If you have any
+questions, please do not hesitate to
+contact us at isss@smu.edu.
+You Are Welcome Here.

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@@ -1,480 +1,1419 @@
-Medicine: Still an Art?—James Best
-353
-Lecture
-22nd Gordon Arthur Ransome Oration: Is Medicine Still an Art?*
-James Best, 1
-MD (Melb.), FRACP, FRCPath
-Distinguished guests and colleagues in medicine, I am
-deeply honoured to have been invited to deliver this 22nd
-oration in honour of Sir Gordon Arthur Ransome, and also
-humbled  when  I  peruse  the  list  of  outstanding  previous
-orators.
-I  took  up  my  position  here  as  Dean  of  the  Lee  Kong
-Chian School of Medicine exactly a year ago, in time to
-welcome  just  the  second  cohort  of  medical  students  to
-Singapore’s newest medical school. Soon after I arrived, I
-was addressing a group of high school students interested
-in studying medicine. I emphasised that medicine is both
-an art and a science. After my address, one of the students
-came up to me and asked, “What do you mean that medicine
-is both an art and a science?”
-I was sure he was not questioning whether medicine is
-a science, but I am not sure my answer convinced him—
-perhaps  because  this  proposition  was  self-evident  at  the
-time when I learnt the practice of medicine and so I have
-not thought very carefully about it in the current era. So
-choosing this topic has given me the opportunity to consider
-this proposition anew and to share with you this evening
-my thoughts about whether medicine is still an art.
-Now I mentioned that I have been living in Singapore
-for only one year but I am not a stranger to Singapore. In
-fact my ﬁ rst visit here, and to Kuala Lumpur on the same
-trip—the ﬁ rst time I left Australia—was in 1963, the same
-year as this Congress was ﬁ rst held. My grandfather brought
-me here to meet his Singaporean friends. Singapore made
-a deep impression on me and I have been here many times
-since. So it is a particular pleasure to speak at the Singapore-
-Malaysia Congress of Medicine over 50 years after my ﬁ rst
-visit to both the island and the peninsula.
-Medicine  Has  Evolved  Since  the  Era  of  Hippocrates
-and Voltaire
-Medicine has long been described as an art. “Life is short,
-the art long, opportunity ﬂ eeting, experience treacherous,
-judgment difﬁ cult” wrote Hippocrates. Voltaire was being
-frivolous when he wrote “Medicine is the art of amusing
-the patient while nature cures the disease” and more serious
-when he wrote “Nothing is more estimable than a physician
-who,  having  studied  nature  from  his  youth,  knows  the
-properties of the human body, the diseases which assail it,
-the remedies which will beneﬁ t it, exercises his art with
-caution, and pays equal attention to the rich and the poor”.
-But we are over 2000 years on from the time of Hippocrates
-and more than 200 years on from the time of Voltaire. Has
-the scientiﬁ c era changed medicine irrevocably from an art to
-a science? Has that other common medical aphorism—“cure
-sometimes, relieve often, comfort always”—been overtaken
-by advances in diagnostic and therapeutic medicine?
-Certainly engineering and technology have brought great
-advances to medicine over the past 40 to 50 years. I choose
-this interval as the likely lifetime in medical practice and
-coincident  with  my  own.  Over  the  past  40  to  50  years,
-dramatic developments in imaging techniques have allowed
-us to see inside the body, particularly the brain, with both
-structural and functional analysis. Surgery has advanced,
-with  laparoscopic  techniques  and  robotic  surgery.  The
-prevention  and  treatment  of  cardiovascular  disease  has
-changed dramatically, with angioplasty and reﬁ nement of
-coronary  artery  bypass  surgery.  In  vitro  fertilisation  has
-brought  the  joys,  and  the  tribulations,  of  parenthood  to
-many families. In my own ﬁ eld of diabetes, we now have
-miniaturised insulin infusion pumps and continuous glucose
-monitoring devices, enabling a more physiological match
-between insulin and glucose levels.
-Advances in therapeutics have been equally impressive.
-Study  of  the  genetic  and  molecular  basis  of  cellular
-function  in  health  and  disease  has  led  to  many  new
-therapies. Inhibitors of the enzyme HMG-CoA reductase
-in  the  cholesterol  synthesis  pathway—statins—have
-revolutionised  the  prevention  and  treatment  of  coronary
-heart disease. We have entered the era of designer drugs,
-targeted  at  cellular  signaling  pathways  and  based  on
-1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
-Address for Correspondence: Prof James Best, Lee Kong Chian School of Medicine, Novena Campus, 11 Mandalay Road, Singapore 308232.
-Email: jamesbest@ntu.edu.sg
-*Delivered on 31 July 2015 at the 49th Singapore-Malaysia Congress of Medicine 2015
-Annals Academy of Medicine
- Medicine: Still an Art?—James Best
-354
-laboratory results mean that the computer screen is or will
-soon be our constant companion during the consultation.
-As we all know, our patients can and do access medical
-information on the internet, as well as from family, friends
-and neighbours, who also get information form the internet.
-And  our  patients  can  also  seek  treatment  through  the
-internet.  Computerised  cognitive  behavioural  therapy  is
-available online for help with anxiety, stress, depression,
-phobias and obsessive compulsive disorders. Systematic
-analysis of studies in this area has demonstrated the utility
-of this approach.
-So  what  are  the  consequences  of  the  explosion  of
-technology  and  scientiﬁ c  discovery  for  the  practice  of
-medicine and the role of the doctor? Science and technology
-of medicine is at its most advanced in the US, of course,
-and  so  perhaps  we  should  look  there  for  the  answer  to
-what lies ahead. Dr Abraham Verghese, physician-author
-and Professor for the Theory and Practice of Medicine at
-Stanford University Medical School says, “I joke, but only
-half joke, that if you show up in an American hospital missing
-a ﬁ nger, no one will believe you until they get a CAT scan,
-MRI and orthopedic consult”. So using one’s judgment and
-common sense is still part of the art of medicine, in both
-diagnosis and treatment. Much of medicine continues to
-involve  complexity  and  uncertainty,  so  there  remains  a
-place for clinical reasoning despite the ubiquity of clinical
-guidelines and decision support systems.
-What  Constitutes  the Art  of  Medicine  and  Is  It  Still
-Required?
-But  what  other  elements  of  medical  practice  remain
-relevant  and  constitute  the  art  of  medicine?  They  are
-contained  in  the  many  strands  that  make  up  the  bond
-between doctor and patient. The basis of the doctor-patient
-relationship is trust—and trust is engendered in ways that
-include active listening, empathy, compassion and physical
-contact.
-That is not easy. As Kafka wrote in his short book, ‘A
-Country Doctor’: “To write prescriptions is easy; to come to
-an understanding with people is hard.” That is the essence of
-clinical medicine: to come to an understanding with people
-and with that understanding to accompany them on their
-medical journey. No matter how sophisticated diagnosis and
-therapy becomes, patients will still appreciate someone they
-trust accompanying them on that journey. What comfort
-can  a  computer  provide?  Even  if  it  does  have  artiﬁ cial
-intelligence and even if it can simulate the human touch,
-it will still be just that—artiﬁ cial and simulated.
-Even with the scientiﬁ c advances over the past 40 to 50
-years, I would contend that this kind of relationship with
-our patients is just as important as it ever was. With more
-knowledge  of  molecular  structures.  For  example,  the
-tyrosine kinase inhibitor, imatinib is dramatically effective
-in several cancers, including chronic myeloid leukaemia
-and gastrointestinal stromal tumour. Biological therapies
-have been developed, such as antibodies designed to block
-the function of the inﬂ ammatory molecule TNFα, which
-have proven very effective in the treatment of rheumatoid
-arthritis and useful in other inﬂ ammatory diseases such as
-ulcerative colitis and psoriasis. Another antibody therapy,
-solanezumab, binds to β amyloid proteins and was reported
-only last week to slow progression of dementia. Stem cell
-therapies are starting to show real promise in the treatment
-of macular degeneration and Parkinson’s disease.
-Laboratory research has also led to an understanding of
-how some existing therapies work. Only recently have we
-known that metformin, ﬁ rstline therapy in the treatment
-of type 2 diabetes for over 50 years, activates the enzyme
-AMP-kinase, which is also activated by exercise. The holy
-grail of research in this area is to develop a therapy which
-is the pharmaceutical equivalent of physical exercise. We
-have also learned that insulin stimulates uptake of glucose
-by muscle tissue through activating transfer of a speciﬁ c
-glucose  transporter  protein—a  sugar  shuttle—from  an
-inactive intracellular site to insert itself in the cell membrane.
-At the same time, particularly in the use of pharmacological
-treatments, medicine has moved from relying too much on
-treacherous experience and difﬁ cult judgment to the use
-of  systematised  evidence  based  on  well  conducted  and
-unbiased clinical trials. One of the great pioneers in this
-area of medicine, David Sackett, died on May 13 this year
-and has left a huge legacy based on judicious application
-of knowledge. For what use is new knowledge if it is not
-used appropriately? It can be considered an art to apply the
-scientiﬁ c basis of medicine wisely and effectively.
-The Era of Precision Medicine
-Now—62  years  after  Watson  and  Crick  reported  the
-structure  of  DNA  and  12  years  after  the  ﬁ rst  human
-genome was sequenced—we stand on the threshold of an
-era named precision medicine. In this proposed model of
-medical care, diagnosis, prognosis and treatment will be
-based on genome analysis—genomics, protein analysis—
-proteomics and metabolite analysis—metabolomics, from
-each individual. This mega-data or big data will be collated
-to predict response and so to individualise therapy.
-Of course this approach relies on high level computing,
-which  is  also  changing  the  nature  of  medical  practice.
-Although it is argued that medicine has been much slower
-to utilise computing technology than other industries such
-as the commercial and engineering ﬁ elds, the advent of the
-electronic medical record and digitisation of imaging and
-September 2015, Vol. 44 No. 9
-355
-Medicine: Still an Art?—James Best
-chronic  disease  and  in  Singapore  an  ageing  population,
-complex illnesses such as diabetes require a strong bond
-between doctor and patient to achieve good outcomes. We
-are far from curative treatments for kidney, liver, lung or
-heart failure, despite the advances in stem cell research.
-Neurodegenerative diseases and musculoskeletal disorders
-are  major  burdens  with  only  modest  advances  in  most
-areas. Mental illness remains a major cause of morbidity
-and  progress  in  the  therapeutic  management  of  major
-psychiatric disorders over the past 40 to 50 years has been
-incremental but not dramatic.
-In cancer treatment there have been signiﬁ cant advances in
-some areas, but cancers of lung, pancreas, breast, ovary and
-prostate are still major causes of mortality and the promise
-of  precise  therapies  based  on  the  genetic  and  molecular
-analysis of individual cancers remains just a promise.
-I do, of course, share the excitement at the discoveries that
-have enhanced our knowledge of the pathophysiological
-basis  of  human  disease  and  I  can  envision  the  amazing
-progress  likely  to  occur  over  the  next  50  years  in  the
-treatment, and hopefully in the prevention, of many of the
-diseases I have mentioned. But I do not foresee medicine
-becoming totally mechanised and even if there are effective
-treatments for all illnesses, they will still need to be managed
-by caring clinicians with empathy and compassion. Just
-as insulin was expected to be a cure for diabetes 94 years
-ago,  I  expect  that  many  of  the  so-called  cures  that  will
-be discovered in the future, will in fact, be imperfect and
-complex therapies.
-Management of Patients with Terminal Illness in the
-Era of Precision Medicine
-One concern about the advent of precision medicine is
-that  we  could,  as  a  profession,  focus  almost  entirely  on
-technical treatment of the disease process and lose our view
-of the whole person, our patient. This danger of applying
-scientiﬁ cally sound therapies in circumstances which are
-futile  already  occurs  frequently  in  the  management  of
-patients with cancer.
-In  his  book  ‘Being  Mortal’,  Harvard  Medical  School
-surgeon Atul  Gawande  writes  “The  simple  view  is  that
-medicine exists to ﬁ ght death and disease, and that is, of
-course,  its  most  basic  task.  But  the  enemy  has  superior
-forces. Eventually, it wins. And in a war that you cannot
-win, you don’t want a general who ﬁ ghts to the point of
-total annihilation.” Treatment that is burdensome—both in
-terms of major side effects and cost—and essentially futile
-in that it may prolong life by only a few months is already
-prevalent in the so-called battle against cancer.
-worthwhile  outcomes.  At  the  same  time,  there  will  be
-many other therapies that have only incremental beneﬁ t,
-extending life by a few months at great cost to all concerned.
-Helping our patients and their families to choose wisely in
-this situation will require great art.
-Sir Murray Brennan, a New Zealand born and educated
-surgical oncologist, who was Chairman of the Department
-of  Surgery  at  Memorial  Sloan  Kettering  Cancer  Center
-in New York for over 20 years, spoke at a symposium I
-attended earlier this year on ‘Affordable Cancer Care.’ He
-spoke about the extensive practice of futile and burdensome
-surgery in cancer care because doctors lose sight of what
-is good for their patients.
-And he contrasted the ways that doctors can care for their
-patients when the decision is made that aggressive treatment
-of the disease is no longer warranted. An all too common
-approach is to say, “There is nothing more I can do for you”
-and to pass the patient on for palliative care management.
-His recommended approach is to say, “I do not think there
-is any further beneﬁ t to be gained from more surgery. But
-I will continue to care for you and make sure you receive
-the best possible treatment.” I believe that is the kind of
-doctor you and I would like to have caring for us.
-So let us make sure that use of the new treatments that
-will become available as the precision medicine wave rolls
-in, is matched by a renewed focus on patient-centred care,
-balancing the science with the art of medicine. Let us afford
-our patients a good death when the time comes, with all
-the care that modern medicine can provide, but avoiding
-futile and invasive treatments that rob them of dignity and
-precious last moments with their loved ones.
-The  Rewards  from  Medicine  as  a  Caring  Profession
-and its Teaching
-While  doctors  who  are  skilled  in  the  art  of  medicine
-provide great beneﬁ t to their patients, we should not forget
-the rewards we receive as clinicians from practising the
-art of medicine. Robert M Solomon, medical graduate of
-University of Singapore and bishop of the Methodist Church
-in Singapore believes that “the quality of the doctor-patient
-relationship…is guided by the best of human virtues such
-as altruism, compassion and the desire to alleviate human
-suffering.” Isn’t that what has drawn us to medicine as a
-career—the opportunity to share in the lives of others and
-to lighten their burden in times of trouble? Doesn’t that
-give meaning to our lives—or at least to our working lives?
-As the American poet and essayist Ralph Waldo Emerson
-said: “To know even one life has breathed easier because
-you have lived. This is to have succeeded.”
-In  the  precision  medicine  age,  we  will  undoubtedly
-see major advances in cancer therapy with dramatic and
-So  if  it  is  important  for  doctors  to  practise  the  art  of
-medicine well into the future, how should we be equipping
-Annals Academy of Medicine
- Medicine: Still an Art?—James Best
-356
-of the College of Physicians, which in turn, derives from
-the writings of his students and colleagues, some of whom
-have spoken of him at earlier orations in his honour. He is
-described as kind and softly spoken. He was always ready
-to answer any cry for help from patients, staff or colleagues.
-When  he  was  with  a  patient,  he  was  transported  into  a
-world where only the patient mattered—and his patients
-knew that. He believed that a doctor is placed in a special
-position to gain the patient’s trust and that a doctor needs to
-be a student of human nature.  He was a master of clinical
-diagnosis and an enthusiastic and effective teacher, fondly
-remembered by his students.
-I want to emphasise here that Gordon Arthur Ransome
-loved teaching, as did William Osler. In fact Osler said: “I
-desire no other epitaph—no hurry about it, I may say—than
-the statement that I taught medical students in the wards,
-as  I  regard  this  as  by  far  the  most  useful  and  important
-work I have been called upon to do.” I am sure Ransome
-knew this Oslerian saying and he himself was notorious for
-becoming so engaged in teaching his medical students that
-they complained he would often keep them through their
-lunch period. He believed that students should study history
-and philosophy—and I am sure he would have approved
-of the introduction of the study of the humanities into the
-modern medical curriculum.
-As  Dean  of  a  medical  school,  I  cannot  pass  up  the
-opportunity  to  recommend  teaching  as  another  way  to
-maintain our currency in the art and science of medicine, as
-well as to give back to the profession which has nurtured us.
-I mentioned earlier the practice of reciting the Hippocratic
-Oath at entry to medical school or after graduation. It is
-usually  a  modern  version  such  as  that  endorsed  by  the
-World Medical Association. Another interpretation that I
-particularly like was written in 1964 by the Dean of Tufts
-University  medical  school,  Dr  Louis  Lasagna.  The  ﬁ rst
-promise  in  this  version  is:  “I  will  respect  the  hard-won
-scientiﬁ c gains of those physicians in whose steps I walk,
-and  gladly  share  such  knowledge  as  is  mine  with  those
-who are to follow.” And there is another promise that is
-relevant to my topic this evening: “I will remember that
-there is art to medicine as well as science, and that warmth,
-sympathy and understanding may outweigh the surgeon’s
-knife or the chemist’s drug.”
-Clearly,  Gordon  Arthur  Ransome  epitomised  the  art
-of medicine and we can learn much from his example of
-selﬂ essness  and  devotion  to  his  patients.  Of  course,  the
-world and its ways have changed since he practised medicine
-here  in  Singapore.  The  gender  balance  of  the  medical
-profession has changed and the importance of family and
-other commitments outside of medicine are acknowledged
-more readily. We are also challenged by changes that can
-distance us from our patients, like the computer terminal, the
-our medical students to learn the art? Again Dr Verghese
-from Stanford: “What we need in medical schools is not
-to teach empathy, as much as to preserve it—the process
-of learning huge volumes of information about disease, of
-learning a specialised language, can ironically make one
-lose sight of the patient one came to serve; empathy can
-be replaced by cynicism.”
-Of course we do attempt now to select students in part
-on  the  basis  of  their  empathic  skills,  but  that  is  a  very
-inexact science. At least we demonstrate that we think it
-is important. Encouraging our students to learn from their
-patients and from other health professionals is part of the
-modern curriculum for instilling a sense of empathy and
-compassion. We can also teach about professionalism and
-ethical  responsibility.  The  development  of  professional
-identity is aided in many medical schools by white coat
-ceremonies  and  recitation  of  the  Hippocratic  Oath  on
-entry to medical school. Over 100 years ago William Osler
-urged us to treat medical students as our junior colleagues,
-surely an important way for them to develop that sense of
-belonging to our profession.
-Innovative programmes in the humanities and medicine
-use art, literature and poetry to explain the human condition
-and to help our students come to an understanding of human
-nature and the effect of illness on the individual. In fact,
-it is not just students who can beneﬁ t from a study of the
-humanities. William Osler read non-medical classics from
-10 to 11 every evening—and just as we keep ourselves up to
-date with medical literature, we can refresh our commitment
-to the art of medicine in this way.
-With all of these efforts to develop our students as caring
-professionals, it is the role model that doctors provide to
-our students that probably has the most impact. Learning
-by example, just as children tend to emulate their parents’
-behaviour, is called the hidden curriculum. That means we
-all have a responsibility to demonstrate the art of medicine
-when we are being observed and to practise it even when
-we are not being observed. Because genuine empathy and
-compassion are not qualities that can be turned on and off
-like a tap.
-What Can We Learn and Emulate from Gordon Arthur
-Ransome?
-In  his  collection  of  aphorisms  called  ‘Aequanimitas’,
-William Osler wrote “the stories of the lives of the masters
-of medicine do much to stimulate our ambition and rouse
-our sympathies.” So what can we learn from that master of
-medicine and ﬁ rst master of the Academy, Gordon Arthur
-Ransome, that will stimulate our ambition to practise the
-art of medicine?
-I draw on his entry in Munk’s Roll of the lives of members
-September 2015, Vol. 44 No. 9
-357
-Medicine: Still an Art?—James Best
-mask and gloves that are now part of the medical uniform
-in many settings. But it is the ethos, the spirit of his legacy
-that we want to emulate and pass on in turn to the future
-members of the medical profession.
-with another aphorism from ‘Aequanimitas’: “The practice
-of medicine is an art, not a trade; a calling, not a business;
-a  calling  in  which  your  heart  will  be  exercised  equally
-with your head.”
-Gordon  Arthur  Ransome  valued  medical  history  and
-medical books and was a devotee of the works of William
-Osler. So it is ﬁ tting to conclude the oration in his honour
-Thank you for this singular honour of addressing you
-this evening.
-Annals Academy of Medicine

+THE INTERNATIONAL
+STUDENT HANDBOOK
+Southern Methodist University | 2025-2026
+L E T T E R   F R O M   T H E   I S S S   D I R E C T O R
+Dear International Student/Scholar:
+On  behalf  of  the  International  Student  &  Scholar  Services  team  (ISSS),  I  would  like  to
+welcome  you  to  Southern  Methodist  University.  You  have  chosen  to  attend  one  of
+America’s premier comprehensive universities, and we are pleased that you are part of the
+SMU  family.  The  SMU  campus  and  community  provide  a  variety  of  resources  to  ensure
+that your time here as a student or scholar is productive on both a personal and academic
+level. The International Student & Scholar Services team is committed to facilitating and
+enriching your experience before you arrive on campus and while you are here in the U.S.
+All  members  of  the  ISSS  team  work  diligently  to  provide  the  best  and  most  useful
+resources  prior  to  your  arrival  through  a  comprehensive  pre-arrival  information  packet
+that will assist the visa application process. Once you arrive on campus, we welcome you
+with  various  immigration  orientations  in  order  to  inform  you  of  the  various  visa
+compliance  regulations  that  you  must  follow  as  an  international  student  or  scholar  in
+order  to  maintain  your  visa  status.  Our  team  is  responsible  for  reporting  to  the  federal
+Government all compliance events relating to our international population through SEVIS
+(Student  and  Exchange  Visitor  Information  System).  For  this  reason  it  is  important  that
+you  check  your  SMU  e-mail  regularly,  since  regulations  sometimes  change.  Once  you
+arrive, it is our desire that you take every opportunity to participate in our programming
+events. Our office coordinates several events throughout the year in order to celebrate the
+different cultures and contributions from our international population. Our staff consists
+of a group of professionals who are prepared to respond to your unique needs through our
+excellent  immigration  advising  system.  Our  staff  is  also  prepared  to  help  you  navigate
+through all the resources that SMU has to offer that will help you achieve your academic
+goals.Once again, welcome to SMU. We are happy that you are with us. Please contact any
+member  of  the  ISSS  team  if  you  have  any  questions  or  concerns.  If  we  do  not  know  the
+answers to your questions, we will try to find someone who does.
+Best Regards,
+Claudia Sotomayor Hart
+What's Inside?
+Get to Know Your New Home
+Life in Dallas, Texas .................................................. 5
+Q&A with International Mustangs ........................ 6
+Becoming a Part of the SMU Community .......... 7
+Our Favorite SMU Traditions ................................. 8
+Getting Ready for Your Arrival
+Welcome New Students .......................................... 9
+Steps to Receive your I-20 .................................... 10
+Getting Ready for Your Arrival ............................. 11
+How to Pack for SMU ............................................. 12
+Packing Must Haves ............................................... 13
+Navigating Living in the U.S.
+Once You've Arrived in the U.S. ........................... 14
+ISSS Office ................................................................. 15
+Transportation in the U.S. ..................................... 16
+U.S. Laws and Safety ................................................17
+Emergencies: Know What To Do ..........................18
+ Student Success and Useful Information
+Health and Wellness ................................................ 19
+Achieving Academic Success at SMU ................... 20
+SMU Honor Code ...................................................... 21
+Student Tips for Class Registration ....................... 22
+Job Prep and Employment ...................................... 23
+On-Campus Dining Facilities .................................. 24
+Eating Vegetarian at SMU ....................................... 25
+Ethnic Grocers and Restaurants............................ 26
+On-Campus Mail Facilities ...................................... 27
+Banking in the U.S. ....................................................28
+Phones in the U.S. .....................................................29
+Important Contact Information ..............................30
+4
+Life in Dallas, Texas
+POPULATION: Dallas is the 9th largest city in the US and the third largest in Texas
+with a population of 1,300,000.
+LOCATION: Dallas is located in the Central Time Zone in North Central Texas, 35 miles
+east of Fort Worth, 245 miles north, northwest of Houston and 300 miles north of the
+Gulf of Mexico.
+CLIMATE: Spring (Mar–May) and fall (Sep–Oct) are warm. Summer (Jun–Aug) is hot.
+Winter (Nov–Feb) is cool to cold.
+Average annual snow days: 1.3
+Average rain days: 81 days
+BUSINESS CLIMATE: The Dallas area is home to 21 Fortune 500 companies including
+Exxon Mobil, JC Penney, AT&T, Texas Instruments, and others.
+SPORTS & RECREATION: Dallas is home to five professional sports teams: The Dallas
+Cowboys (NFL); Dallas Stars (NHL); Dallas Mavericks (NBA); Dallas Wings (WNBA); FC
+Dallas (MLS) and the Texas Rangers (MLB) plus NASCAR and Indy racing.
+DID YOU KNOW?
+The 52 foot 'Big Tex' statue that greets visitors at the annual State Fair of Texas is the tallest
+cowboy in Texas.
+With the roof enclosed, the entire Statue of Liberty could fit into the Cowboys Stadium.
+The first convenience store, 7-eleven, got its start in Dallas and the corporation is
+headquartered there today.
+5
+Q&A with International
+Mustangs
+Rasiq H.
+India
+Software Engineering
+Amanda B.
+Brazil
+Accounting
+What do you do on weekends in Dallas?
+I  generally  like  to  hang  out  with  my  friends.  We  binge
+watch  shows,  play  poker,  and  have  dinner  parties.
+Sometimes  I  try  to  emulate  a  new  recipe  that  I  came
+across  during  the  course  of  the  week  and  test  it  on  my
+friends. If the weather is not unforgiving, we play soccer
+near my apartment complex. I also try to get done with my
+errands  such  as  laundry,  grocery  runs,  meal  prep  and  if
+time permits, I go record player shopping.
+I  love  trying  new  restaurants!  Dallas  is  filled  with  places
+from  different  cuisines  and  cultures.  I  also  have  a
+membership to the Arboretum, which is a botanical garden
+that  you  can  walk  around  to  see  the  different  flowers;
+there is also events and cool picnic spots there. Lastly, the
+Farmer’s  Market  is  my  favorite  place  to  go  on  the
+weekends for breakfast and shops.
+What helped you make friends at SMU?
+I  reached  out  to  a  lot  of  people  at  SMU  on  LinkedIn
+before I came, the ones that responded connected me to
+the  other  students  who  had  reached  out  to  them  as  well.
+So, I had a good mix of a network that was new and old to
+SMU.  The  people  I  met  at  the  Orientation  and  Welcome
+Party  are  still  my  best  buddies.  I  made  a  lotta  friends  at
+events and also while working at ISSS.
+To me, at first it was hard to make friends because I was
+so nervous and still adapting to the culture here. But once
+I  joined  different  organizations  on  campus  -  International
+Leadership  Program  and  the  Brazilian  and  Portuguese
+Speakers Association - I was able to meet the people that
+became my support group. I also gained the confidence to
+meet other people at events on campus and at the library.
+What's your favorite restaurant in the area?
+I honestly wish I could select one, but Dallas is such a
+heavenlike place for people who like diverse cuisines. I
+have tried so many new cuisines here such as Thai,
+Pakistani, Iraqi, Italian, French and Tex-Mex. If I had to, I
+think I would put it between Deccan Grill or Olivella’s. The
+Former because it reminds me of home, and the Latter
+because I think they make the best pizza in the world.
+I enjoy trying different restaurants but here are some of
+my favorites: Delucca Gaucho Pizza is an all you can eat
+Brazilian pizza for a really affordable price. Hibiki Sushi
+and Vidora (Tex-Mex food) are both at Deep Ellum, a spot
+in Dallas with a bunch of restaurants and local shops.
+Honey Berry Pancakes is awesome for breakfast and has
+a huge menu - their Nutella pancake is amazing!
+What helped if you felt homesick?
+Luckily,  I  haven’t  felt  homesick  because  I  never  really
+isolated  myself  from  people.  Making  new  friends  is  hard,
+but if you just try a little to ask people around campus or
+events  about  their  degree  or  where  they  come  from,  I’m
+sure  that  will  go  a  long  way  in  helping  you  feel  more  at
+home. Because every time you see that person on campus,
+you  have  someone  to  talk  to,  share  experiences  with,  and
+maybe  go  out  with  them.  It  takes  time,  some  will  want  to,
+some  won’t.  But  that  doesn’t  mean  you  stop  trying  to
+socialize.
+I  regularly  call  and  Facetime  my  family  and  friends.  The
+distance  is  harder  during  special  occasions  like  birthdays
+and  holidays,  but  it  made  me  more  appreciative  of  the
+present and helped me learn to enjoy the little things. I also
+made my own chosen family here, they helped me through
+tough times and celebrated every milestone with me! Some
+of  my  friends  are  from  Brazil  as  well,  so  it  helped  a  lot
+with homesickness. Now, I have two places to call home and
+I am so grateful for that.
+6
+#YouAreWelcomeHere
+Get Involved!
+Getting involved on campus is a great way to get connected to the SMU community!
+There are over 200 student organizations at SMU including academic, athletic,
+cultural, and interest groups! Some of these organizations include...
+International Leadership Program
+K-pop Club
+Intramurals Sport Clubs
+Indian Student Association
+Virtual Reality Club
+Asian Council
+Esports Club
+Outdoor Adventures
+Discover all the organizations at SMU at Connect.SMU.edu
+Check out the SMU International Student & Scholar Services
+Channel for our #YouAreWelcomeHere video.
+7
+Our favorite
+SMU Traditions
+“We don’t tailgate, we boulevard”
+is one of the most common
+phrases that comes up when
+talking about SMU tradition. A day
+or two before each football game,
+beautiful white tents are put up all
+along the Boulevard and the lawn
+in front of Dallas Hall. Then, three
+hours before the game, SMU
+students, faculty, alumni and
+friends come out to enjoy food
+and games on the Boulevard.
+At the beginning of each school
+year there are many events to
+enjoy and make new friends.
+Usually there is also a chance to
+get free food too! The New Student
+Welcome Party hosted by ISSS has
+always been a good one!
+Homecoming is always a big tradition at SMU.
+There is banner making, window painting,
+Peruna painting and float building. Then there is
+also the much-anticipated Homecoming court in
+which each organization nominates a candidate
+for homecoming queen and king. The week builds
+up to the Homecoming parade to showcase the
+floats students have worked on.
+The Celebration of Lights! Every year in
+December thousands of lights are displayed on
+Dallas Hall and it’s surrounding area. SMU
+students come out to sing , listen to groups
+perform and hear President Turner read The
+Christmas Story. The finale of the night is
+always the lighting of the Christmas tree,
+Dallas Hall and the surrounding trees with
+more than 100,000 twinkling lights that
+helps everyone feel the holiday spirit.
+8
+W E L C O M E   N E W
+S T U D E N T S !
+Here's what to expect from now until your arrival in Dallas, Texas.
+1
+Pre-Arrival
+Pay close attention to your SMU email address inbox. The ISSS office and
+other  campus  offices  will  be  reaching  out  to  you  with  important
+information. We will also have webinars available to help you get ready for
+your arrival and life at SMU.
+Immigration Compliance Course &
+Government Document Check-In
+2
+All  F-1  or  J-1  visa  holders  are  required  to  complete  the  Immigration
+Compliance  Course.  Then,  you  must  complete
+the  mandatory
+goverment document check-in once you arrive at SMU.
+3
+Campus Welcome
+We  are  looking  forward  to  welcoming  you  to  the  SMU  community.  We'll
+host  opportunities  for  you  to  develop  new  friendships,  become  familiar
+with  U.S./Texas  culture  and  help  prepare  for  the  next  stage  of  your
+professional life. These include; Orientation, Welcome Party, and More!
+You are welcome here.
+For details visit the ISSS website and review "New Student Information"
+9
+S T E P S   T O   R E C E I V E
+Y O U R   S M U   I - 2 0
+In order to receive your SMU I20 please follow the steps below. Contact your admitting
+department directly for instructions on how to submit the required documents.
+STEP 1: Have a photocopy of valid passport ready
+STEP 2: Prepare financial documents
+Funds available must meet or exceed cost for 1 year of student expenses
+Dated no more than 6 months prior to submission
+Printed on bank or financial institution letterhead
+Must be printed in English
+Includes account holder name and account information
+Financial Commitment Form - this will only apply if funds are not personal funds
+Funds must be liquid without restrictions
+Student Loans
+Student loan applications are not accepted.  Approved loans with a dollar amount will be accepted.
+Financial Documentation not accepted:
+Stocks or Bonds, Life Insurance, Property or Land, Proof of Employment or Tax Documents
+For more information about the estimated tuition, fees and other expenses for your program please visit the Estimated
+Expenses for I-20 page on the International Student and Scholar Services website.
+STEP 3: If requesting an F-2 Dependent Visa
+The F-2 dependent visa is a nonimmigrant visa which allows dependent spouses and children (unmarried,
+under 21 years old) of F-1 student visa holders to enter into the U.S. The following is required if your
+dependents will apply for an F2 visa and travel to the U.S. with you:
+Photocopy of Valid Passport for all dependents
+Photocopy of Marriage Certificate (translated in English) for dependent spouse
+Copy of Birth Certificate (translated in English) for dependent children
+F1 must provide additional funds for each dependent
+STEP 4: Receiving your I-20 Form
+Form I-20's are sent to students via SMU email. Students should monitor their SMU email address for their I-20
+document. Students should then print and sign their I-20 in ink.
+10
+G E T T I N G   R E A D Y   F O R
+Y O U R   A R R I V A L
+Request an I-20
+Verify information on I-20/DS2019 is accurate. If you see any errors contact  ISSS
+immediately at isss@smu.edu
+Pay SEVIS fee *
+Apply for New Visa, F or J *
+Prepare for your visa interview and take the following documents with you:
+SEVIS Fee Receipt
+Letter of Admission
+Form I-20/DS-2019
+Passport
+Proof of funding and/or educational sponsorship documents reflected on
+I-20/DS-2019
+Check your SMU email regularly for updates related to class registration,
+orientation and notices from campus departments
+Register for health insurance & complete immunizations to ensure there are no
+holds on your account. You can register through my.SMU.edu. For more information
+visit the SMU Health Center website.
+Complete the International Student Compliance Course
+Plan for housing and an SMU meal plan if required
+Book your flight and plan travel to campus. Be sure to enter the U.S. with your F-1
+or J-1 student visa; do not enter the U.S. with a tourist visa. You are allowed to enter
+U.S. up to 30 days prior to program start date listed on I-20/DS-2019
+Prepare for payment of tuition for more information visit the SMU Bursars Office
+website and view the section about "Paying Tuition as an International Student"
+Video tutorial is available on ISSS website under "New Student Information"
+11
+A guide from students, for students
+How to Pack for SMU
+Packing for a long trip can be stressful and that's okay. We're here to help.
+Top 4 Packing Tips
+1.
+2.
+3.
+4.
+Bring Just the Essentials
+A lot of items can be purchased locally upon arrival and saves room in your suitcase.
+Plan Ahead
+Get to know what the weather is like in Dallas to plan your clothes accordingly.
+Bring a Few Sentimentals
+Have a few pictures or small momentos that remind you of home.
+Don't Forget Anything
+Make a packing list and check it twice. Include what you plan to buy here in the states!
+12
+Packing Must Haves
+How to Pack for SMU
+Must-have items:
+Wallet & Money
+Passport
+Printed Compliance
+Course
+Important
+Documents
+Medical &
+Immunization
+Records
+Emergency
+Contact
+Clothing and Accessories
+Clothes
+Glasses
+Shoes
+Under Clothes
+Small Towels
+Recommended
+Electronics &
+Chargers
+Bring just the essentials
+A lot of items, such as shampoo, towels, etc. can be purchased locally.
+Medicine
+Hygiene
+Products
+Snacks
+Universal
+Adapter
+Protective
+Lotions
+Check out the SMU International Student & Scholar Services
+Channel for our packing video.
+13
+O N C E   Y O U ' V E
+A R R I V E D   I N   T H E   U . S .
+We hope you had safe travels!
+Continue checking your SMU email regularly. You will be receiving updates related
+to expectations upon arrival and other important information.
+Update your U.S. residence address and U.S. phone number in your My.SMU
+account. Department of Homeland Security requires you to update your U.S. local
+address and phone number within 10 days of any change.
+Manage holds on your account if you have any remaining  to register for classes if
+still needing to do so. To view, access your Student Center from your My.SMU
+account and holds will be listed at the top of the right hand side of the screen.
+Ensure that you have completed the International Student Compliance Course
+on SMU Canvas smu.instructure.com. Log-in with SMU ID number and password.
+*video tutorial is available on ISSS website under "New Student Information"
+Complete Mandatory Document Check-In. Link is available on the ISSS website
+under Students Tab > “New Student Information” > Mandatory Government Check-in
+Review SMU shuttle, parking services and transportation options at
+parking.smu.edu
+Pay your tuition and fees through the Bursar’s Office
+https://www.smu.edu/EnrollmentServices/Bursar
+14
+International Student &
+Scholar Services Office
+No matter where you are across the globe, the International Student and Scholar
+Services (ISSS) team is here to support you. ISSS provides services to help you
+maintain your immigration status and promote your success here at SMU. Stay
+up to date via our website www.smu.edu/enrollmentservices/international.
+Laura Lee Blanton Building, Suite 101
+6185 Airline Rd, Dallas, TX 75205
+214-768-4475
+isss@smu.edu
+ISSS Document Pick-Up Hours:
+Monday - Friday:
+9:00 AM - 4:00 PM
+Wednesdays:
+10:00 AM - 4:00 PM
+ISSS Advising Hours:
+Meet with an advisor on Zoom or in-person
+Monday to Thursday:
+Virtual: 9:00 AM -11:00 AM
+In-person: 2:00 - 4:00 PM
+Follow us:
+@smuinternational
+@smuintlservices
+SMU International Student
+and Scholar Services
+15
+T R A N S P O R T A T I O N   I N
+T H E   U . S .
+Concerned about how you are going to get around when you
+come to Dallas? Don't worry- there are a lot of options!
+On-Campus
+Off-Campus
+Walk
+Most students walk to class.  Just make sure you
+leave with enough time to make it to class! Google
+Maps works great in the area and on campus.
+Bikes
+When going to a university, lots of students may
+bring a bicycle for transportation around campus.
+SMU provides various areas to keep your bikes,
+just bring your lock.
+Look into purchasing a bike at popular stores such
+as Walmart, Target, Dick's Sporting Goods, or
+Academy Outdoors!
+Tapride
+If you find yourself feeling uncomfortable walking
+alone after a long night in the library, call a safe
+ride using the app Tapride. An SMU security officer
+will pick you up in a golf cart and take you
+wherever you need on campus.
+Pro Tip: It's a good idea to consider how far
+away your classes are from each other when
+selecting them, especially since most classes
+are 10 minutes apart
+Ride Share Services
+The  most  popular  option  for  transportation  around
+Dallas are ride sharing services such as Uber and Lyft.
+Just  download  the  apps  and  input  your  destination!
+Always make sure the license plate matches.
+DART
+The Dallas Area Rapid Transit service is a railway that
+travels around the Dallas area including to the airport
+and NorthPark Mall. Conveniently, across the street
+from SMU campus is a DART station! SMU students
+are eligible for a free SMU DART transit pass by
+enrolling through the Parking and ID Card Services
+Office with a valid U.S. phone number. DART is
+typically much cheaper than ride sharing options.
+Pro Tip: While the DART is typically safe it
+would be smart to travel with a friend and
+avoid riding the DART late at night.
+SMU Express
+The SMU Express is a DART operated bus that goes
+on campus and makes stops at nearby apartments,
+shopping centers and resturaunts.
+For more information visit  the SMU Parking and ID
+Services Office website.
+Transportation from the airport upon arrival in the U.S.
+Most students use ride sharing options such as Uber or Lyft for their commute
+from the airport to campus, but others may use DART.
+16
+U.S. LAWS & SAFETY
+Did You Know?
+Emergency Blue Lights
+There are over 55 emergency Blue Light phones across
+SMU's Campus, typically placed outside or in parking
+garages. If you are in danger, find the nearest blue light
+phone, press the emergency button, and you will be
+connected with the police department and an officer will be
+dispatched.
+SMU Alerts
+In the case of a campus wide safety threat, SMU will send
+out alerts through the Emergency Notification System (ENS)
+to alert everyone on campus that there is a threat. Alerts
+will also be posted on all official SMU social media sites,
+emailed, and in buildings alarms will sound.
+Seatbelts
+In the U.S. it is required��to wear a seatbelt in a vehicle,
+regardless of whether you are driving or not.
+Drinking and Driving
+In the U.S. it is not permitted to operate a vehicle under the
+influence of alcohol. If you do, you will jeopardize your
+student visa status.
+Alcohol on Campus
+Alcohol is not permitted in any public area on SMU's campus
+including the residence halls regardless of your age.
+Legal Ages
+in the U.S.
+Drinking Age: 21+
+Tobacco Age: 21+
+Smoking on
+Campus
+Smoking is prohibited
+within twenty-five (25)
+feet of any entrance to
+buildings on campus.
+Learn more on SMU's Risk Management website
+17
+EMERGENCIES AT SMU:
+KNOW WHAT TO DO
+In the case of an on-campus emergency, alarms will sound across campus
+buildings with audio instructions on what to do. Students will also get an
+emergency alert to their emails and phones with updates on the situation.
+Learn more at SMU's Risk Management website
+18
+HEALTH
+AND WELLNESS
+Office of the Chaplain
+& Religious Life
+Inspiring the Expression of Religious
+Faith and Discourse in the University
+The Office of the Chaplain works to
+ensure that SMU is a place that
+welcomes religious diversity while
+offering student support.
+https://www.smu.edu/studentaffairs/religious-
+life
+Dr. Bob Smith
+ Health Center
+The health center is an on
+campus clinic that provides
+students with access to medical,
+counseling, and dental services.
+Also, the heath center has a
+pharmacy and offers student
+health insurance.
+https://www.smu.edu/studentaffairs/h
+ealth-center
+Dedman Center for
+Lifetime Sports
+The recreation center offers a
+free-weight and cardio gym as
+well as basketball, volleyball,
+and tennis courts. You will also
+find indoor and outdoor pools
+and countless fitness classes
+including spin and yoga!
+Check out the SMU International Student & Scholar Service
+Channel for our mental health video.
+19
+ACHIEVING ACADEMIC
+SUCESS AT SMU
+Altshuler Learning
+Enhancement Center (A-LEC)
+The ALEC offers free peer tutoring, writing
+center, academic counselors, and academic
+success workshops to undergraduates.
+smu.edu/alec
+Disability Accommodation and
+Success Strategies (DASS)
+The DASS office advocates, assists, and
+accommodates students with physical or
+learning disabilities. DASS also provides
+mentoring, self-advocacy, time management,
+and other success strategies to aide in the
+academic success of students with
+disabilities.
+https://www.smu.edu/provost/saes/academi
+c-support/disability-accommodations
+ESL (English Second Language)
+The Department of Intensive English
+Program partners with the
+ISSS Office regarding free classes for
+students who are having
+academic difficulties due to the English
+language.
+ smu.edu/Dedman/Resources/Students/ESL
+Fondren Library
+Online Databases
+Fondren offers an extensive online library
+database to aide students in their research.
+Study Spaces
+Need a quiet place to study? Reserve a
+private study room in the library or go to the
+Centennial Reading Room, otherwise,
+Fondren library offers many places for you
+and your friends to study!
+Research Support
+Need help navigating research, finding
+scholarly sources, or creating citations?
+Fondren library offers support both online
+and in-person in these areas.
+smu.edu/libraries/fondren
+Pro Tip: Don't forget to go to your professors office
+hours with any questions about lectures, due dates,
+grades, or anything at all. Professors are there to
+help you so make sure you take advantage!
+20
+Understanding SMU's
+Honor Code
+WHAT IS ACADEMIC DISHONESTY?
+SMU's Student Handbook defines academic dishonesty in five different ways...
+1.
+2.
+3.
+4.
+5.
+ Academic Sabotage. Intentionally taking any action which negatively
+affects the academic work of another student.
+ Cheating. Intentionally using or attempting to use unauthorized
+materials, information, or study aids in any academic exercise.
+ Fabrication. Intentional and unauthorized falsification or invention of
+any information related in an academic exercise.
+ Facilitating Academic Dishonesty. Intentionally or knowingly helping
+or attempting to to help another to violate any provision of the Honor
+Code.
+ Plagiarism. Intentionally or knowingly representing the words or ideas
+of another as one’s own in any academic exercise.
+Note: This includes ghostwriters.
+WHAT ARE POSSIBLE SANCTIONS?
+1.
+2.
+3.
+4.
+5.
+6.
+Informal Warning. Not a part of the student's formal conduct record.
+Formal Conduct Warning. Part of the student's formal conduct record.
+Conduct Probation. A warning that is
+Deferred Suspension
+Suspension
+Expulsion
+To learn more about Academic Dishonesty and Conduct Proceedings, please view the SMU
+Student Handbook at smu.edu/StudentAffairs/officeofthedeanofstudents/StudentHandbook
+21
+STUDENT TIPS
+FOR CLASS
+REGISTRATION
+Sohyun 'Jun',
+Accounting
+1
+Review All Your Options
+University course catalog, major track, ratemyprofessor.com
+If you have decided your major, browse through the university
+course catalog and major track to learn about your required courses. If not, you still have plenty of
+time to discover your interests and passions by taking advantage of all the diverse classes that
+SMU has to offer. I personally like to check out the course overview on the university course
+catalog and instructors reviews on the ratemyprofessor website.
+2
+Make Your Own Schedule
+“Wunderlist”, “Class Timetable”, "Coursicle"
+As an undergraduate I usually enroll in 4 to 6 classes and try to evenly spread them out over the
+week. Remember that as international students we are required to enroll full-time every fall and
+spring semester. If possible, try to have a day off from a school to dedicate for your work,
+internship, exam prep and more. You can utilize apps like Wunderlist and Class Timetable that will
+help you visualize your college schedule.
+3
+4
+5
+Talk To Your Academic Advisor
+This will vary depending on your academic level and department
+New undergraduate students will be able to schedule an appointment with an academic advisor
+from the University Advising Center (UAC) for assistance with class selection and registration. New
+graduate students have a difference process based on the academic department. Something I
+found helpful when deciding between classes was to contact the instructor of the class to ask if
+you can be added or just simply for class information. You can always find instructors contact
+information on the SMU faculty website.
+Be Strategic Selecting Classes
+Excel templates for college courses
+Create an excel file to keep track of a list of courses you need to take at SMU per semester at a
+glance. While still making sure to keep a balanced life, I worked on getting the core classes and
+University Curriculum (UC) credits out of the way as soon as possible. Note: undergraduates there
+are classes that meet 2-4 UC requirements - keep an eye out for these, they are a timesaver!
+Complete all Requirements Needed to Complete Class Registration
+Set a reminder for the time/date you can register for classes
+Make sure to put classes in the cart to make the registration process smooth and fast. Remember
+that before you can register, you will need to complete the Immigration Compliance Course on
+SMU Canvas. Then upon arrival at SMU, attend the Mandatory Government Document Check-in to
+remain in good visa status. Register in advance for the document-check-in on the ISSS website.
+22
+JOB PREP AND
+ EMPLOYMENT
+at SMU
+Job Preparation
+SMU's Hegi Career Development
+Center offers career fairs and
+other career resources including
+resume building, cover letter
+writing, job research tips,
+interview tips, career counseling,
+and even professional headshots!
+Learn more at smu.edu/StudentAffairs
+12twenty is an employment
+search engine that connects
+students to potential off-campus
+employers and on-campus job
+opportunities.
+https://www.smu.edu/studentaffairs/hegi
+-career-center/twelve-twenty/students
+On-Campus Employment
+International students may get an
+on-campus job
+Note: F-1 and J-1 visa holders
+are not eligible for federal work
+study positions.
+Students who obtain employment
+are REQUIRED to visit the ISSS
+Office and get permission BEFORE
+you begin your job for
+authorization.
+Off-Campus Employment
+Students who have maintained
+their status for one academic year
+are eligible to apply for Curricular
+Practical Training (CPT) or Optional
+Practical Training (OPT) which
+allows them to work off-campus.
+Learn more at
+smu.edu/EnrollmentServices/international
+Pro Tip: Meet with a Hegi Career
+Center advisor to create a U.S. style
+resume and form a strong career plan!
+23
+The Market in Hughes-Trigg Student Center
+Mon - Thu  9:00AM - 8:00PM
+Fri 9:00AM - 4:00PM
+Sat 9:00AM - 4:00PM
+Sun 2:00PM - 6:00PM
+Arnold Dining Hall
+Breakfast
+Mon - Fri
+7:00AM - 10:30AM
+Dinner
+Mon - Thu.
+5:00PM - 9:00PM
+Brunch
+Sat - Sun
+9:30AM - 2:00PM
+Dinner
+Fri. and Sat.
+5:00PM - 7:00PM
+Lunch
+Mon - Sun
+11:00AM - 2:00PM
+Dinner
+Sunday
+5:00PM - 8:00PM
+Umphrey Lee Dining Hall
+Breakfast
+Mon - Fri
+7:00AM - 10:30AM
+Sat - Sun
+9:30AM - 2:00PM
+Lunch
+Mon - Fri
+11:00AM - 2:00PM
+Dinner
+Mon - Fri, Sun
+5:00PM - 8:00PM
+Saturday
+5:00PM - 7:00PM
+Other On-Campus Dining Options
+Starbucks  - Fondren Library
+Lawyer's Inn - Law School Quad
+TeaCo - Law School Quad
+Chick-Fil-A - Hughes-Trigg Student Center
+Panera - Hughes-Trigg Student Center
+Sushic - Hughes-Trigg Student Center
+ShakeSmart - Dedman Center for Lifetime Sports
+Mac’s Place - McAlvaney Commons
+Sclafani's Bagels and Sandwiches- Cox School Of Business
+For more information and the most up to date hours visit: smu.campusdish.com/ 24
+s
+e
+i
+t
+i
+l
+i
+c
+a
+F
+g
+n
+n
+D
+i
+i
+s
+u
+p
+m
+a
+C
+-
+n
+O
+Eating
+Vegetarian at SMU
+In Dallas
+Being vegetarian can feel daunting in situations when
+it seems hard to find options to fill one’s appetite.
+However, the proximity of SMU to downtown Dallas
+provides students with a greater variety of choices.
+Every corner gives rise to a new discovery of small
+restaurants with unique styles and food. Right across
+the North East dorms there is the Sinder Plaza which
+is a common place for students to hangout while
+studying or to visit restaurants or ice cream shops.
+If one wants to go further off campus, there is an
+abundance of opportunities to explore new and
+wonderful flavors on the weekends by planning an
+adventure with your friends to downtown Dallas
+using the DART (Dallas Transit) which is free for all
+SMU students
+At SMU: Dining Halls
+Umphrey Lee
+The brownies at the Vegan Dessert Section at Umph
+are  delicacies  and  if  you  are  an  SMU  student  the
+Umph  cookies  have  a  fame  of  their  own.  If  you
+consume dairy products and have a sweet tooth, the
+Umph Dessert Section is a blessing.
+Another  captivating  feature  is  the  make-your-own
+sandwich  and  salad  area  at  Umph,  it  provides  you
+with the flexibility to choose your own ingredients to
+make your own veggie salad or sandwich.
+Arnold
+Arnold, has their own make-your-taco section which
+again, could be made vegetarian with only a red bean
+paste filling.
+Arnold also has a Mongolian grill station where
+students can make their own grill with rice or
+noodles hence, vegetarians have the ability to
+personalize their food.
+Other Options on Campus
+ Something notable about Mac’s place is that it
+offers Beyond Meat style burgers for us vegetarian
+lovers. Another favorite are the salads here! Though
+they are made available in the menu with meat it
+could be replaced while you are placing your order.
+ A vegetarian or vegan is in for a treat at the Food
+Market! There is a whole section dedicated to vegan
+versions of food. It ranges from vegan ice creams to
+vegan oven cooked food and biscuits. It is my haven.
+We also have restaurants on campus which are
+Chick-fil-a , Lawyer’s Inn and Cinco Taco. While at
+Chick-fil-a there are not many vegetarian options, it is
+a go-to for french fries. The potato tots at Lawyer’s
+Inn are my vegetarian choice.
+Tips from Upperclassmen
+ Tread with Caution! It might be hard to
+differentiate between the meat option and
+vegetarian options sometimes, so when in doubt
+check with the staff and double check yourself!
+ Double Check! Check before consuming boiled
+or cooked vegetables since sometimes in the
+cooking process butter is added.
+Take Advantage! If you're at the SMU dining
+halls, there are a variety of fruit options available
+to take and it is a healthy snack between meals
+and classes to keep around. So grab a fruit on
+your way out!
+Dedeepya 'Deepu'
+Chinnam
+Business, Economics, and
+Statistics
+25
+Ethnic Grocers and
+Resturaunts
+African
+European
+Latin
+Maru Grocers
+8353 Park Ln Dallas, TX
+75231
+Affribean Market
+ 2717 E Belt Line Rd Apt 109,
+Carrollton, TX
+9724160701
+Desta Ethipoian
+12101 Greenville Ave Ste
+105 Dallas, TX 75243
+Asian
+Hong Kong Market
+9780 Walnut St Dallas, TX
+75243
+Thai Oriental Food
+Store
+5615 Sears St Dallas, TX
+75206
+Patel Brothers
+8150 Walton Blvd Irving, TX
+75063
+Gui-Rock Korean BBQ
+2625 Old Denton Rd Ste 700
+Carrollton, TX 75007
+Royal Thai
+5500 Greenville Ave Ste 608
+Dallas, TX 75206
+Cafe Madrid
+4501 Travis St Dallas, TX
+75205
+Bavarian Grill
+221 W Parker Rd Ste 527
+Plano, TX 75023
+Wooden Spoon
+Scandinavian Shop
+1617 K Ave Plano, TX 75074
+Middle
+Eastern
+Cafe Istanbul
+7300 Lone Star Dr Ste 160
+C Plano, TX 75024
+Ali Baba Mediterranean
+Grill
+2103 N Central Expy
+Richardson, TX 75080
+Jasmine Market & Café
+820 S Sherman St, Richardson, TX
+75081
+9724374522
+Haji Foods Market & Deli
+4621 W Park Blvd Ste 108
+Plano, TX 75093
+El Rio Grande Latin
+Market
+5308 Maple Ave Dallas, TX
+75235
+Fiesta Mart
+5334 Ross Ave Dallas, TX
+75206
+Nazca Kitchen
+8041 Walnut Hill Ln Ste 854
+Dallas, TX 75231
+La Michoacana Meat
+Market
+6770 Greenville Ave, Dallas, TX
+75231
+For more
+information and
+reviews of Dallas
+Restaurants,
+please visit: Yelp,
+Zomato, or Guide
+Live
+26
+Post Office
+SMU has a conveniently located mail center in
+Hughes-Trigg Student Center where you can
+send letters and if you live on-campus you can
+pick-up packages. The on-campus post office
+also offers international shipping and mailing
+supplies such as envelopes, stamps, and boxes.
+Front Counter Hours
+Monday - Friday
+8:00 AM - 4:30 PM
+Mail PIck Up
+Monday - Friday
+8:00 AM - 5:30 PM
+Saturday
+11:00 AM - 2:00 PM
+For questions email postoffice@smu.edu or call 214-768-4450.
+Copy Center
+The copy center, located next to the Post
+Office in Hughes-Trigg student Center,
+prints posters, yard signs, booklets,
+resumes, and projects.
+Copy Services
+Monday - Friday
+8:00 AM - 5:00 PM
+For questions or job
+submissions email
+copycentral@smu.edu or
+call 214-768-7901
+Learn more at the SMU Mail and Copy Center website.
+27
+s
+e
+i
+t
+i
+l
+i
+c
+a
+F
+l
+i
+a
+M
+s
+u
+p
+m
+a
+C
+-
+n
+O
+Banking in the U.S.
+Below is a list of major banks near the SMU campus:
+28
+Phones in the U.S.
+Information about some companies that offer local phone
+service in the DFW area is provided below.
+Research more options on Google!
+29
+Important Contact Information
+United States Emergency
+Phone Number:
+911
+Campus Police:
+214-768-3333
+Campus Police
+(Non-Emergency):
+214-768-3388
+International Student
+& Scholar Services:
+214-768-4475
+isss@smu.edu
+ISSS Document Pick-Up Hours:
+Monday to Friday:
+9:00 AM - 4:00 PM
+Wednesdays: 10:00 AM - 4:00 PM
+ISSS Virtual Advising Hours:
+Monday to Thursday:
+Virtual: 9:00 AM -11:00 AM
+In-person: 2:00 PM - 4:00 PM
+SMU IT Help Desk:
+214-768-4357
+help@smu.edu
+help.smu.edu
+Bob Smith Health Center:
+Medical Services:
+214-768-2141
+Nurse Advice:
+214-768-3194
+Pharmacy:
+214-768-2149
+Counseling Services:
+214-768-2277
+Health Education:
+214-768-2393
+Violence Prevention and
+Support Services:
+214-768-4512
+SMU General Helpline:
+214-768-2000
+What's the difference between U.S. emergency number and the
+campus police?
+Campus police are real police officers that deal specifically with campus
+safety. They monitor and patrol campus 24 hours a day to ensure SMU is
+a safe place! Call the campus police when there is an incident on-
+campus.
+Learn more (including how to report an incident) at smu.edu/BusinessFinance/Police 30
+The ISSS office is looking forward to
+welcoming you to SMU. If you have any
+questions, please do not hesitate to
+contact us at isss@smu.edu.
+You Are Welcome Here.

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+    "resize_r1_20.pdf"
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-P R E S E N T S
-Dr. Mufa T. Ghadiali is skilled in all aspects of General Surgery.
-His General Surgery Services include:
-General Surgery
-Advanced Laparoscopic Surgery
-Surgical Oncology
-Gastrointestinal Surgery
-Hernia Surgery
-Endoscopy
-Barium Swallow
-Multimedia Health Education
-Disclaimer
-This film is an educational resource only and should not be used to make a
-decision on Barium Swallow. All such decisions must be made in
-consultation with a physician or licensed healthcare provider.
-Mufa T. Ghadiali, M.D., F.A.C.S
-Diplomate of American Board of Surgery
-6405 North Federal Hwy., Suite 402
-Fort Lauderdale, FL 33308
-Tel.: 954-771-8888
-Fax: 954- 491-9485
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-MULTIMEDIA HEALTH EDUCATION MANUAL
-TABLE OF CONTENTS
- SECTION
- CONTENT
-1 .  Introduction
-a.   What is a Barium Swallow?
-b.   Why is Barium used with X-rays?
-2 .  Purpose of Barium Swallow
-a.  Why is Barium Swallow Test Performed?
-3 .  Procedure
-a.   How is a Barium Swallow Test Performed?
-b.   What are the Risks?
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-INTRODUCTION
-This film is an educational resource only and should not be used to make a
-decision on Barium Swallow. All such decisions must be made in consultation
-with a physician or licensed healthcare provider.
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-Unit 1:
-Introduction
-What is a Barium Swallow?
-A barium swallow is a radiographic (X-
-ray) examination of the upper
-gastrointestinal (GI) tract.
-The  test  may  be  used  to  determine  the
-cause of
-Painful swallowing
-Difficulty with swallowing
-Abdominal pain
-Bloodstained vomit, or
-Unexplained weight loss
-(Refer fig. 1)
-Why is Barium used with X-rays?
-Barium sulfate is a metallic compound
-that shows up on X-ray and is used to
-help see abnormalities in the esophagus
-and stomach.
-When taking a barium swallow test, you
-will be asked to drink a preparation
-containing this solution. Barium is a dry,
-white, chalky, metallic powder that is
-mixed with water to make a thick,
-milkshake-like drink.
-The X-rays track the barium as it moves
-through your digestive system. Barium is
-an X-ray absorber that appears white on
-X-ray film.
-When swallowed, the barium solution
-coats the inside walls of the pharynx and
-esophagus and shows differences that
-might not be seen on standard X-rays.
-Barium is used only for diagnostic studies
-of the GI tract.
-(Refer fig. 2 & 3)
-(Fig.1)
-(Fig.2)
-(Fig.3)
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-Unit 2:
-Unit 2:
-Purpose of Barium Swallow
-Why is Barium Swallow Test Performed?
-A barium swallow may be performed to
-diagnose structural or functional
-abnormalities of the pharynx and
-esophagus.
-These abnormalities may include, but are
-not limited to, the following:
-(Fig.4)
-Disorders of swallowing
-Narrowing or irritation of the esophagus
-Hiatal hernia
-Abnormally enlarged veins in the esophagus that cause bleeding
-Ulcers
-Tumors
-Polyps (growths that are usually not cancerous, but could be precancerous)
-(Refer fig. 4)
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-Unit 3:
-Unit 3:
-Unit 1:
-Procedure
-Procedure
-Introduction
-How is a Barium Swallow
-Test Performed?
-Before the Procedure :
-You will be asked to fast for eight hours
-before the procedure,
-generally after midnight.
-If you are pregnant or suspect that you
-may be pregnant, you should
-notify your physician.
-(Fig.5)
-Notify your physician if you are sensitive to or are allergic to any medications, latex, tape, or
-anesthetic agents.
-Notify the radiologist if you have had a recent barium X-ray or cholangiography procedure, as this
-may interfere with obtaining an optimal X-ray exposure of the upper GI area.
-(Refer fig. 5)
-During the Procedure:
-You will be asked to remove any clothing,
-jewelry, or other objects that may
-interfere with the procedure.
-You  will  be  positioned  on  an  X-ray  table
-that  can  tilt  you  from  a  horizontal  to  an
-upright position. You may also be asked to
-change  positions  at  intervals  during  the
-procedure.
-Standard chest and abdominal X-rays may
-be performed first.
-(Fig.6)
-The radiologist will ask you to drink about 1 1/2 cups of a barium preparation-a chalky drink with
-the consistency of a milk shake.
-X-rays will be taken again as the barium moves through the digestive system. You will be
-asked to take more swallows so more pictures can be taken.
-As the barium moves down your digestive system, the table will be tilted at various angles
-to help spread the barium for different views. Pressure may be applied to your abdomen
-to spread the barium.
-The barium swallow procedure can take anywhere from 30-60 minutes to finish.
-(Refer fig. 6)
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-Unit 1:
-Unit 3:
-Introduction
-Procedure
-After the Procedure:
-You can resume your normal diet after going home unless you are advised otherwise by your
-doctor.
-Because the barium is white, your stools will be chalky and light-colored for 1-3 days. Do not
-be concerned about this.
-You should drink lots of fluids to help flush the barium from your system and to prevent
-constipation.
-Eating foods with lots of roughage and fiber such as raw fruits and raw vegetables will also
-help in preventing constipation from the barium solution.
-What are the Risks?
-A barium swallow is generally a safe test,
-but like any procedure,there are
-occasionally complications. Your doctor
-should be advised of problems so you
-can be treated right away.
-Following are some of the general
-complications:
-Allergic reaction or anaphylaxis may
-occur in people who are allergic to the
-barium drink.
-(Fig.7)
-If you are pregnant or suspect that you may be pregnant, you should notify your physician.
-Radiation exposure during pregnancy may lead to birth defects.
-Constipation or fecal impaction may occur if the barium is not completely eliminated from the
-body.
-(Refer fig. 7)
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-Unit 1:
-Unit 3:
-Introduction
-Disclaimer
-Although every effort is made to educate you on BARIUM SWALLOW and take control, there
-will be specific information that will not be discussed. Talk to your doctor or health care
-provider about any concerns you have about BARIUM SWALLOW.
-www.ghadialisurgery.com
-Barium Swallow
-Multimedia Health Education
-YOUR SURGERY DATE
-READ YOUR BOOK AND MATERIAL
-VIEW YOUR VIDEO /CD / DVD / WEBSITE
-PRE - HABILITATION
-ARRANGE FOR BLOOD
-MEDICAL CHECK UP
-ADVANCE MEDICAL DIRECTIVE
-PRE - ADMISSION TESTING
-FAMILY SUPPORT REVIEW
-Physician's Name :
-Physician's Signature:
-Date :
-Patient’s Name :
-Patient’s Signature:
-Date :
-www.ghadialisurgery.com

+ACR–SPR PRACTICE PARAMETER FOR THE
+PERFORMANCE OF THE MODIFIED BARIUM
+SWALLOW
+The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists,
+radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional
+society whose primary purposes are to advance the science of radiology, improve radiologic services to the
+patient, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for
+radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields.
+Revised 2023 (Resolution 18)*
+The American College of Radiology will periodically define new practice parameters and technical standards for
+radiologic practice to help advance the science of radiology and to improve the quality of service to patients
+throughout the United States. Existing practice parameters and technical standards will be reviewed for revision
+or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.
+Each practice parameter and technical standard, representing a policy statement by the College, has undergone a
+thorough consensus process in which it has been subjected to extensive review and approval. The practice
+parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic
+radiology requires specific training, skills, and techniques, as described in each document. Reproduction or
+modification of the published practice parameter and technical standard by those entities not providing these
+services is not authorized.
+  PREAMBLE
+This document is an educational tool designed to assist practitioners in providing appropriate radiologic care for
+patients. Practice Parameters and Technical Standards are not inflexible rules or requirements of practice and are
+not intended, nor should they be used, to establish a legal standard of care1. For these reasons and those set
+forth below, the American College of Radiology and our collaborating medical specialty societies caution against
+the use of these documents in litigation in which the clinical decisions of a practitioner are called into question.
+The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the
+practitioner considering all the circumstances presented. Thus, an approach that differs from the guidance in this
+document, standing alone, does not necessarily imply that the approach was below the standard of care. To the
+contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in this
+document when, in the reasonable judgment of the practitioner, such course of action is indicated by variables
+such as the condition of the patient, limitations of available resources, or advances in knowledge or technology
+after publication of this document. However, a practitioner who employs an approach substantially different from
+the guidance in this document may consider documenting in the patient record information sufficient to explain
+the approach taken.
+The practice of medicine involves the science, and the art of dealing with the prevention, diagnosis, alleviation,
+and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the
+most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be
+recognized that adherence to the guidance in this document will not assure an accurate diagnosis or a successful
+outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on
+current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care.
+The purpose of this document is to assist practitioners in achieving this objective.
+_________________________________________________________________________________________________
+1 Iowa Medical Society and Iowa Society of Anesthesiologists v. Iowa Board of Nursing, 831 N.W.2d 826 (Iowa
+2013) Iowa Supreme Court refuses to find that the "ACR Technical Standard for Management of the Use of Radiation in
+Fluoroscopic Procedures (Revised 2008)" sets a national standard for who may perform fluoroscopic procedures in light of the
+standard’s stated purpose that ACR standards are educational tools and not intended to establish a legal standard of care. See
+also, Stanley v. McCarver, 63 P.3d 1076 (Ariz. App. 2003) where in a concurring opinion the Court stated that “published
+standards or guidelines of specialty medical organizations are useful in determining the duty owed or the standard of care
+applicable in a given situation” even though ACR standards themselves do not establish the standard of care.
+ I.  INTRODUCTION
+The modified barium swallow (MBS) or videofluoroscopic swallow study is a proven and useful procedure for
+evaluating oral and pharyngeal swallowing function and airway protection [1-6]. Although it is used primarily for
+the evaluation of function, structural abnormalities may also be revealed and may be a primary cause of
+swallowing dysfunction. A tailored MBS focusing primarily on function may be performed . Because symptoms of
+dysphagia are often poorly localized, a complete evaluation of these symptoms may require spot film images of
+the pharynx for structural assessment or an esophagram in addition to an MBS. For the purposes of this practice
+parameter, MBS focuses on the assessment of the functional swallowing regions including the oral cavity,
+pharynx, larynx, and pharyngoesophageal junction . For evaluation of the esophagus, see the  ACR Practice
+Parameter for the Performance of Esophagrams and Upper Gastrointestinal Examinations in Adults [7] and the
+ACR–SPR Practice Parameter for the Performance of Contrast Esophagrams and Upper Gastrointestinal
+Examinations in Infants and Children [8].
+The MBS may be performed because of known or suspected swallowing dysfunction or because of the presence
+of conditions that are strongly associated with swallowing dysfunction. The MBS should be performed only for a
+valid medical reason and with the minimum radiation dose necessary to achieve a study of diagnostic quality [9].
+Additional or specialized examinations may be required to complete the patient’s assessment.
+The primary purposes of the MBS include the following: identify and distinguish the presence, type, and
+estimated severity of physiologic swallowing impairment; determine the safety of oral intake (airway protection);
+determine the efficiency of oral intake (clearance); detail the effects of selected frontline interventions (postures,
+maneuvers, bolus variables) on swallowing physiology, airway protection, and efficiency; identify indications for
+specific interventions that may be appropriate for the clinical condition of the patient; and develop intake (oral,
+tube, etc) and diet texture/nutritional management plans in collaboration with the physician and other
+interdisciplinary team members [10].
+Although it is not possible to detect all structural and functional swallowing abnormalities using the MBS,
+adherence to the following practice parameter will maximize the probability of their detection.
+ II.  INDICATIONS AND CONTRAINDICATIONS
+Indications for the MBS include, but are not limited to:
+1.
+2.
+3.
+4.
+5.
+6.
+7.
+8.
+9.
+10.
+11.
+12.
+Oropharyngeal dysphagia
+Coughing, choking, or drooling
+Known or suspected aspiration or aspiration pneumonia
+Frequent respiratory tract infections
+Neurologic or neurodegenerative disorders likely to affect swallowing
+Myoneural junction disorders likely to affect swallowing
+Pulmonary conditions possibly related to swallowing dysfunction
+Myopathy or nerve injury involving the pharynx, cervical esophagus, or upper airway
+Masses of the tongue, pharynx, larynx, or retropharyngeal region that may affect swallowing
+Preoperative and follow-up posttreatment (operative, radiation, and/or chemotherapy) evaluation of the
+mouth, pharynx, larynx, retropharyngeal, or pharyngo-esophageal junction area [11-13]
+Follow-up of known oropharyngeal swallowing dysfunction
+Follow-up assessment of dietary restrictions and protective maneuvers to limit or prevent aspiration
+Practice Parameter1Modified Barium Swallow13.
+14.
+15.
+16.
+17.
+18.
+19.
+20.
+Follow-up assessment of patients recovering from trauma and/or coma
+Oral feeding safety assessment for ventilator-dependent patients [14]
+Poor feeding, sucking, swallowing (neonate)
+Patients with basilar pulmonary fibrosis
+After prolonged intubation and/or deconditioning
+Prior abnormal MBS with subsequent modification of swallow technique or improvement in patient
+conditioning
+Nasal stuffiness or noisy breathing that worsens with feeding (pediatrics)
+Laryngotracheal cleft
+For the pregnant or potentially pregnant patient, see the ACR–SPR Practice Parameter for Imaging Pregnant or
+Potentially Pregnant Patients with Ionizing Radiation [15,16].
+Potential Contraindications
+1.
+2.
+Known or suspected leak from the pharynx or esophagus such as following trauma or surgery. If a leak is
+suspected, an esophagram using nonionic low osmolar water-soluble contrast material should be
+performed before MBS.
+Known or suspected tracheoesophageal fistula. If suspected, an esophagram using low osmolar water-
+soluble contrast material should be performed before MBS.
+ III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
+A. Physician
+Examinations must be performed by or under the supervision of a licensed physician and interpreted by a
+physician with the following qualifications:
+Certification in Radiology, Diagnostic Radiology or Interventional Radiology/Diagnostic Radiology (IR/DR) by the
+American Board of Radiology , the American Osteopathic Board of Radiology, the Royal College of Physicians and
+Surgeons of Canada, or the Collège des Médecins du Québec.
+or
+Completion of a residency program approved by the Accreditation Council for Graduate Medical Education , the
+Royal College of Physicians and Surgeons of Canada , the Collège des Médecins du Québec, or the American
+Osteopathic Association and must have documented formal training in the performance and interpretation of
+gastrointestinal fluoroscopy, including MBS.
+and
+The physician shall have documented training in and understanding of the physics of diagnostic radiology and the
+equipment needed to produce the images. This should include radiography, fluoroscopy, and digital image
+processing. In addition, the physician must be familiar with the principles of radiation protection, the hazards of
+radiation, and radiation monitoring requirements as they apply to both patients and personnel.
+and
+The physician shall have documented training in and understanding of the value of MBS examinations and
+oropharyngeal swallowing function relative to other medical imaging procedures (general radiography,
+fluoroscopy, CT, ultrasound, MRI, and nuclear medicine) to best evaluate a patient’s clinical symptoms.
+Continuing Medical Education
+The physician’s continuing medical education should be in accordance with the ACR Practice Parameter for
+Continuing Medical Education (CME) [17].
+ III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
+Practice Parameter2Modified Barium SwallowB. Non-Physician Radiology Provider (NPRP)
+NPRPs are all Non-Physician Providers (e.g., RRA, RPA, RA, PA, NP, ...) who assist with or participate in portions of
+the practice of a radiologist-led team (Radiologists = diagnostic, interventional, neurointerventional radiologists,
+radiation oncologists, and nuclear medicine physicians). The term “NPRP” does not include radiology, CT, US, NM
+MRI technologists, or radiation therapists who have specific training for radiology related tasks (e.g., acquisition of
+images, operation of imaging and therapeutic equipment) that are not typically performed by radiologists.
+The term 'radiologist-led team' is defined as a team supervised by a radiologist (i.e., diagnostic, interventional,
+neurointerventional radiologist, radiation oncologist, and nuclear medicine physician) and consists of additional
+healthcare providers including RRAs, PAs, NPs, and other personnel critical to the provision of the highest quality
+of healthcare to patients. (ACR Resolution 8, adopted 2020).
+ III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
+C.  Radiologic Technologist
+Qualifications of technologists performing GI radiography should be in accordance with the current ACR policy
+statement for fluoroscopy[2] and with the operating procedures or manuals at the imaging facility. Fluoroscopy
+technologists assisting in MBS examinations should be thoroughly trained in GI radiography.Certification by the
+American Registry of Radiologic Technologists (ARRT) or unrestricted state licensure is required.
+______________________________________________________________________________________________
+[2]The American College of Radiology approves of the practice of certified and/or licensed radiologic technologists
+performing fluoroscopy in a facility or department as a positioning or localizing procedure only, and then only if
+monitored by a supervising physician who is personally and immediately available.* There must be a written
+policy or process for the positioning or localizing procedure that is approved by the medical director of the facility
+or department/service and that includes written authority or policies and processes for designating radiologic
+technologists who may perform such procedures. (ACR Resolution 26, 1987 – revised in 2007, Resolution 12-m)
+*For the purposes of this parameter, "personally and immediately available” is defined in manner of the "personal
+supervision” provision of CMS—a physician must be in attendance in the room during the performance of the
+procedure. Program Memorandum Carriers, DHHS, HCFA, Transmittal B-01-28, April 19, 20
+ III.  QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
+D.  Speech-Language Pathologist
+A speech-language pathologist may also be involved in the performance and interpretation of MBS studies, in
+conjunction with the radiologist. This professional should have specific education and training related to the
+indications and to the performance and interpretation of the MBS using validated and standardized methods. It is
+recommended that the individual hold the Certificate of Clinical Competence in Speech-Language Pathology from
+the American Speech-Language-Hearing Association. The speech-language pathologist should have knowledge of
+the patient’s medical condition and current cognitive and mental status.
+ IV.  SPECIFICATIONS OF THE EXAMINATION
+The written or electronic request for modified barium swallow should provide sufficient information to
+demonstrate the medical necessity of the examination and allow for its proper performance and interpretation.
+Documentation that satisfies medical necessity includes 1) signs and symptoms and/or 2) relevant history
+(including known diagnoses). Additional information regarding the specific reason for the examination or a
+provisional diagnosis would be helpful and may at times be needed to allow for the proper performance and
+interpretation of the examination.
+The request for the examination must be originated by a physician or other appropriately licensed health care
+provider. The accompanying clinical information should be provided by a physician or other appropriately licensed
+health care provider familiar with the patient’s clinical problem or question and consistent with the state’s scope
+Practice Parameter3Modified Barium Swallowof practice requirements. (ACR Resolution 35 adopted in 2006 – revised in 2016, Resolution 12-b)
+ IV. SPECIFICATIONS OF THE EXAMINATION
+A. Patient Selection, Preparation, and Positioning
+The patient must have sufficient cognitive awareness to cooperate with the study. The swallowing functions are
+usually evaluated initially in the lateral plane with the patient upright with gravity assistance to mimic the eating
+and drinking position. The lateral view may be followed by frontal view observations whenever positioning allows
+to provide evaluation of symmetry of swallowing function. Stable, commercially prepared barium and validated,
+standard protocols are encouraged to optimize visualization and reproducibility of the MBS and comparison of
+findings across sites [18-20]. Special chairs are available to assist with patient positioning if the patient is unable to
+stand or sit upright unsupported, but they are not necessary to perform an adequate study. For infants, the MBS
+should be performed with the patient upright and sitting supported in a secured chair/seat preferentially designed
+for oropharyngeal motility studies. For patients who cannot be placed upright, a semi-upright swallowing study
+can be performed with the patient placed in the lateral decubitus position on the fluoroscopy table and the table
+tilted as close to upright as the patient can tolerate.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+B. Personnel
+The examination may be performed by a physician alone (or an NPRP with physician supervision) for diagnostic
+evaluation or by a physician (or an NPRP with physician supervision) and a speech-language pathologist for both
+diagnosis and recommendation regarding therapy.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+C. Method of Recording
+For functional assessment, the fluoroscopic portion of the examination should be recorded on high-resolution
+videofluorographic (VF) and/or rapid digital fluorographic imaging [10,21]. For morphologic assessment, spot
+images and/or rapid digital fluorographic imaging with double-contrast or single-contrast technique should be
+used .
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+1. Examination
+The examination should include evaluation of oral, nasopharyngeal, pharyngeal, laryngeal, and
+pharyngoesophageal segment function and morphology in the lateral projection. Evaluation in the frontal
+projection may be useful to view symmetry of function and effects of applied compensatory strategies on
+swallowing safety and bolus clearance. Observation of the esophagus in the frontal projection to ensure
+unimpeded pharyngo-esophageal drainage may be helpful. It is important to recognize that the assessment of
+gravity-assisted pharyngo-esophageal clearance of barium during MBS is a limited assessment and does not imply
+the esophagus is normal. Depending on patient symptoms and findings (or lack of findings) on MBS, an
+esophagram may be required to complete the assessment of the patient. [22-25]. The examination may need to
+be terminated prematurely if the patient demonstrates severe aspiration (such as aspiration below the sternal
+notch) and does not respond to protective or therapeutic maneuvers.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+2. VF recording medium
+It is recommended that VF and/or rapid digital fluorographic recordings are performed while the patient is
+administered barium consistencies and volumes customized for the MBS and that approximate the consistencies
+of liquids and food in an oral diet to detect swallowing impairment. Use of a standardized and validated set of
+commercially prepared barium consistencies and volumes is recommended whenever possible, to ensure the
+Practice Parameter4Modified Barium Swallowability to reproduce or compare repeat evaluation results, risks associated with aspiration of these substances,
+and infection control issues [26]. . If aspiration occurs, the patient’s response to aspiration and ability to clear the
+aspirated materials and response to protective and therapeutic maneuvers should be assessed wherever possible.
+The literature supports a fluoroscopic acquisition rate of 30 pulses per second or continuous fluoroscopy
+whenever possible to provide optimal visualization of rapid movements associated with swallowing and aspiration
+detection. [9,27,28]. However, fluoroscopic acquisition rates should be determined by the supervising radiologist
+with attention to optimally minimizing the patient’s radiation exposure and maximizing adequate swallowing
+evaluation.
+a.
+b.
+Spot radiographs
+Spot radiographs are not needed for all patients. When obtained, double-contrast spot radiographs and/or
+rapid digital fluorographic images of the pharynx may include lateral views during both suspended
+respiration and phonation and frontal views during both suspended respiration and modified Valsalva
+maneuver. Single-contrast radiographs and/or rapid digital fluorographic images may be substituted if
+warranted by the patient’s clinical condition. For pediatric patients, spot radiographs and double contrast
+examinations are seldom necessary.
+Esophagram
+An evaluation of esophageal structure and function is beyond the scope of the MBS, which is focused on
+assessment of functional swallowing in the areas of the oral cavity, pharynx, larynx, and pharyngo-esophageal
+junction. For evaluation of the esophagus, see the ACR Practice Parameter for the Performance of Esophagrams
+and Upper Gastrointestinal Examinations in Adults [7] and the ACR–SPR Practice Parameter for the Performance
+of Contrast Esophagrams and Upper Gastrointestinal Examinations in Infants and Children [8]. In cases of
+significant aspiration, the esophagram may be performed with an injection of contrast material directly into the
+esophagus through a feeding tube, either pre-existing or placed by the radiologist.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+3. Tailored Examination
+The method of examination may vary based on the patient’s history, the clinical questions to be answered, and
+the findings during the study; however, standard protocols, assessment, interpretation, and reporting are
+encouraged [19].
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+4. Protective and therapeutic measures
+When aspiration does occur, the effect of maneuvers to limit or prevent aspiration may be assessed. These may
+include changes in neck or body position or other special maneuvers. If swallowing dysfunction is present,
+additional compensatory strategies may be assessed to improve swallow physiology [14].
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+5. Provocative maneuvers
+When the patient’s symptoms are not explained by the standard examination, provocative or helpful maneuvers
+based on the history may be needed. Changes in head or body position may be used to evoke subtle swallowing
+dysfunction, including head turn or flexion . Similarly, a change in the position of an infant’s head (flexion) may
+also be useful, once aspiration has been shown, to determine if head position eliminates aspiration.
+In the event of aspiration during the study, frontal chest radiography may be helpful at the end of the examination
+to document or determine the extent of aspiration.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+D. MBS Technique
+Practice Parameter5Modified Barium Swallow6. Pediatric considerations
+The examination may be tailored for pediatric patients, these considerations include:
+1.
+2.
+3.
+4.
+5.
+6.
+Pulsed fluoroscopy, preferably at 15 frames per second, is recommended to reduce the radiation dose.
+Use of barium mixed with home or in-house food products of various consistencies (eg, milk, barium
+cookie) to ensure palatability and patient cooperation
+Use of various nipples to meter flow of liquids and bolus size for bottle-fed children
+Use of unique cups and straws to meter flow of liquids and bolus size for children who drink from a cup
+Use of pediatric chairs of various sizes to optimize positioning during the examination. Note that neonates
+who are not able to sit upright may be imaged in a right lateral decubitus position with the table tilted
+upwards
+Images should be collimated superiorly to include the nasopharynx but exclude the orbits. This positioning
+balances the ability to identify nasopharyngeal reflux but excludes the radiation sensitive lens.
+ IV. SPECIFICATIONS OF THE EXAMINATION
+E. Radiographic Quality Control
+Proper functioning of the imaging equipment should be assured before beginning the examination. If spot images
+are obtained, image quality should be checked by a qualified technologist or physician before the patient is
+dismissed. Images not of diagnostic quality should be repeated as necessary. Provision should be made for
+recording all available radiation dose data in the patient’s medical record. If cumulative air kerma or air kerma-
+area-product data are not available, the fluoroscopic exposure time and the number of acquired images
+(radiography or cine) should be recorded in the patient’s medical record, according to the ACR–AAPM Technical
+Standard for Management of the Use of Radiation in Fluoroscopic Procedures [29].
+ V. DOCUMENTATION
+Reporting should be in accordance with the ACR Practice Parameter for Communication of Diagnostic Imaging
+Findings [30].
+When the examination is performed by a radiologist, a supervised resident or fellow, or a qualified supervised
+NPRP and a speech-language pathologist, the images should be reviewed by the performing team with a
+discussion of the findings and conclusions agreed upon by them. This should be done out of hearing of the patient.
+If there are any discordant opinions not resolved by image review, additional imaging should be performed.
+Comparison to prior MBS studies should be performed when relevant, particularly when the examination is
+performed to follow up previously demonstrated abnormalities. Patient identity (using name and/or a unique
+identifying number) and examination date should be recorded on the VF recording medium. Each institution
+should develop a policy on retention and reporting results of video images, which are considered part of the
+medical record consistent with applicable state or federal policies. It is recommended that the radiologist and
+speech-language pathologist corroborate findings at the conclusion of the examination [10].
+ VI. EQUIPMENT SPECIFICATIONS
+Examinations should be performed with fluoroscopic and radiographic equipment meeting all applicable federal,
+state, and local regulations. The equipment should be part of a Quality Management (QM)/Quality Control (QC)
+Program. The QM/QC program should include an annual survey by a medical physicist. The fluoroscopic and
+recorded images should be of diagnostic quality. In selected cases, patient monitoring may be desirable. However,
+most patients do not require any additional monitoring other than that which may already be in use.
+Equipment performance monitoring should be in accordance with the ACR–AAPM Technical Standard for
+Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment [18] and the ACR–AAPM
+Technical Standard for Diagnostic Medical Physics Performance Monitoring of Fluoroscopic Equipment [19].
+ VII. RADIATION SAFETY IN IMAGING
+Practice Parameter6Modified Barium SwallowRadiologists, medical physicists, non-physician radiology providers, radiologic technologists, and all supervising
+physicians have a responsibility for safety in the workplace by keeping radiation exposure to staff, and to society
+as a whole, "as low as reasonably achievable” (ALARA) and to assure that radiation doses to individual patients are
+appropriate, taking into account the possible risk from radiation exposure and the diagnostic image quality
+necessary to achieve the clinical objective. All personnel who work with ionizing radiation must understand the
+key principles of occupational and public radiation protection (justification, optimization of protection, application
+of dose constraints and limits) and the principles of proper management of radiation dose to patients
+(justification, optimization including the use of dose reference levels). https://www-
+pub.iaea.org/MTCD/Publications/PDF/PUB1775_web.pdf
+Nationally developed guidelines, such as the ACR’s Appropriateness Criteria®, should be used to help choose the
+most appropriate imaging procedures to prevent unnecessary radiation exposure.
+Facilities should have and adhere to policies and procedures that require ionizing radiation examination protocols
+(radiography, fluoroscopy, interventional radiology, CT) to vary according to diagnostic requirements and patient
+body habitus to optimize the relationship between appropriate radiation dose and adequate image quality.
+Automated dose reduction technologies available on imaging equipment should be used, except when
+inappropriate for a specific exam. If such technology is not available, appropriate manual techniques should be
+used.
+Additional information regarding patient radiation safety in imaging is available from the following websites –
+Image Gently® for children (www.imagegently.org) and Image Wisely® for adults (www.imagewisely.org). These
+advocacy and awareness campaigns provide free educational materials for all stakeholders involved in imaging
+(patients, technologists, referring providers, medical physicists, and radiologists).
+Radiation exposures or other dose indices should be periodically measured by a Qualified Medical Physicist in
+accordance with the applicable ACR Technical Standards. Monitoring or regular review of dose indices from
+patient imaging should be performed by comparing the facility’s dose information with national benchmarks, such
+as the ACR Dose Index Registry and relevant publications relying on its data, applicable ACR Practice Parameters,
+NCRP Report No. 172, Reference Levels and Achievable Doses in Medical and Dental Imaging: Recommendations
+for the United States or the Conference of Radiation Control Program Director’s National Evaluation of X-ray
+Trends; 2006, 2009, amended 2013, revised 2023 (Res. 2d).
+ VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION
+Policies and procedures related to quality, patient education, infection control, and safety should be developed
+and implemented in accordance with the ACR Policy on Quality Control and Improvement, Safety, Infection
+Control, and Patient Education appearing under the heading Position Statement on Quality Control &
+Improvement, Safety, Infection Control, and Patient Education on the ACR website
+(https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Quality-Control-and-Improvement).
+  ACKNOWLEDGEMENTS
+This practice parameter was revised according to the process described under the heading The Process for
+Developing ACR Practice Parameters and Technical Standards on the ACR website (https://www.acr.org/Clinical-
+Resources/Practice-Parameters-and-Technical-Standards) by the Committee on Body Imaging (Abdominal) of the
+ACR Commission on Body Imaging and the Committee on Practice Parameters – General, Small, Emergency and/or
+Rural Practice of the ACR Commission on General, Small, Emergency and/or Rural Practice and the Committee on
+Practice Parameters – Pediatric Radiology of the ACR Commission of Pediatric Radiology, in collaboration with the
+SPR.
+Writing Committee – members represent their societies in the initial and final revision of this practice parameter
+ACR
+SPR
+Practice Parameter7Modified Barium SwallowMary Ann Turner, MD, FACR, FSAR, Chair
+Ann D. Schechter, MD
+Jesse Berman, MD
+Priya G. Sharma, MD
+Laura R. Carucci, MD, FACR, FSAR
+David J. DiSantis, MD, FACR, FSAR
+Meg Fynes, MD
+Francis J. Scholz, MD, FACR, FSAR
+Ellen L. Wolf, MD, FACR, FSAR, FAAWR
+Jessica G. Zarzour, MD, FSAR
+Committee on Body Imaging - Abdominal
+(ACR Committee responsible for sponsoring the draft through the process)
+Benjamin M Yeh, MD, Chair
+Alec J. Megibow, MD, MPH, FACR
+Olga R. Brook, MD
+Achille Mileto, MD
+Laura R. Carucci, MD, FACR
+Erick M. Remer, MD, FACR
+Alice Won-Whai Fung, MD, BA
+Mary A. Turner, MD, FACR
+Alessandro Furlan, MD
+Ellen L. Wolf, MD, FACR
+David Kim, MD, FACR
+Ashish Wasnik, MD
+Diego R. Martin, MD, PhD
+Paula Yeghiayan, MD
+Committee on Practice Parameters – General, Small, Emergency and/or Rural Practices (GSER)
+Practice Parameter8Modified Barium Swallow(ACR Committee responsible for sponsoring the draft through the process)
+Candice A. Johnstone, MD, FACR, Chair
+Nathan J. Rohling, DO
+Justin P. Dodge, MD
+Samir S. Shah, MD
+Brian D. Gale, MD, MBA, FACR
+Derrick Siebert, MD
+Rachel Gerson, MD
+Michael Straza, MD, PhD
+Mallikarjunarao Kasam, PhD
+Committee on Practice Parameters – Pediatric Radiology
+(ACR Committee responsible for sponsoring the draft through the process)
+Terry L. Levin, MD, FACR, Chair
+Hollie A. Lai, MD
+John B. Amodio, MD, FACR
+Lauren P. Nicola, MD
+Bradford W. Betz, MD, FACR
+Sakura Noda, MD
+Harris L. Cohen, MD, FACR
+Erica Poletto, MD
+Michael Collard, MD
+Summit Shah, MD
+Adam Goldman-Yassen, MD
+Andrew T. Trout, MD
+Jane Sun Kim, MD
+Esben S. Vogelius, MD
+Jessica Kurian, MD
+Jason Wright, MD
+Andrew B. Rosenkrantz, MD, FACR, Chair, Commission on Body Imaging
+Mark D. Alson, MD, FACR, Chair, Commission on General, Small, Emergency and/or Rural Practice
+Richard A. Barth, MD, FACR, Chair, Commission on Pediatric Radiology
+Practice Parameter9Modified Barium SwallowDavid B. Larson, MD, MBA, FACR, Chair, Commission on Quality and Safety
+Mary S. Newell, MD, FACR, Chair, Committee on Practice Parameters and Technical Standards
+Comments Reconciliation Committee
+Ivan M. DeQuesada, III, MD, Chair
+Mary S. Newell, MD, FACR
+Derrick Siebert, MD, Co-Chair
+Beverly Newman, MB, BCh, BSc, FACR
+Mark D. Alson, MD, FACR
+Eric M. Remer, MD, FACR
+Richard A. Barth, MD, FACR
+Andrew B. Rosenkrantz, MD, FACR
+Jesse Berman, MD
+Ann D. Schechter, MD
+Michael Booker, MD
+Francis J. Scholz, MD, FACR, FSAR
+Laura R. Carucci, MD, FACR, FSAR
+Priya G. Sharma, MD
+Timothy A. Crummy, MD, FACR
+Elizabeth Tang, MD
+David J. DiSantis, MD, FACR, FSAR
+Alexander J. Towbin, MD
+Meg Fynes, MD
+Mary A. Turner, MD, FACR, FSAR
+Candice A. Johnstone, MD, FACR
+Ellen L. Wolf, MD, FACR, FSAR, FAAWR
+Amy L. Kotsenas, MD, FACR
+Roland Wong, ScM
+David B. Larson, MD, MBA
+Benjamin M. Yeh, MD
+Terry L. Levin, MD, FACR
+Jessica G Zarzour, MD, FSAR
+  REFERENCES
+1.
+2.
+Dodds WJ, Logemann JA, Stewart ET. Radiologic assessment of abnormal oral and pharyngeal phases of
+swallowing. AJR Am J Roentgenol 1990;154:965-74.
+Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of
+swallowing. AJR Am J Roentgenol 1990;154:953-63.
+Practice Parameter10Modified Barium Swallow3.
+4.
+5.
+6.
+7.
+8.
+9.
+10.
+11.
+12.
+13.
+14.
+15.
+16.
+17.
+18.
+19.
+20.
+21.
+22.
+23.
+24.
+25.
+26.
+Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modified barium
+swallow. Dysphagia 2000;15:136-41.
+Rubesin SE. The pharynx. Structural disorders. Radiol Clin North Am 1994;32:1083-101.
+Jones B. The pharynx. Disorders of function. Radiol Clin North Am 1994;32:1103-15.
+Beall J, Hill EG, Armeson K, Garand KLF, Davidson KH, Martin-Harris B. Classification of Physiologic
+Swallowing Impairment Severity: A Latent Class Analysis of Modified Barium Swallow Impairment Profile
+Scores. Am J Speech Lang Pathol 2020;29:1001-11.
+American College of Radiology. ACR Practice Parameter for the Performance of Esophagrams and Upper
+Gastrointestinal Examinations in Adults. Available at: https://www.acr.org/-/media/ACR/Files/Practice-
+Parameters/UpperGIAdults.pdf. Accessed December 17, 2020.
+American College of Radiology. ACR–SPR Practice Parameter for the Performance of Contrast Esophagrams
+and Upper Gastrointestinal Examinations in Infants and Children. Available at: https://www.acr.org/-
+/media/ACR/Files/Practice-Parameters/UpperGI-Infants.pdf. Accessed December 17, 2020.
+Bonilha HS, Wilmskoetter J, Tipnis S, Horn J, Martin-Harris B, Huda W. Relationships Between Radiation
+Exposure Dose, Time, and Projection in Videofluoroscopic Swallowing Studies. Am J Speech Lang Pathol
+2019;28:1053-59.
+Martin-Harris B, Canon CL, Bonilha HS, Murray J, Davidson K, Lefton-Greif MA. Best Practices in Modified
+Barium Swallow Studies. Am J Speech Lang Pathol 2020;29:1078-93.
+Bleier BS, Levine MS, Mick R, et al. Dysphagia after chemoradiation: analysis by modified barium swallow.
+Ann Otol Rhinol Laryngol 2007;116:837-41.
+Nguyen NP, Frank C, Moltz CC, et al. Aspiration risk and postoperative radiation for head and neck cancer.
+Cancer Invest 2009;27:47-51.
+Nguyen NP, Frank C, Moltz CC, et al. Risk of aspiration following radiation for non-nasopharyngeal head and
+neck cancer. J Otolaryngol Head Neck Surg 2008;37:225-9.
+Davis LA, Thompson Stanton S. Characteristics of dysphagia in elderly patients requiring mechanical
+ventilation. Dysphagia 2004;19:7-14.
+Newman LA, Keckley C, Petersen MC, Hamner A. Swallowing function and medical diagnoses in infants
+suspected of Dysphagia. Pediatrics 2001;108:E106.
+American College of Radiology. ACR–SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant
+Patients with Ionizing Radiation Available at: https://www.acr.org/-/media/ACR/Files/Practice-
+Parameters/Pregnant-Pts.pdf. Accessed December 17, 2020.
+American College of Radiology. ACR Practice Parameter for Continuing Medical Education (CME). Available
+at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/CME.pdf. Accessed December 17, 2020.
+Martin-Harris B, Brodsky MB, Michel Y, et al. MBS measurement tool for swallow impairment--MBSImp:
+establishing a standard. Dysphagia 2008;23:392-405.
+Martin-Harris B, Bonilha HS, Brodsky MB, et al. The Modified Barium Swallow Study for Oropharyngeal
+Dysphagia: Recommendations From an Interdisciplinary Expert Panel. Perspectives of the ASHA Special
+Interest Groups 2021;6:610-19.
+Steele C, Martin-Harris, B., Gosa, M., Allen, S. . Applications in Contrast Imaging: Diagnosis and
+Management of Swallowing Physiology: Standardized Contrast, the MBSImP™, & the IDDSI Framework
+Continuing Education Monograph, Applied Radiology, . Available at:
+https://www.appliedradiology.org/aici/. Accessed August, 2021.
+Jones B, Donner MW. Examination of the patient with dysphagia. Radiology 1988;167:319-26.
+Gullung JL, Hill EG, Castell DO, Martin-Harris B. Oropharyngeal and esophageal swallowing impairments:
+their association and the predictive value of the modified barium swallow impairment profile and combined
+multichannel intraluminal impedance-esophageal manometry. Ann Otol Rhinol Laryngol 2012;121:738-45.
+Allen JE, White C, Leonard R, Belafsky PC. Comparison of esophageal screen findings on videofluoroscopy
+with full esophagram results. Head & neck 2012;34:264-9.
+Miles A, McMillan J, Ward K, Allen J. Esophageal visualization as an adjunct to the videofluoroscopic study
+of swallowing. Otolaryngol Head Neck Surg 2015;152:488-93.
+O'Rourke A, Morgan LB, Coss-Adame E, Morrison M, Weinberger P, Postma G. The effect of voluntary
+pharyngeal swallowing maneuvers on esophageal swallowing physiology. Dysphagia 2014;29:262-8.
+Hazelwood RJ, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B. Identification of Swallowing Tasks From a
+Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment. J Speech Lang
+Practice Parameter11Modified Barium Swallow27.
+28.
+29.
+30.
+Hear Res 2017;60:1855-63.
+Bonilha HS, Humphries K, Blair J, et al. Radiation exposure time during MBSS: influence of swallowing
+impairment severity, medical diagnosis, clinician experience, and standardized protocol use. Dysphagia
+2013;28:77-85.
+Mulheren RW, Azola A, González-Fernández M. Do Ratings of Swallowing Function Differ by
+Videofluoroscopic Rate? An Exploratory Analysis in Patients After Acute Stroke. Archives of physical
+medicine and rehabilitation 2019;100:1085-90.
+American College of Radiology. ACR–AAPM Technical Standard for Management of the Use of Radiation in
+Fluoroscopic Procedures. Available at: https://www.acr.org/-/media/ACR/Files/Practice-
+Parameters/MgmtFluoroProc.pdf. Accessed December 17, 2020.
+American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Finding.
+Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/CommunicationDiag.pdf.
+Accessed December 17, 2020.
+*Practice parameters and technical standards are published annually with an effective date of October 1 in the
+year in which amended, revised or approved by the ACR Council. For practice parameters and technical standards
+published before 1999, the effective date was January 1 following the year in which the practice parameter or
+technical standard was amended, revised, or approved by the ACR Council.
+Development Chronology for this Practice Parameter
+2001 (Resolution 30)
+Revised 2006 (Resolution 50, 17, 34, 35, 36)
+Amended 2007 (Resolution 12m)
+Amended 2009 (Resolution 11)
+Revised 2011 (Resolution 49)
+Amended 2014 (Resolution 39)
+Revised 2017 (Resolution 4)
+Amended 2018 (Resolution 44)
+Revised 2023 (Resolution 18)
+Practice Parameter12Modified Barium Swallow

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 COMPETITOR ANALYSIS
-© InnoValor, 2018
-© InnoValor, 2018
-How to use
-Template
-Example
-Competitor Analysis
-A Competitor Analysis helps you to understand your
-competition. It supports you in creating your unique position in
-the market. With this analysis you make an assessment of the
-strengths and weaknesses of your current and potential
-competitors. With a better understanding of your competition
-you can choose and implement effective strategies that will
-improve your competitive advantage.
-Tips for use
-With the Competitor Analysis you analyze your competitors’
-strengths and weaknesses. This tool can easily be used by
-yourself, or with colleagues. Print the template and use the tool
-to create an understanding of your competition.
-Have a look at the example of Fleur Flowers to get an
-understanding of a Competitor Analysis.
-How to use
-With the Competitor Analysis you analyze your competitors’
-strengths and weaknesses. Follow the steps to complete your
-own Competitor Analysis.
-Summarize your target group
-Shortly describe your target group. Who are the customers that
-buy your offering? Make the description as specific as possible. If
-© InnoValor, 2018
-your target group consist of businesses you can mention their
-size, industry or their offering. If your target group consist of
-consumers you can mention their age, goals, gender, education
-level or interests.
-Identify your competitors
-Write the names for up to three competitors in the first row. To
-help you generate this list, think of where your customers would
-go if they cannot buy your product or service.
-Determine competitors’ strengths and weaknesses
-Now think like your customers. Why would a customer go for the
-services of your competitors instead of coming to your company?
-You can describe this by thinking about the offerings of your
-competitors. It would even be better when you visit your
-competitors and experience what their customers experience.
-Write down three strengths of each competitor. Also consider
-why customers would not go to your competitors. Write down
-three weaknesses of each competitor.
-Describe the key findings
-Finally, in the fourth column of the template write down the key
-findings for the strengths. What stands out? What patterns can
-you discover from your competitors? And which opportunities
-can you come up with? Also, write down your key
-findings for the weaknesses. What are the aspects that
-your competitors don’t do well? How could you avoid making
-the same mistakes? What should you do to serve your customers
-in such a way that you differentiate from your competitors in a
-positive way?
-© InnoValor, 2018
-competitor analysis
-name
-target group
-competitors
-most important findings
-s
-h
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-n
-e
-r
-t
-s
-s
-e
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-date
-Example Fleurs Flowers
-industry
-Retail
-products &
-services
-Flowers
-size of
-business
-2 full-timers 2 part-timers
-revenue
-€ 37,000
-location
-Main street - Bloomfield
-Fleurs Flowers is a flower shop in a small town. Fleur sells
-flowers to a small group of regular clients who regularly
-purchase fresh flowers from her shop. Her customers generally
-consist of men and women aged 25. The customers often just
-bought a house and flowers are the perfect way to bring
-atmosphere to the new place. In addition, she has customers
-who buy flowers for birthday and holiday occasions. With
-Valentine’s and Mother's Day she is working overtime to meet
-the demand
-Fleurs Flowers’ competitor analysis
-A company like Fleurs Flowers has a difficult time in today's
-society. She has a physical store that is open during shopping
-hours. Her customers are people who also work at those times.
-These customers search for convenience in their shopping.
-Internet shopping is very popular amongst these people. Fleur
-wants to increase her appeal to her target group. She
-investigates the advantages and disadvantages of the sales
-strategies of her main competitors. For her research Fleur visits
-her competitors and buys their flowers. The results of Fleur’s
-competitor analysis can be read in the example on the next page.
-© InnoValor, 2018
-competitor analysis
-Fleurs Flowers
-name
-target group
-Men or women from 25 years old with an average salary
-fromyouflowers.com
-Lidl
-Valentino flowershop
-competitors
-most important findings
-Offers flowers online
-The price for flowers is low
-Customers can order
-flowers online but have to
-pick them up at the store
-Delivers at home though
-whole the region within 24
-hours
-Customers can buy flowers
-while doing groceries, they do
-not have to visit a different store
-When ordering flowers above a
-certain amount the customer
-will receive a free vase
-Package deals – get a
-discount on a vase when
-flowers are bought
-Everyday there are new flowers
-A lot of time is spend on
-wrapping the flowers as a gift
-An online shop seems to be more
-and more important. Customers
-want to be able to order flowers
-from their home. Customers also
-like it when they get something for
-free or a discount on something
-when they buy flowers
-There is no way that a
-customer can see the flowers
-before they are ordered
-Customers cannot create
-their own piece since the
-flowers are all prearranged
-The price for flowers is higher
-than in other shops
-Ordering flowers is less
-personal
-The flowers are made in mass
-Ordering flowers takes
-quite some time
-Customers cannot create
-their own bouquet of flowers
-Buying flowers is not a special
-occasion since it is been done
-during doing groceries
-The shop is not as much open
-as customers would like, for
-instance it is closed on Mondays
-Customers seem to think that
-buying flowers is a personal and
-special occasion. They do not like
-it when buying flowers is less
-personal. They also do not like that
-they cannot create their own
-bouquet
 s
-h
 t
-g
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-s
-s
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-k
-a
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-w
-date

 COMPETITOR ANALYSIS
+John A. Czepiel
+Professor of Marketing and Stern Teaching Excellence Fellow
+Leonard N. Stern School of Business
+New York University
+New York, New York  10012
+Telephone:  (212) 998-0510
+e-mail:  jczepiel@stern.nyu.edu
+and
+Roger A. Kerin
+Harold C. Simmons Distinguished Professor of Marketing
+Edwin L. Cox School of Business
+Southern Methodist University
+Dallas, Texas  75275
+Telephone:  (214) 768-3162
+e-mail:  rkerin@mail.cox.smu.edu
+COMPETITOR ANALYSIS
+Competitive marketing strategies are strongest either when they position a firm's strengths against
+competitors' weaknesses or choose positions that pose no threat to competitors. As such, they require
+that the strategist be as knowledgeable about competitors' strengths and weaknesses as about customers'
+needs or the firm's own capabilities. This chapter is designed to assist the strategist understand how to
+gather and analyze information about competitors that is useful in the strategy development process. It
+discusses the objectives of competitor analysis and proceeds through the processes involved in
+identifying important competitors and information needs, gathering necessary information, and
+interpreting this information.
+THE OBJECTIVES OF COMPETITOR ANALYSIS
+The ultimate objective of competitor analysis is to know enough about a competitor to be able to think
+like that competitor so the firm's competitive strategy can be formulated to take into account the
+competitors' likely actions and responses.  From a practical viewpoint, a strategist needs to be able to
+live in the competitors’ strategic shoes. The strategist needs to be able to understand the situation as the
+competitors see it and to analyze it so as to know what actions the competitors would take to maximize
+their outcomes to be able to calculate the actual financial and personal outcomes of the competitor’s
+strategic choices. They must be able to:
+1.  Estimate the nature and likely success of the potential strategy changes available
+to a competitor;
+2.  Predict each competitor’s probably responses to important strategic moves on
+the part of the other competitors; and
+3.  Understand competitors’ potential reactions to changes in key industry and
+environmental parameters.
+What then should one expect from competitor analysis?  Underneath all of the complexities and depth of
+competitor analysis are some simple and basic practical questions, of which the following are typical:
+  Which competitors does our strategy pit us against?
+  Which competitor is most vulnerable and how should we move on its customers?
+1
+
+Is the competitor's announced move just a bluff? What's it gain if we accept it at
+face value?
+  What kind of aggressive moves will the competitor accept? Which moves has it
+always countered?
+IDENTIFYING COMPETITORS
+Identifying competitors for analysis is not quite as obvious as it might seem. Two complementary
+approaches are possible. The first is demand-side based, comprised of firms satisfying the same set of
+customer needs. The second approach is supply-side based, identifying firms whose resource base,
+technology, operations, and the like, is similar to that of the focal firm. However, the firm must pay
+attention not only to today's immediate competitors but also to those that are just over the horizon (such
+as cellphones once were to cameras, social networking sites once were to web portals, or the internet
+once was to video rental stores). There are three domains for recognizing the sources and types of direct
+and less direct competitors to which the firm must also attend.  These domains represent (1) the areas of
+influence, (2) the contiguous area, and (3) the areas of interest.1
+  The area of influence is the territory, market, business, or industry in which the
+firm is directly competing with other firms to serve the same customer needs
+using the same resources. It is the arena in which Ford, Honda, Toyota, Kia, and
+General Motors compete with each other; where Nokia competes with Samsung
+and Motorola in cellphones. These are a firm’s direct competitors.
+
+Immediately contiguous areas are those in which competition is close but indirect;
+comprising those firms that serve the same customer need but with different
+resources. Many food products fit into this category such as snack foods (potato
+chips versus pretzels versus peanuts), or packaging (glass versus plastic versus
+aluminum). They may serve the same need but through differing distribution
+channels (direct such as Avon versus retail such as Revlon). These are a firm’s
+indirect competitors.
+  Areas of interest are composed of firms that do not currently serve the same
+customer base but have the same resource base or, in broader terms, have
+capability equivalence – the ability to satisfy similar customer needs.2 For
+1 William L. Sammon, Mark A. Kurland, and Robert Spitalnic, Business Competitor Intelligence: Methods for Collecting,
+Organizing, and Using Information. John Wiley and Sons, 1984; Mark Bergen and Margaret A. Peteraf,”Competitor
+Identification and Competitor Analysis: A Broad-Based Managerial Approach,” Managerial and Decision Economics 23,
+(June-August 2002): 157-169; Bruce H. Clark and David B. Montgomery, “Managerial Identification of Competitors,”
+Journal of Marketing, (July 1999), 67-83.
+2 Margaret A. Peteraf and Mark E. Bergen, “Scanning Dynamic Competitive Landscapes: A Market-Based and Resource-
+Based Framework,” Strategic Management Journal 24, 2003, 1027-1041.
+2
+example, many firms possess the necessary capabilities to produce a wide range
+of digital electronic devices whether cell phones, PDAs, cameras, or “pad”
+computers. These comprise a firm’s potential competitors.
+We will first examine product/market level competition – serving the same needs to the same customer
+group. Next we will examine firm-level competition.
+Identifying Competitors at the Product-Market Level
+The most direct competitor competes for the exact same customers in exactly the same way as the
+subject firm. It sells the same product made by the same technology to the same customers via the same
+marketing channels. If the firm cannot win customer patronage versus such an identical competitor, then
+it is unlikely that it can do any better competing against its indirect or potential competitors. Why? If the
+firm's exact counterpart can win in direct competition, then that same competitor should also win more
+against the less direct competitors.
+Companies, per se, do not compete with each other in the marketplace.  Rather, their individual
+businesses compete with each other.  The strategic marketing literature denotes a business as a division,
+product line, or other profit center with a company that produces and markets a well-defined set of
+related products and/or services, serves a clearly defined set of customers, and competes with a distinct
+set of competitors.3
+A business is further defined in terms of a number of key dimensions, which reflect the ways and places
+in which it has chosen to compete. Primary among these are the products it offers and the types of
+customers to whom it chooses to sell.
+The products a firm offers can be defined along three dimensions: functions, technology, and materials:
+  Customer function is concerned with what need is being satisfied. This is the most natural
+way to think about a product. Electromechanical devices, for example, can frequently be
+designed to satisfy any size set of functions from very narrow to very wide. For example,
+some cooking appliances are single function (microwave ovens), others are dual function
+(combination convection-microwave ovens), while others are multifunction (combination
+convection-microwave-conventional ovens). Another example concerns over-the-counter
+medications which, although identical in ingredients, may be positioned or sold for the
+3 Roger A. Kerin, Vijay Mahajan, and P. Rajan Varadarajan, Contemporary Perspectives on Strategic Market Planning.
+Boston:  Allyn & Bacon, 1990.
+3
+relief of colds or allergies or sinus symptoms. Others, such as Nyquil, are sold for even
+more specific usage applications (night-time cold relief).
+  Technology tells how the customer function(s) are being satisfied. For example, kitchen
+ranges may use two sources of thermal energy (gas or electric) or, alternatively,
+microwave energy to cook. X rays, computerized axial tomography (CAT scan
+machines), and NMR (nuclear magnetic resonance) are three different technologies used
+in medical diagnostic imaging.
+  The materials used in the manufacture of the product may also differ, producing slight
+differences in products that are otherwise identical. Cabinets may be made of chipboard
+versus plywood; bottles of glass or of such plastics as PET, polypropylene, or
+polyethylene; and beverage cans of aluminum or steel.
+The customer group being served is a key dimension. Automobile parts manufacturers, for example,
+may choose to serve either the original equipment manufacture (OEM) market or the automotive
+aftermarket, or both. One competitor may focus on serving urban markets while another serves rural
+markets. Wal-Mart's initial success came from its focus on serving small, rural markets that traditional
+discounters had thought too small and too poor to serve. In contrast, J.C. Penney has defined its
+customers as those households in the middle 80% of the U.S. income distribution. Lane Bryant stores
+cater to women in need of larger sizes. There are obviously many ways of defining a firm's targeted
+customer groups.
+The product manager needs to understand the exact extent of competition among the products available
+on the market. At this level, competitors are best identified by customers – the demand side – rather than
+by supply characteristics.
+Substitution-in-use.  Current thinking about identifying the competitive structure for any given product
+is based on the idea of substitution-in-use. Three premises underlie the idea:
+1.  People seek the benefits that products provide rather than the products per se.
+2.  The needs to be satisfied and the benefits which are being sought are dictated by the
+usage situations or applications being contemplated.
+3.  Products and technologies are considered part of the set of substitutes if they are
+perceived to provide functions which satisfy the needs determined by intended
+usage.4
+4George  S.  Day,  "Strategic  Market  Analysis:  Top-Down  and  Bottom-Up  Approaches"  (Cambridge,  MA:  Marketing  Science  Instjtute,
+Report No. 80-105, August 1980), p. 14.
+4
+Determining a product's direct competition, then, may provide an answer that says, "It depends." It
+depends on (l) the number of separate and different uses or applications for the products in the market;
+(2) the number of different usage situations which customers encounter; and (3) user characteristics,
+including the number of product types or brands that a customer would evoke and choose among.5
+Some markets are relatively simple because the offerings within them provide only a single function for
+one or a few uses. Travelers checks or bathroom tissue are two such products. Other examples include
+home pasta makers and irons, both of which perform a specific function across a small number of
+different usage situations. At the other extreme are complex markets in which each customer has many
+uses for the product and many alternatives to consider.  Snack foods or dessert foods are such.
+Depending on the intended usage occasion or situation, each of those product categories has many
+different kinds of products in competition.  In the snack category, potato chips, pretzels, and various
+kinds of nuts, among others, compete.  In the dessert realm, cakes, pies, ice cream, cookies, brownies,
+among others, compete.
+Consider the cosmetics market structure shown in Exhibit 1.  Consumers have a number of different
+need states ranging from personal expression, everyday usage, health or nourishing, reward, or special
+times.  Depending on both their own economics and the need state, they may seek different price points
+and distribution outlets for their purchase.  For any given need state, then, the competitive set will vary
+depending on price points, distribution, and exact type of outlet chosen or encountered.  Consider the
+cosmetics brand Aveda.  Aveda distributes its cosmetics and personal care products through its own
+stores.  While its products compete at a high level with those offered by such firms as Revlon or
+L’Oreal, the competition is not as direct as it is between brands whose products are next to each other on
+the drugstore shelf .
+Financial services offer a similar example. One study, for example, defined a product market to be "the
+set of products judged to be substitutes within those usage situations in which similar patterns of benefits
+are sought by groups of customers."6 In the study, upscale customers were asked to judge the
+appropriateness of twenty-four different financial services across each of twelve different usage
+situations. One such usage situation was described thus: While you are out of town on a trip you have
+5Day, "Strategic Market Analysis, "p. 20; see also Glen L. Urban, Philip L. Johnson, and John R. Hauser, "Testing Competitive Market
+Structures," Marketing Science, 3, no.2 (spring 1984), 83-112.
+5
+some unexpected problems with your car. The repair bill, at a small independent garage, is about $100
+and must be paid immediately.
+EXHIBIT 1:     Cosmetics Market Structure
+Cosmetics
+Female Situations
+Male  Situations
+Need
+States:
+Quality/
+Price:
+Personal
+Expression
+Everyday
+Usage
+Health/
+Nourishing
+Reward
+Special
+Times
+Everyday
+Usage
+Health/
+Nourishing
+Special
+Times
+Low
+Medium
+High
+Super
+Premium
+Distribution:
+Broad
+Prestige
+Alternative
+Outlets:
+d
+o
+o
+F
+g
+u
+r
+D
+t
+n
+u
+o
+c
 s
+i
+D
+s
+s
+a
+M
+b
+u
+l
+C
+y
 t
+l
+a
+i
+c
+e
+p
+S
 n
+i
+a
+h
+C
+s
 e
 r
+o
 t
+S
+.
+t
+p
+e
+D
+t
+c
+e
+r
+i
+D
+e
+e
+r
+F
+g
+n
+i
+d
+n
+a
+t
+S
+d
+o
+o
+F
+h
+t
+l
+a
 e
+H
 s
+n
+o
+l
+a
+S
+/
+V
+T
+/
+l
+i
+a
+M
+t
+n
+i
+r
+P
+Using Purchase Behavior to Identify Competitors. No matter how much logical sense an analysis
+such as the foregoing makes, it is based on what customers say, not on what they do. Several researchers
+have developed techniques which are based on actual purchase data. Exhibit 2, for example, depicts the
+competitive structure of the toothpaste and bathroom tissue markets estimated on the basis of
+supermarket scanning data.7  In this instance, the map positions products on the basis of their attributes
+on a per-dollar basis. As the map shows clearly, all toothpastes are not alike. Customers preferring taste
+over anti-cavity qualities are more likely to buy Close-Up or Aim than Crest. Furthermore, Close-Up
+and Aim are closer competitors than either is with Crest. The bathroom tissue market shows a similar
+6Rajendra  K.  Srivastava,  Mark  I.  Alpert,  and  Allan  D.  Shocker,  "A  Customer-Oriented  Approach  for  Determining  Market  Structures,"
+Journal of Marketing, 48, no.2 (spring 1984), p. 32.
+7Steven  M.  Shugan,  "Estimating  Brand  Positioning  Maps  Using  Supermarket  Scanning  Data,"  Journal  of  Marketing  Research,  XXIV
+(February  1987),  1-18;  see  also  Steven  M.  Shugan,  "Brand  Positioning  Maps  from  Price/Share  Data:  The  Case  of  Bathroom  Tissue"
+(unpublished  working  paper,  University  of  Chicago  Graduate  School  of  Business,  July  1986,  Revised)  and  Terry  Elrod,  "Choice  Map:
+Inferring a Product-Market Map from Panel Data," Marketing Science, 7, no. 1 (winter 1988), 21-39.
+6
+positioning along its two primary dimensions: absorbency and softness. To say that Scott and White
+Cloud compete is true and not true at the same time. One might better say that Scott and Northern are in
+closer competition than either is with White Cloud or Charmin.
+EXHIBIT 2:     Brand Positioning Maps
+Close-up/Aim mint
+•
+e
+t
 s
+a
+t
+/
+e
+r
+u
+t
+x
 e
+T
+•
+Aim regular
+•
+Aqua Fresh
+y
+c
 n
 e
+b
+r
+o
+s
+b
+A
+•
+Soft ‘N Pretty
+•
+Charmin
+Scott
+• •
+Northern
+Crest
+•
+White Cloud
+•
+Anticavity
+Toothpaste market
+(attributes per dollar)
+(a)
+Softness
+Bathroom tissue market
+(attributes per dollar)
+(b)
+SOURCE:  Adapted from Steven M. Shugan, “Estimating Brand Positioning Maps Using Supermarket Scanning
+Data,” Journal of Marketing  Research, XXIV (February 1987), p.8; and “Brand Positioning Maps from Price/Share
+Data: The Case of Bathroom Tissue” (unpublished working paper, University  of Chicago Graduate School of
+Business, July 1986), p.21
+Identifying Potential Competitors
+Depending on the purposes of the competitive analysis, it may also be important to identify potential
+competitors. The process starts by identifying firms for whom the various barriers to entry to the
+industry are low or easily surmountable. These may include the following:
+  Technology: Firms which possess the technologies necessary to operate in an industry
+represent one source of potential competitors. Analysis of patent activity frequently
+signals intentions well prior to actual entrance.
+  Market access: In businesses where market access is a key factor for success, firms
+with that access frequently attempt to leverage it by acquiring additional product lines
+to be sold in that channel or to those customers.
+  Reputation and image: Brand extension strategies are based on the use of a firm's
+reputation in one product area to leverage its entry into another. Clairol used its
+reputation in hair coloring to enter into the hair dryer business.
+7
+  Operating knowledge and skills: Regional competitors in a business often expand
+geographically. Entenmann's Bakeries moved into Florida and Midwestern markets
+from their original Northeastern base, similar to the path taken by Thomas's English
+Muffins. Folger's coffee was originally a regional brand on the West Coast until
+purchased by Procter & Gamble which expanded its distribution nationwide.
+Identifying Competitors at the Firm Level
+The concept of interfirm rivalry extends beyond the product/market level. Competition can also occur as
+firms use related resources to bear on individual product/market level rivalry.  The theory of
+multimarket competition describes those situations in which firms compete against each other in
+multiple markets.8 For example, in 1989, America West entered the Houston, Texas market –
+Continental Airline’s home base -- with low introductory fares.9  Continental retaliated, not by lowering
+prices in Houston but by lowering prices in Phoenix, Arizona , America West’s home base and then
+communicated its displeasure with America West’s actions in Houston. As a result, America West
+rescinded its low prices in the Houston market and, subsequently, Continental ceased its low-price
+counterattack in Phoenix.  Such behavior requires that the manager understand the broader firm-level
+competitive set capable of such competitive behavior. One approach is to identify the different strategic
+groups in an industry.
+The strategic group approach to identifying competitors is based on the differences in firms' strategies
+for competing in an industry. As such, it is a more general concept than the business definition approach.
+Like the business definition approach, the concept is intuitively appealing and understandable. For
+example, a hypothetical industry may be composed of three strategic groups:
+1.  A set of large firms pursuing a strategy of low-cost production of a full line of
+standardized products through mass-market outlets;
+2.  Another set of firms whose strategy emphasizes high-quality, differentiated, and
+branded products sold through specialty shops; and
+8 Aneel Karni and Birger Wernerfelt, “Multiple Point Competition,” Strategic Management Journal, 6 1985, 87-96 and
+Satish Jayachandran, Javier Gimeno, and P. Rajan Varadarajan, “The Theory of Multimarket Competition: A Synthesis and
+Implications for Marketing Strategy,” Journal of Marketing, (July 1999), 49-66.
+9 Asra Nomani, “Airlines May be using a Price-Data Network to Lessen Competition,” The Wall Street Journal, June 28,
+1994, A1.
+8
+3.  A group of smaller firms which have gained strategic advantage by specializing in
+serving either specific customer groups or producing a very narrow range of
+products.10
+The strategic group concept is useful in identifying and analyzing firm-level competitors because
+members of a strategic group not only resemble each other but are also affected similarly by any given
+event or change in the environment. Given that they are playing the same game in the same way, it
+would indicate that their economics are similar. The commonality in their strategies means that they will
+likely respond in a similar manner to competitive threats or moves.
+A further point should be noted about strategic groups. While all of the firms in an industry are in
+competition at a broad level, those in the same strategic group compete more closely among themselves
+than with those in other groups.11  For example, Proctor & Gamble, Unilever, and Colgate-Palmolive in
+the household and personal care products markets are in closer competition with each other than they are
+with direct sellers of household and personal care products such as Amway or Avon. Further, the
+competition between and among groups is not equal – the various pairs of groups may compete more or
+less intensely. By observing the successes of the different strategic groups, one can better understand the
+potential for multimarket competition.
+Competitive Blind Spots
+Much competitive information is bounded by the assumptions that managers’ have with respect to their
+industry and these assumptions may lead to blind spots.  The effect of such blind spots may cause the
+strategist to not recognize the significance of events, interpret them inappropriately, or see them only
+slowly.12 There are six serious blind spots in competitive analysis:13
+1.  Misjudging Industry Boundaries. Too often firms define their industry around their current
+products, customer groups, and geographies blinding themselves to adjacent competitors which
+subsequently enter their current space.
+10This hypothetical industry, in fact resembles the home appliance industry in the 1960s as described by Michael S. Hunt in his dissertation.
+Hunt  coined  the  phrase  "strategic  groups"  to  explain  the  differences  in  profitability  he  observed  within  the  industry.  Michael  S.  Hunt,
+"Competition in the Major Home Appliance Industry, 1960-1970" (unpublished doctoral dissertation, Harvard University, 1972).
+11  The  biological  analogy  predicts  this.  As  Bruce  Henderson(the  founder  of  the  Boston  Consulting  Group)  noted,  "The  more  similar
+competitors are to each other, the more severe their competition. This observation was made by Darwin in The Origin of Species." Bruce
+Henderson, "The Anatomy of Competition," Journal of Marketing, (Spring 1983), p. 8.
+12 Michael E. Porter, Competitive Strategy. New York: The Free Press, 1980, 59.
+9
+2.  Poor Identification of Competitors.  Strategists frequently focus on only the largest and most
+well-known companies to the exclusion of other viable competitors – those potential competitors
+noted earlier in this chapter.
+3.  Overemphasis on Competitors’ Visible Competence. Competitor analysis often focuses on
+competitors’ hard assets and technology skills and ignore equally potent capabilities such as
+logistics, product design, or human resources.
+4.  Emphasis on Where, Not How to Compete.  Strategists too often assume that competitors’
+strategies will shift only incrementally to the exclusion of radical repositioning in how they could
+compete.
+5.  Faulty Assumptions about Competitors.  Prisoners of assumptions about competitors – the
+overuse of stereotypes ��� cause strategists to misjudge competitors’ competences and competitive
+advantages.
+6.  Paralysis by Analysis. Obsession with the task of data collection results in information overload
+to the detriment of analysis and insight.
+IDENTIFYING COMPETITOR INFORMATION NEEDS
+The goal of competitor analysis is to be able to predict a competitor's probable future actions, especially
+those made in response to the actions of the focal business. This requires information that is both
+quantitative and factual (what the competitor is doing and can do) as well as that which is qualitative and
+intentional (what the competitor is likely to do).  There are four key knowledge areas:
+1.  The competitor’s marketplace strategy in terms of scope, posture, and goals;14
+2.  The sources of competitive advantage that give its marketplace strategy potency
+including resources and capabilities, organization, mind-set, and its place in the
+industry eco-system;
+3.  The interpretation of the signals being sent by the competitor both by its actions and
+communications; and
+4.  A competitive response profile which analyzes the competitor’s possible future
+moves.
+13 Shaker A. Zahra and Sherry S. Chaples, “Blind Spots in Competitive Analysis,” Academy of Management Executive, 7,
+no.2, (1993), 7-28; E. J. Zajac and M. H. Bazerman, “Blind Spots in Industry and Competitor Analysis: Implications of
+Interfirm (Mis)perception for Strategic Decisions, Academy of Management Review, 16:1, 1991, 37-56.
+14 Liam Fahey, Competitors: Outwitting, Outmaneuvering, and Outperforming. New York: John Wiley & Sons, 1999.
+10
+The Competitor’s Marketplace Strategy
+The competitor’s marketplace strategy defines the way the competitor is currently competing in the
+marketplace. 15  It defines the strategic choices the competitor has made about where, how, and why it
+seeks to attract, win, and retain customers.  A competitor’s marketplace strategy has three elements:
+1.  Scope – the product-customer segments the organization is in or wants to be in;
+2.  Posture – how it competes or wants to compete in those marketplace segments;
+3.  Goals – its purpose in being in those segments.
+Scope defines the products offered to the market and the customers that purchase them.  It needs to
+incorporate both “static” and “dynamic” analyses.  A static analysis defines where the competitor is and
+what it is doing at the present time; dynamic analysis refers to the moves the competitor has or is
+making over time in its choice of products or customers or both. Customer segments may be identified
+by needs or the demographics tied to those need states.
+Posture defines how a competitor plays in the marketplace to win customers; most importantly it is
+about how it differentiates itself from competitors in the eyes of customers. As with scope, it needs be
+both static and dynamic.  Exhibit 3 lists eight of the more common means of defining how the
+competitor competes, such as product line width, product features, and the like. Successful competitors
+generally employ a number of interrelated modes to compete.  Seldom is the reliance on one dominant
+mode (say low price, for example) a successful strategy.
+Goals address the why of the scope and posture strategies that a competitor uses.  Goals are the end
+whereas scope and posture are the means to that end.  While it is easy to say that the goal is to generate
+profit, that is an end result several steps beyond the scope and posture actions being taken.  Goals may
+be at the highest level of the business’s intent and vision, such as Apple’s intention to integrate voice,
+data, and video.  It may be at a lower level focusing on the short to medium term such as penetrating
+each major channel of distribution or the attainment of a specific gross margin objective. Or it may be
+even more short term as achieving market share goals, cost efficiencies, or cash flow targets. Unless the
+goals have been publicly announced as a signal to the marketplace or to competitors, the analysis often
+15 This section is based on Liam Fahey,  pp. 108 – 118.
+11
+must infer the competitor’s goals from the flow of observable actions it has taken.  At the heart of such
+an analysis is the question: “Why is the competitor taking the observed action?”
+EXHIBIT 3     Identifying How a Competitor Competes
+Modes of Competition
+Possible Dimensions
+Sample Indicators
+Product line width
+Breadth of product lines
+Breadth of types within lines
+Product lines and items
+Features
+Physical aspects of individual
+Functionality
+Service
+Availability
+Image and reputation
+Selling and relationships
+Price
+products
+Packaging
+Terms and conditions
+Performance
+Reliability
+Durability
+Ease of use
+Taste
+Shelf life
+Maintenance
+Installation
+Help line
+Training
+Technical assistance
+Repair
+Response time
+Distribution channels
+Amount
+Delivery
+Shape
+Style
+Color
+Design
+Speed
+Breakdowns
+Customer perceptions
+Contracts
+Service announcements and
+programs
+Customer reports
+Speed of competitor’s responses
+Individual channels
+Image of the company
+Image of products
+Reputation for rapid response time
+Reputation for best value
+Content of advertising
+Actions and words of customers
+Third-party reports
+Customer coverage
+Detailing of products
+Relationships with distributors
+Relationships with end users
+Actions of sales force
+Frequency of calls
+Judgments of channels
+Customer’s comments
+List prices
+Discount prices
+Price-performance
+Price-value
+Actual prices
+Channel/Customer assessments
+SOURCE:  Liam Fahey, Competitors: Outwitting, Out Maneuvering, and Out Performing.  John Wiley & Sons, Inc. 1999 at
+p.11.
+12
+The Competitor’s Source(s) of Competitive Advantage
+Beneath a competitor’s marketplace strategy lie the organization and the functional operations and
+processes that make the strategy possible.  If the competitor is rational, then its marketplace strategy will
+have been built around those functions and activities where it is competitively advantaged versus
+competitors.16  The ability to assess the economics of a competitor is key to competitive analysis.
+Incorporating knowledge about the competitor’s advantages is key to understanding its strengths and
+weaknesses and its likely moves in the marketplace.
+Inputs are a key source of advantage in many industries.  Since very few businesses are completely
+vertically integrated, but simply add value to purchased inputs through its operations, assessing a
+competitor’s costs of its raw materials is an important analysis.  Identifying a competitor’s suppliers and
+estimating such things as transportation costs is the first step.  In businesses for which labor is a large
+part of its cost structure, that is the second step.  Labor contracts are one source of such information as
+are the various wage surveys available.  The third element of inputs is the firm’s weighted average cost
+of capital (WACC).  A firm with a lower WACC can invest at a lower hurdle rate – the rate of return an
+investment must earn to gain corporate approval – and expand faster than one with a higher WACC.
+Equity analysts and many financial data services calculate the WACCs of firms.
+Technology is the second focus, especially in industries that are still evolving.  Assessing competitors’
+current operations and product technology is one step.  Assessing the direction of its technology
+investments is the second.  Many firms announce the present and future state of their technology to
+signal to competitors their competitive advantages. In other instances, following a competitor’s
+published patents and scientific publications can give the analyst good indications of its direction.
+Estimating the number of R&D personnel is another common technique.  As a generalization, a
+competitor that put more resources against a given technology will create better technology faster than
+competitors giving it better products and operations.
+Operations is the third focus.  Many aspects of a competitor’s operations can be accessed simply by
+buying its products and examining or reverse engineering them. Quality, fit and finish, durability, and
+the like can give the analyst insight into aspects of its operations.  In service businesses, it is not difficult
+13
+to benchmark one’s own operations versus competitors’ to understand how customers experience those
+operations.  Comparing the Cost of Goods Sold line of competitors’ operating statements is another
+route.
+Products are the primary locus of marketplace strategy.  There are many ways to assessing advantage of
+competitors’ products.  The important aspect is to assess the products as customers see them.  Customer
+surveys are a key and frequently used tool in this analysis.  While many of the technical performance
+features are easy to measure, understanding the sources of customer value indicate what aspects of the
+products to analyze.
+Access, Segments, and Customers are the final steps in understanding a competitor's sources of
+competitive advantage.  Analyzing the type, number, and quality of channel members serving a
+competitor, and its coverage in different channels of distribution are key to assessing a competitor’s
+advantage.  For example, Anheuser-Busch, which sells almost 50 % of the beer in the United States, has
+been able to attract the highest quality distributors.  In fact, some 60 to 70% of those distributors carry
+only Anheuser-Busch products.  Other brewers, therefore, are not able to attract the same quality or must
+settle for distributors that also sell competing beers.  Knowledge of competitors’ penetration of the
+various segments is also important.  Competitors who have a large share of growing customer segments
+are advantaged. Similarly, the customers a firm chooses sells to can be a source of competitive
+advantage or disadvantage.  One supplier to the slow growing personal care market, for example, chose
+to target as its customers the small number of firms that were growing in the otherwise stagnant market,
+thereby growing while its competitors lost volume. In the early 2000s, Mitsubishi targeted the youth
+market in the United States with fast, small and sporty cars.  Unfortunately, their customers’ credit was
+poor and too many defaulted on the car loans.
+Assessing and Interpreting Competitive Signals and Actions
+Competitor analysis is more than a static activity. It requires more than the creation of a comprehensive
+report detailing the apparent strategies of the key industry competitors. It often means having only an
+hour or two to interpret the meaning of a competitor's 10% across-the-board price cut and to formulate a
+response. It often means being able to predict the reaction of competitors to your announcement of a
+16 George S. Day and Prakash Nedungadi, “Managerial Representations of Competitive Advantage,” Journal of Marketing
+14
+major joint venture with the technology leader from an adjacent industry, or to your preannouncement of
+a major new product.17  It means being able to understand what the leading competitor's chief executive
+means when quoted as saying of his company, "We must absolutely be as competitive as we possibly
+can." Is the message intended to rally the troops or to warn competitors?
+Interpreting Competitive Signals.  Exhibit 4 presents a representative picture of the domain of
+competitive signaling. Interpreting a competitor’s message requires that one simultaneously consider the
+form of the message, its probable function, the forum or medium in which it is communicated, and the
+probable veracity of the message.
+Message Form. Prior announcements are perhaps the most often used form of competitive signaling
+because of their absolute versatility and ambiguity. One can announce with complete truthfulness the
+intention to expand capacity at some future point in time and change one’s mind at some point
+thereafter. Prior announcements admit to the largest range of purposes and forums.
+Announcements of accomplished fact or results, on the other hand, admit to a smaller range of
+application perhaps, but gain in the willingness of the receiver to believe that what has been announced
+has actually happened. Of course, this belief does not necessarily extend to swallowing whole the exact
+numbers, market shares, and so forth that are offered in the announcement.
+Public discussions of the state of the industry or competition within it rival prior announcements in their
+frequency and breadth of purpose. Speeches made at industry conferences, especially those attended
+exclusively by top-level executives, are carefully crafted to convey messages to participants and just as
+carefully dissected by rivals. Some, of course, need little interpretation. In an article in the Wall Street
+Journal, a portfolio manager with large holdings of Alcatel-Lucent stock was quoted saying:
+“the debilitating price wars between Alcatel-Lucent and its rivals could be
+“stabilizing,” citing statements by Ericsson’s (an Alcatel-Lucent competitor)
+management that the firm wouldn’t push to gain market share in wireless equipment by
+cutting prices as it had early last year.”18
+(April 1994), 31-44.
+17Jehoshua Eliasberg and Thomas S. Robertson, "New Product Preannouncing Behavior," Journal of Marketing Research, (August 1988),
+282-92.
+18 Wall Street Journal, “Alcatel-Lucent Deal, Revisited,” February 7, 2007, p.C2.
+15
+EXHIBIT 4:     The Domain of Competitive Signaling
+FORM
+  Prior announcement
+  Announcement after
+the fact
+  Public discussion of
+PURPOSE
+(UNDERLYING
+OSTENSIBLE)
+  Preemption
+  Communicate
+strategic advantages
+  Threat of contingent
+VERACITY
+  True/untrue
+  Bluff
+  Misleading
+  Over/understated
+industry
+action
+  Discussion of own
+  Express pleasure or
+moves
+displeasure
+  Test of competitors’
+sentiments
+  Minimize
+provocative
+potential of own
+action
+  Avoid simultaneous
+actions
+  Inform financial
+community
+  Gain internal
+support
+MESSAGE
+CONTENT
+  Firm’s goals
+  Internal situation of
+firm
+  Firm’s intention
+  Expectations of
+competitor behavior
+  Rules of
+game/nature of
+dilemma
+FORUM OR
+MEDIUM
+  Broad, prestigious
+industry audience
+  Financial analysts
+meeting
+  Interview in major
+industry/business
+publication
+  Press release
+  Letter to customers
+or suppliers
+  Private
+communication
+with competitor
+Discussing one's own move in terms of its intent or rationale happens with less frequency than prior
+announcements but possibly with greater impact. The apparent openness with which a competitor
+discusses the rationale underlying a given strategic move adds the luster of truth to the message,
+especially if it is shared in whispered tones with key customers or suppliers,  Few public relations
+campaigns can spread news through an industry faster than sharing a strategy "in confidence, of course,"
+with a customer whose greatest benefit is served by keeping competition for his or her business at a high
+pitch.
+Message Function. The range of functions served by signaling is wide, and any given message may
+fulfil1 several simultaneously. Attempts to preempt competitors are certainly a leading function. During
+periods of shortages, industry publications are replete with competitors trying to preempt others from
+adding capacity by announcing their own capacity additions first. Announcing the future availability of
+major product developments to postpone customer purchase of competitors' products is another form of
+preemption. To the extent that it can be achieved, preemptive announcements are also used as the
+16
+occasion to communicate strategic advantage to discourage less advantaged competitors from cluttering
+up the playing field.
+Some messages are intended to minimize competitive provocation by explaining the rationale behind
+projected actions which could otherwise be interpreted as aggressively competitive.  Consider, as an
+example, the announcement for lowering CD prices by the Universal Music Group in 2003:
+"We're going to reinvigorate the record business in North America.  Our new pricing policy will
+allow us to take the initiative in making music the best entertainment value and most compelling
+option for consumers.  UMG is responsible for almost 30 percent of album sales in the U.S. so
+we are uniquely positioned to try this new strategy. . . .  We strongly believe that when prices are
+dramatically reduced on so many titles, we will drive consumers back to stores and significantly
+bolster music sales."19
+Some external signals are given to gain internal support. Announcements in the public press by a
+company's president or chairman of its new drive to provide the highest level of quality are frequently
+more credible to employees than many internal communications programs. A variation is the external
+announcement that is made to cutoff further internal discussion of a given strategy or specific action.
+Along the same line, some announcements are made primarily to communicate indirectly with the
+financial community. Signals such as these may indeed carry little of import for competitors.
+Message Content. The actual content type of the message is important. One researcher has studied the
+various messages allowed in experimental studies of negotiation, cooperation, and competition built
+around the various forms of the prisoner's dilemma and was able to discern different types of content.20
+Communication about the firm's goals has the potential to remove the dilemma in a situation in which
+the motivations are not clear. For example, if both are cooperatively disposed and both are aware of that,
+the obvious choice is to cooperate. Signals which communicate information about the internal situation
+of the firm, its health, success, and feelings about its outcomes and situation give others that knowledge
+necessary to infer its payoff matrix.
+Signals about a firm's intentions give competitors information about how best to plan their own actions;
+this is especially so if the statement reveals commitment as well. Such knowledge is clearly important if
+19 Ethan Smith, "Universal Slashes CD Prices to Revive Music Industry," Wall Street Journal, September 4, 2003, pp. B1,
+B8.
+20Marian Chapman Bourke, "Signalling and Screening: Tactics in Negotiations Across Organizations" in Blair Sheppard, Max Bazerman,
+and Roy Lewicki, eds., Research on Negotiations in Organizations (Greenwich, CT: JAI Press, 1988).
+17
+the goal is to chart nonintersecting strategies. Communications or signals which state expectations of the
+competitor's behavior maybe helpful in situations in which competition or cooperation are the choices
+and it is not clear to others how they should act.
+It has been said that discussing the rules of the game and nature of the dilemma is particularly relevant
+in competitive inter-firm situations because this message content contains more information than any of
+the others. Not only are statements about the nature of the game the most innocuous, but a cooperative
+equilibrium typically requires that competitors share a common view of how the game is played.
+Ultimately, of course, all competitors must limit their competitive behavior, and public discussions
+about how the buyer is the only winner in price wars are one way of signaling the need to cool the
+competitive state.  David Steiner, the then Chief Executive Office of industry-leading Waste
+Management, made the following statements during a conference call with investors:
+“If you are going to continue to raise prices as an industry you’ve got to have all the industry
+players acting consistently.  We’re going to continue to raise price. We would certainly hope that
+the industry follows along with us.”21
+Forum or Medium. Where and how a message is delivered is of key importance in its interpretation.
+Messages delivered before prestigious industry audiences or to a formal meeting with financial analysts
+are taken to contain higher truth content than those delivered in other forums. This is simply because
+both groups have good memories and require relationships based on personal trust.
+Interviews in industry and business publications, on the other hand, are taken for what they are---the
+attempt by the competitor to deliver a carefully crafted message to a specific audience. The reality of the
+situation is that no executive has to consent to be interviewed and that consent is only given when there
+is some purpose to be served. Press releases are in a similar category. Letters to customers, on the other
+hand, carry a lot of weight.
+Veracity. Truth in strategic communication is a relative concept. While a communication may indeed be
+just what it is and says, the strategist is better off asking how it would benefit the sender if it were to be
+accepted as true by the receiver. Some signals are bluffs which will not be implemented if the bluff is
+successful in deterring competitive action but probably would not have been implemented anyway. Too
+18
+many bluffs, however, and all parties suspend belief and the firm has lost a valuable tool through
+overuse.  More often, the content of communications contains some aspects that are misleading or
+simply over or understated.  These aspects require the analyst to cross-check all numbers and to analyze
+every statement for possible alternative interpretations. Sometimes ambiguity is intentional to allow one
+to read a possible worst-case scenario into an otherwise innocuous message. Some signals carry as much
+contradictory and hidden meaning as the gambits and contrivances one finds in the best of the Cold War
+spy novels.
+Interpreting Competitive Actions.  Interpreting a competitor’s actions follows a similar analysis,
+beginning with the overriding question: “Why is the action being taken?”  In seeking to answer that
+question, the first step is to characterize the type of action. A frontal attack is where the competitor
+directly attacks with an identical or similar product.  In the 1990s, Unilever directly attacked P&G’s Joy
+brand dishwashing liquid with an identical product under the brand name Sunlight.  Both were yellow,
+lemon scented products in identical bottles promising shiny dishes.  A flanking attack, on the other hand,
+is when the competitor enters an adjacent product-customer segment rather than going head-to-head.  In
+the 1980s, for example, Bic entered the men’s shaving business with a disposable razor rather than the
+traditional razors offered by Gillette.  Pricing actions are of a number of types. They may simply be
+meeting the competition, undercutting the competition, a cross parry in order to retaliate, or a widely
+announced increase.  Alternatively, a pricing action may be a “non-action” – that is not following a
+price leader’s announced price increases.  Northwest Airlines (now Delta) frequently acted as a spoiler
+by not following competitors’ price increases in the early 2000s, causing them to be rescinded.
+The nature of the action is the next step.  The analyst needs to ask the following questions:
+  What was the action relative to the potential actions that could have been taken?  Was it
+more or less severe?
+  How was the action taken?  Was it announced?  Quietly implemented?
+  How did it match or differ from the competitor’s past actions and strategies?  Does it
+suggest a continuation of past policies or does it mark a change in its strategy or mode of
+action?
+  Does the action follow accepted industry practice?  Is the competitor seeking to lead the
+industry into a new competitive territory?
+21 Lan Brat, “Garbage Haulers Raise Prices: Truce Allows Waste Management, Allied, and Republic to Push Higher.” Wall
+Street Journal, September 18, 2008, page B1.
+19
+  Does the competitor expect other firms to follow it?
+
+Is the move aggressive or does it suggest a more “cooperative” way of competing?
+It should be noted that competitive actions can be outside of the marketplace.  Legal actions are a case in
+point.  Lawsuits over trademarks and brands are frequent and can tie up a firm’s executive and managers
+for long periods of time.  Private antitrust suits are another form of competitive action.  In both
+instances, a deep pocketed competitor can cause great harm to smaller, less wealthy firms.
+The Competitor's Response Profile
+The likelihood of competitive reactions depends on:
+1.  The characteristics of the firm taking the action.  For example, its size and reputation for
+competitiveness.
+2.  The characteristics of the action.  It could be a new market entry or price change.
+3.  The characteristics of the rival. Its size, performance, or desired reputation.
+4.  Environmental characteristics such as market turbulence, growth.22
+Given some insight into these four factors, the firm or analyst can take some more concrete steps as
+shown in Exhibit 5 which portrays a helpful framework for analyzing present and potential competitor
+moves and responses.  The combination of this analysis of competitors' goals and assumptions together
+with competitors' current strategies and capabilities allow one to estimate their response profiles. A
+response profile tells one what kinds of actions a competitor is likely to take, if any, in response to the
+firm's own actions.  Again, what this means is that you have to be able to think like your competitor.
+It may sound simplistic, but one of the most powerful determinants of a competitor's future actions is the
+set of economic outcomes that would result from each different competitive response. To the extent,
+then, that one can calculate the financial results that would flow from different actions, one should be
+able to predict competitors' actions.
+22 David B. Montgomery, Marian Chapman Moore, and Joel E. Urbany, “Reasoning About Competitive Reactions: Evidence
+from Executives,” Marketing Science (Winter 2005) 138-149;
+20
+One approach is to estimate the competitor’s reactiveness to a competitive move on a particular product
+in a given geographical (or other defined market) market and the relative clout it has with which to
+respond to competitive move.23  Reactiveness is simply the competitor’s incentive to counter
+competitive moves.  It can be measured by estimating the contribution (revenues, profits, etc.) that the
+product delivers in that market and that it delivers to the business unit of which it is a part adjusted for
+the strategic importance of the product and market to the competitor.  Take, for example, a move against
+P&G’s Tide laundry detergent product in the United States.  With its leading market share it contributes
+both book profits and strong cash flow to the division of which it is a part and to the corporation as a
+whole.  As the anchor product of the detergent aisle in supermarkets it is of strategic importance in
+maintaining the support of the channel.  One can say with reasonable certainty that P&G would exhibit
+high reactiveness to any competitive move against Tide.  Relative Clout asks which of the competitors is
+in a better position to make a strategic move in that specific product/market arena.  It is the ability to
+fight or to fight back.  As with reactiveness, relative clout can be estimated from the competitors’
+relative sizes, cash positions, distribution coverage, and the relative number of salespeople.
+Theoretically, the issue goes beyond reactiveness and clout.  It is more complex. Economists use the
+term conjectural variation to refer to what is known about the likelihood and the intensity of competitors'
+responses. Specifically, a conjectural variation is what is believed about the relationship between a
+firm's own behavior and the corresponding return-maximizing action that will be taken by the
+competitor.24   The interesting aspect is that estimating a competitor's actions requires the recognition
+that the competitor's decision involves more than simply choosing the action that yields it the highest
+relative financial result from among the set of actions available to it.  This is because those financial
+results themselves are simultaneously affected by the competitor’s own conjectures concerning the
+acting firm’s response profile to its response.
+23 Ian C. MacMillan, Alexander B. van Putten, and Rita Gunther McGrath, “Global Gamesmanship.” Harvard Business
+Review Vol. 81, May 2003, pp 62-71.
+24Raphael  Amit,  Ian  Domowitz,  and  Chaim  Fershtman,  "Thinking  One  Step  Ahead:  The  Use  of  Conjectures  in  Competitor  Analysis,"
+Strategic Management Journal, 9, (1988), 431-442.
+21
+EXHIBIT 5:     Analyzing a Competitor’s Response Profile
+What Drives the Competitor
+FUTURE GOALS
+At all levels of management and in
+multiple dimensions
+What the Competitor is Doing
+and Can Do
+CURRENT STRATEGY
+How the business is currently
+competing
+COMPETITOR’S RESPONSE PROFILE
+Is the competitor satisfied with its current position?
+What likely moves or strategy shifts will the competitor make?
+Where is the competitor vulnerable?
+What will provoke the greatest and most effective  retaliation by the
+competitor?
+ASSUMPTIONS
+Held abut itself and the industry
+CAPABILITIES
+Both strengths and weaknesses
+SOURCE:  Michael Porter, Competitive Advantage, (New York: The Free Press, 1980, p. 49.
+ In more practical terms for the strategist, this means working two moves ahead—estimating whether the
+competitor would see its action choices as leading to more or less effective countermoves. Game theory
+provides one framework for analyzing the situation. The main point, however, is to attempt to calculate
+the relative financial implications of the competitor's possible responses.  A second approach suggests
+that one analyze the past effectiveness of the competitor's marketing mix elements. As theory would
+suggest, a competitor's response to, say, the market entry of a new product will be to adopt the approach
+that has shown the greatest response elasticity in the past. 25
+SUMMARY
+Competitive marketing strategy requires that the strategist position the firm's offerings such that they
+minimize direct competition either by choosing vulnerable competitors or by pitting strength against
+weakness. The goal of competitor analysis is to provide the strategist with the means needed to achieve
+that result.
+25 Kevin P. Coyne and John Horn, "Predicting Your Competitor's Reaction," Harvard Business Review, April 2009, pp. 90-
+97.
+22

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-Special Publication 800-145
-The NIST Definition of Cloud
-Computing
-Recommendations of the National Institute
-of Standards and Technology
-Peter Mell
-Timothy Grance
-NIST Special Publication 800-145
-The NIST Definition of Cloud Computing
-Peter Mell
-Timothy Grance
-C  O  M  P  U  T  E  R      S  E  C  U  R  I  T  Y
-Computer Security Division
-Information Technology Laboratory
-National Institute of Standards and Technology
-Gaithersburg, MD 20899-8930
-September 2011
-U.S. Department of Commerce
-Rebecca M. Blank, Acting Secretary
-National Institute of Standards and Technology
-Patrick D. Gallagher, Under Secretary for Standards and
-Technology and Director
-Reports on Computer Systems Technology
-The  Information  Technology  Laboratory  (ITL)  at  the  National  Institute  of  Standards  and  Technology
-(NIST) promotes the U.S. economy and public welfare by providing technical leadership for the nation’s
-measurement  and  standards  infrastructure.    ITL  develops  tests,  test  methods,  reference  data,  proof  of
-concept  implementations,  and  technical  analysis  to  advance  the  development  and  productive  use  of
-information  technology.    ITL’s  responsibilities  include  the  development  of  technical,  physical,
-administrative,  and  management  standards  and  guidelines  for  the  cost-effective  security  and  privacy  of
-sensitive  unclassified  information  in  Federal  computer  systems.    This  Special  Publication  800-series
-reports  on  ITL’s  research,  guidance,  and  outreach  efforts  in  computer  security  and  its  collaborative
-activities with industry, government, and academic organizations.
-National Institute of Standards and Technology Special Publication 800-145
-7 pages (September 2011)
-Certain  commercial  entities,  equipment,  or  materials  may  be  identified  in  this
-document  in  order  to  describe  an  experimental  procedure  or  concept  adequately.
-Such identification is not intended to imply recommendation or endorsement by the
-National Institute of Standards and Technology, nor is it intended to imply that the
-entities, materials, or equipment are necessarily the best available for the purpose.
-ii
-Acknowledgements
-The  authors  Peter  Mell  and  Timothy  Grance  of  the  National  Institute  of  Standards  and  Technology
-(NIST) would like to thank the many experts in industry and government who contributed their thoughts
-to  the  creation  and  review  of  this  definition.  We  especially  acknowledge  Murugiah  Souppaya  and  Lee
-Badger,  also  of  NIST,  and  Wayne Jansen  of  Booz  Allen  Hamilton,  whose  advice  and technical insight
-assisted this effort.
-Errata
-The following changes have been incorporated into Special Publication 800-145, as of the date indicated
-in the table.
-DATE
-4/27/2012
-TYPE
-Editorial
-Corrected page number from “2” to “1”
-CHANGE
-PAGE NUMBER
-1
-iii
-1.
-Introduction
-1.1  Authority
-The National Institute of Standards and Technology (NIST) developed this document in furtherance of its
-statutory  responsibilities  under  the  Federal  Information  Security  Management  Act  (FISMA)  of  2002,
-Public Law 107-347.
-NIST  is  responsible  for  developing  standards  and  guidelines,  including  minimum  requirements,  for
-providing  adequate  information  security  for  all  agency  operations  and  assets;  but  such  standards  and
-guidelines shall not apply to national security systems.  This guideline is consistent with the requirements
-of  the  Office  of  Management  and  Budget  (OMB)  Circular  A-130,  Section  8b(3),  “Securing  Agency
-Information  Systems,”  as  analyzed  in  A-130,  Appendix  IV:  Analysis  of  Key  Sections.    Supplemental
-information is provided in A-130, Appendix III.
-This  guideline  has  been  prepared  for  use  by  Federal  agencies.    It  may  be  used  by  nongovernmental
-organizations on a voluntary basis and is not subject to copyright, though attribution is desired.
-Nothing  in  this  document  should  be  taken  to  contradict  standards  and  guidelines  made  mandatory  and
-binding  on  Federal  agencies  by  the  Secretary  of  Commerce  under  statutory  authority,  nor  should  these
-guidelines be interpreted as altering or superseding the existing authorities of the Secretary of Commerce,
-Director of the OMB, or any other Federal official.
-1.2  Purpose and Scope
-Cloud computing is an evolving paradigm. The NIST definition characterizes important aspects of cloud
-computing and is intended to serve as a means for broad comparisons of cloud services and deployment
-strategies, and to provide a baseline for discussion from what is cloud computing to how to best use cloud
-computing.  The service and deployment models defined form a simple taxonomy that is not intended to
-prescribe or constrain any particular method of deployment, service delivery, or business operation.
-1.3  Audience
-The intended audience of this document is system planners, program managers, technologists, and others
-adopting cloud computing as consumers or providers of cloud services.
- 1
-2.
-The NIST Definition of Cloud Computing
-Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared
-pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that
-can be rapidly provisioned and released with minimal management effort or service provider interaction.
-This cloud model is composed of five essential characteristics, three service models, and four deployment
-models.
-Essential Characteristics:
-On-demand  self-service.  A  consumer  can  unilaterally  provision  computing  capabilities,  such  as
-server  time  and  network  storage,  as  needed  automatically  without  requiring  human
-interaction with each service provider.
-Broad network access. Capabilities are available over the network and accessed through standard
-mechanisms  that  promote  use  by  heterogeneous  thin  or  thick  client  platforms  (e.g.,
-mobile phones, tablets, laptops, and workstations).
-Resource  pooling.  The  provider’s  computing  resources  are  pooled  to  serve  multiple  consumers
-using  a  multi-tenant  model,  with  different  physical  and  virtual  resources  dynamically
-assigned  and  reassigned  according  to  consumer  demand.  There  is  a  sense  of  location
-independence in that the customer generally has no control or knowledge over the exact
-location of the provided resources but may be able to specify location at a higher level of
-abstraction  (e.g.,  country,  state,  or  datacenter).  Examples  of  resources  include  storage,
-processing, memory, and network bandwidth.
-Rapid  elasticity.  Capabilities  can  be  elastically  provisioned  and  released,  in  some  cases
-automatically, to scale rapidly outward and inward commensurate with demand. To the
-consumer, the capabilities available for provisioning often appear to be unlimited and can
-be appropriated in any quantity at any time.
-Measured service. Cloud systems automatically control and optimize resource use by leveraging
-a metering capability1 at some level of abstraction appropriate to the type of service (e.g.,
-storage,  processing,  bandwidth,  and  active  user  accounts).  Resource  usage  can  be
-monitored,  controlled,  and  reported,  providing  transparency  for  both  the  provider  and
-consumer of the utilized service.
-Service Models:
-Software  as  a  Service  (SaaS).  The  capability  provided  to  the  consumer  is to  use  the  provider’s
-applications  running  on  a  cloud  infrastructure2.  The  applications  are  accessible  from
-various client devices through either a thin client interface, such as a web browser (e.g.,
-web-based email), or a program interface. The consumer does not manage or control the
-underlying cloud infrastructure including network, servers, operating systems, storage, or
-even  individual  application  capabilities,  with  the  possible  exception  of  limited  user-
-specific application configuration settings.
-Platform as a Service (PaaS). The capability provided to the consumer is to deploy onto the cloud
-infrastructure  consumer-created  or  acquired  applications  created  using  programming
-1 Typically this is done on a pay-per-use or charge-per-use basis.
-2  A  cloud  infrastructure  is  the  collection  of  hardware  and  software  that  enables  the  five  essential  characteristics  of  cloud
-computing. The cloud infrastructure can be viewed as containing both a physical layer and an abstraction layer. The physical
-layer consists of the hardware resources that are necessary to support the cloud services being provided, and typically includes
-server,  storage  and  network  components.  The  abstraction  layer  consists  of  the  software  deployed  across  the  physical  layer,
-which manifests the essential cloud characteristics.  Conceptually the abstraction layer sits above the physical layer.
- 2
-languages,  libraries,  services,  and tools  supported  by  the  provider.3  The  consumer  does
-not  manage  or  control  the  underlying  cloud  infrastructure  including  network,  servers,
-operating systems, or storage, but has control over the deployed applications and possibly
-configuration settings for the application-hosting environment.
-Infrastructure  as  a  Service  (IaaS).  The  capability  provided  to  the  consumer  is  to  provision
-processing,  storage,  networks,  and  other  fundamental  computing  resources  where  the
-consumer  is  able  to  deploy  and  run  arbitrary  software,  which  can  include  operating
-systems and applications. The consumer does not manage or control the underlying cloud
-infrastructure but has control over operating systems, storage, and deployed applications;
-and possibly limited control of select networking components (e.g., host firewalls).
-Deployment Models:
-Private cloud. The cloud infrastructure is provisioned for exclusive use by a single organization
-comprising  multiple  consumers  (e.g.,  business  units).  It  may  be  owned,  managed,  and
-operated by the organization, a third party, or some combination of them, and it may exist
-on or off premises.
-Community  cloud.  The  cloud  infrastructure  is  provisioned  for  exclusive  use  by  a  specific
-community  of  consumers  from  organizations  that  have  shared  concerns  (e.g.,  mission,
-security  requirements,  policy,  and  compliance  considerations).  It  may  be  owned,
-managed,  and  operated  by  one  or  more  of  the  organizations  in  the  community,  a  third
-party, or some combination of them, and it may exist on or off premises.
-Public cloud. The cloud infrastructure is provisioned for open use by the general public. It may be
-owned, managed, and operated by a business, academic, or government organization, or
-some combination of them.  It exists on the premises of the cloud provider.
-Hybrid  cloud.  The  cloud  infrastructure  is  a  composition  of  two  or  more  distinct  cloud
-infrastructures (private, community, or public) that remain unique entities, but are bound
-together  by  standardized  or  proprietary  technology  that  enables  data  and  application
-portability (e.g., cloud bursting for load balancing between clouds).
-3 This capability does not necessarily preclude the use of compatible programming languages, libraries, services, and tools from
-other sources.
- 3

+ETSI White Paper No. 11
+Mobile Edge Computing
+A key technology towards 5G
+First edition – September 2015
+ISBN No. 979-10-92620-08-5
+Authors:
+Yun Chao Hu, Milan Patel, Dario Sabella, Nurit Sprecher and Valerie Young
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+About the authors
+Yun Chao Hu
+Contributor, Huawei, Vice Chair ETSI MEC ISG, Chair MEC IEG Working Group
+Milan Patel
+Contributor, Huawei
+Dario Sabella
+Contributor, Telecom Italia; Vice-Chair MEC IEG Working Group
+Nurit Sprecher
+Contributor, Nokia; Chair ETSI MEC ISG
+Valerie Young
+Contributor, Intel
+Mobile Edge Computing - a key technology towards 5G
+2
+Contents
+About the authors
+Contents
+Introduction
+Market Drivers
+Business Value
+Mobile Edge Computing Service Scenarios
+General
+Augmented Reality
+Intelligent Video Acceleration
+Connected Cars
+Internet of Things Gateway
+Deployment Scenarios
+ETSI Industry Specification Group on Mobile Edge Computing
+Proofs of Concept
+Conclusions
+References
+2
+3
+4
+5
+6
+7
+7
+8
+9
+9
+11
+11
+12
+13
+14
+15
+Mobile Edge Computing - a key technology towards 5G
+3
+Introduction
+Mobile Edge Computing (MEC) is a new technology which is currently being standardized in an ETSI
+Industry Specification Group (ISG) of the same name. Mobile Edge Computing provides an IT service
+environment and cloud-computing capabilities at the edge of the mobile network, within the Radio
+Access Network (RAN) and in close proximity to mobile subscribers. The aim is to reduce latency, ensure
+highly efficient network operation and service delivery, and offer an improved user experience.
+Mobile Edge Computing is a natural development in the evolution of mobile base stations and the
+convergence of IT and telecommunications networking. Based on a virtualized platform, MEC is
+recognized by the European 5G PPP (5G Infrastructure Public Private Partnership) research body as one
+of the key emerging technologies for 5G networks (together with Network Functions Virtualization (NFV)
+and Software-Defined Networking (SDN)) [1]. In addition to defining more advanced air interface
+technologies, 5G networks will leverage more programmable approaches to software networking and
+use IT virtualization technology extensively within the telecommunications infrastructure, functions, and
+applications. MEC thus represents a key technology and architectural concept to enable the evolution to
+5G, since it helps advance the transformation of the mobile broadband network into a programmable
+world and contributes to satisfying the demanding requirements of 5G in terms of expected throughout,
+latency, scalability and automation.
+MEC is based on a virtualized platform, with an approach complementary to NFV: in fact, while NVF is
+focused on network functions, the MEC framework enables applications running at the edge of the
+network. The infrastructure that hosts MEC and NFV or network functions is quite similar; thus, in order
+to allow operators to benefit as much as possible from their investment, it will be beneficial to reuse the
+infrastructure and infrastructure management of NFV to the largest extent possible, by hosting both
+VNFs (Virtual Network Functions) and MEC applications on the same platform.
+The environment of Mobile Edge Computing is characterized by low latency, proximity, high bandwidth,
+and real-time insight into radio network information and location awareness. All of this can be
+translated into value and can create opportunities for mobile operators, application and content
+providers enabling them to play complementary and profitable roles within their respective business
+models and allowing them to better monetize the mobile broadband experience.
+Mobile Edge Computing opens up services to consumers and enterprise customers as well as to adjacent
+industries that can now deliver their mission-critical applications over the mobile network. It enables a
+new value chain, fresh business opportunities and a myriad of new use cases across multiple sectors.
+The intention is to develop favourable market conditions which will create sustainable business for all
+players in the value chain, and to facilitate global market growth. To this end, a standardized, open
+environment needs to be created to allow the efficient and seamless integration of such applications
+across multi-vendor Mobile Edge Computing platforms. This will also ensure that the vast majority of the
+customers of a mobile operator can be served.
+The objectives of this white paper are to introduce the concept of Mobile Edge Computing and the
+related key market drivers, and to discuss the business and technical benefits of Mobile Edge
+Computing. A few examples of service scenarios that can benefit from the technology and possible
+deployment scenarios are presented. The white paper explains what is being standardized and how
+Mobile Edge Computing - a key technology towards 5G
+4
+innovation can be stimulated through using a standardized API. It outlines the specifications being
+produced by the Industry Specification Group on MEC.
+ETSI ISG MEC encourages Proofs of Concept (PoC) to demonstrate the viability of MEC implementations.
+PoCs help to build awareness and confidence in the technology, and to develop a diverse and open MEC
+ecosystem. This white paper describes the MEC PoC framework and calls for active participation.
+Market Drivers
+The growth of mobile traffic and pressure on costs are driving a need to implement several changes in
+order to maintain quality of experience, to generate revenue, and optimize network operations and
+resource utilization.  The Internet of Things is further congesting the network and network operators
+need to do local analysis to ease security and backhaul impacts.  Enterprises want the ability to enable
+and engage with their customers with more efficient, secure and low latency connections.  Application
+and content providers are challenged with the latency of the network when connecting to the cloud.
+These challenges need to be resolved.
+Mobile operators need to shorten the time to launch new revenue generating applications for current
+customers but also for specific industries and sectors, such as but not limited to automotive, industry
+automation and welfare industries.  Business transformation based on collaboration with the different
+players in the value chain can help in facing these challenges.
+Technology improvements which provide low latency, better flexibility, agility, usage of virtualization,
+network and context awareness, etc. can provide the opportunity to increase the Quality of Experience
+of end users and make network operation more cost effective and competitive.
+Smart phone applications and content are moving to the cloud. The access to the cloud needs to be
+optimised to guarantee a rich experience for consumers of an application or consumers of content and a
+tight collaboration is essential between network operators and application and content providers. This
+collaboration can lead to the deployment of applications/content at the edge of the mobile operator’s
+network, providing awareness of the network and context information.  Standardization will be essential
+to support this collaboration and the hosting of cloud or internet based applications within a multi-
+vendor environment.
+The market drivers of MEC include business transformation, technology integration and industry
+collaboration (as illustrated in Figure 1). All of these can be enabled by MEC and a wide variety of use
+cases can be supported for new and innovative markets, such as e-Health, connected vehicles, industry
+automation, augmented reality, gaming and IoT services.
+Mobile Edge Computing - a key technology towards 5G
+5
+Figure 1: MEC market drivers
+Business Value
+Mobile Edge Computing offers an IT service environment at a location considered to be a lucrative point
+in the mobile network: the Radio Access Network (RAN) edge. Characterized by proximity, low latency
+and high bandwidth, this environment will offer localized cloud computing capabilities as well as
+exposure to real-time radio network and context information.
+Opening up this IT service environment will allow applications and services from mobile operators,
+service and content providers to be efficiently and seamlessly integrated across multi-vendor, mobile
+edge computing platforms. The characteristics and capabilities offered by a MEC platform can be
+leveraged in a way that will allow proximity, context, agility and speed to be used for wider innovation
+that can be translated into unique value and revenue generation.
+Access to content and applications can be accelerated; their responsiveness can be increased,
+maximizing speed and interactivity. Popular and locally-relevant content can be delivered directly where
+users connect, limiting ingress bandwidth to the core and cloud.
+Knowledge of real-time radio network conditions and context information can be used to optimize the
+network and service operation (responding and adapting to changing network conditions). This would
+improve service experience and the utilization of network resources, enabling them to efficiently handle
+increased amounts of traffic. Real-time network and fine-granular context information (including
+Mobile Edge Computing - a key technology towards 5G
+6
+location) could be used to enrich the mobile broadband experience by creating highly personalized
+services which are tailored to individual needs and preferences.
+Operators can reposition themselves in the value chain and redefine personalized services. They can
+capitalize their networks and open them up to authorized third-parties (in a secure way), exposing
+capabilities to Over the Top (OTT) players and application developers to flexibly, agilely and rapidly
+deploy innovative applications and services towards mobile subscribers, enterprises and vertical
+segments. Operators will be able to create new revenue streams, delight their customers by developing
+a new breed of applications that provide incremental value, and open up new market opportunities. In
+addition, applications supporting tighter integration of network and service parameters will improve
+both service experience and utilization of the network resources.
+Application service providers, OTT players and independent software vendors will be able to translate
+proximity and context into value, and be able to generate new revenue.  Their applications and services
+can be enhanced and accelerated to provide a unique and unparalleled experience. Innovative
+applications can be deployed rapidly in a new standards-based environment, taking advantage of new
+levels of flexibility and agility. Applications will be able to expand their cloud into the mobile network
+and create a whole new set of services. They will be able to feel and react to end-user experience in real
+time, based on the actual radio conditions. The new MEC specifications will allow applications and
+services to be deployed on top of multi-vendor Mobile Edge Computing platforms, enabling them to be
+used by the vast majority of the customers of a single mobile operator. The mobile end user will enjoy a
+unique, gratifying and personalized mobile-broadband experience.
+The MEC initiative will help to develop favourable market conditions for all players in the value chain as
+well as facilitate economic growth with a myriad of new use cases across multiple sectors (see Figure 2).
+Figure 2: Improved QoE with Mobile Edge Computing in close proximity to end users
+Mobile Edge Computing Service Scenarios
+General
+The following sections describe a number of service scenarios that have been considered within ETSI ISG
+MEC. These illustrate various scenarios which can take advantage of Mobile Edge Computing to either
+Mobile Edge Computing - a key technology towards 5G
+7
+increase performance compared to providing such services through the cloud or through core network
+servers, or to utilize the unique capabilities offered by MEC platforms such as proximity to the user and
+network edge, serving a highly localized area. It should be noted these examples are non-exhaustive and
+further service scenarios are available in the ETSI ISG MEC specification for Mobile Edge Computing
+Service Scenarios, GS MEC 004. Other scenarios which can make use of MEC are also possible.
+Augmented Reality
+New services become possible when mobile networks supporting high data rates and low latency
+computation are deployed. One example of such services is Augmented Reality. Augmented reality (AR)
+is the combination of a view of the real-world environment and supplementary computer-generated
+sensory input such as sound, video, graphics or GPS data. Augmented reality can enhance the
+experience of a visitor to a museum or another point of interest. Consider a visitor to a museum, art
+gallery, city monument, music or sports event, holding their mobile device towards a particular point of
+interest with the application related to their visit activated (i.e., the museum application). The camera
+captures the point of interest and the application displays additional information related to what the
+visitor is viewing.
+Augmented reality services require an application to analyse the output from a device's camera and/or a
+precise location in order to supplement a user's experience when visiting a point of interest by providing
+additional information to the user about what they are currently experiencing. The application needs to
+be aware of a user's position and the direction they are facing, either through positioning techniques or
+through the camera view, or both. After analysing such information, the application can provide
+additional information in real-time to the user. If the user moves, the information needs to be
+refreshed. Hosting the Augmented Reality service on a MEC platform instead of in the cloud is
+advantageous since supplementary information pertaining to a point of interest is highly localised and is
+often irrelevant beyond the particular point of interest. Figure 3 shows how a MEC platform can be used
+to provide an Augmented Reality service.
+Figure 3: Augmented Reality Service Scenario
+Additionally, the processing of user location or camera view can be performed on a MEC platform rather
+than on a more centralized server. There may be a need to update information at a fast rate, depending
+on how the user moves, and the context in which the augmented reality service is used (e.g. in an art
+gallery, exhibits are positioned only a few metres apart and each piece is supplemented with additional
+text on the artist, the interpretation of the artwork, etc.) In other words, augmented reality data
+requires low latency and a high rate of data processing in order to provide the correct information to
+Mobile Edge Computing - a key technology towards 5G
+8
+the user's device depending on the location and orientation of the user. Performing such data
+processing on the MEC platform also has the advantage of collecting metrics, anonymized meta-data,
+etc., in order to analyse the service usage and help to improve the service in order to provide a better
+user experience.
+Intelligent Video Acceleration
+End user Quality of Experience (QoE) and utilization of radio network resources can be improved
+through intelligent video acceleration. Internet media and file delivery are typically streamed or
+downloaded today using Hypertext Transmission Protocol (HTTP) over the TCP protocol. Available
+capacity can vary by an order of magnitude within seconds (as a result of changes in radio channel
+conditions, devices entering/leaving network). TCP may not be able to adapt fast enough to rapidly-
+varying conditions in the radio access network (RAN). This may lead to under-utilisation of precious
+radio resources and to a sub-optimal user experience.
+Figure 4 shows an example of the intelligent video acceleration service scenario which attempts to
+overcome the challenges described above. In this scenario, a radio analytics application, which resides in
+a MEC server, provides the video server with an indication on the throughput estimated to be available
+at the radio downlink interface. This information can be used to assist the TCP congestion control
+decisions (for example in selecting the initial window size, setting the value of the congestion window
+during the congestion avoidance phase, and adjusting the size of the congestion window when the
+conditions on the "radio link" deteriorate). The information can also be used to ensure that the
+application-level coding matches the estimated capacity at the radio downlink.
+The video server may use this information to assist TCP congestion control decisions (for example by
+ensuring that the application level coding matches the estimated capacity at the radio downlink). The
+content’s time-to-start as well as video-stall occurrences can be reduced, enabling improved video
+quality and throughput.
+ Figure 4: Intelligent Video Acceleration Service Scenario
+Connected Cars
+The number of connected vehicles is rapidly growing and will continue to do so over the coming years.
+Communication of vehicles and roadside sensors with a roadside unit is intended to increase the safety,
+efficiency, and convenience of the transportation system, by the exchange of critical safety and
+Mobile Edge Computing - a key technology towards 5G
+9
+operational data. The communication can also be used to provide value added services, such as car
+finder, parking location and to support entertainment services (e.g. video distribution).
+As the number of connected vehicles increases and use cases evolve, the volume of data will continue to
+increase along with the need to minimize latency.  Whilst data stored and processed centrally may be
+adequate for some use cases, it can be unreliable and slow for others.
+LTE can significantly accelerate the deployment of connected vehicle communications.  LTE cells can
+provide “beyond the line of sight” visibility i.e. beyond the range of direct communication between
+vehicles of 300 – 500m. It can also satisfy the tight latency requirement of connected vehicle
+communications, below 100ms in some use cases. Messages could be distributed in real time over LTE,
+eliminating the need to build a countrywide Digital Short-Range Communications (DSRC) network. Cars
+can leverage their increasingly inbuilt LTE connectivity; in deployments where DSRC exists, LTE would be
+able complement it.
+Mobile Edge Computing can be used to extend the connected car cloud into the highly distributed
+mobile base station environment, and enable data and applications to be housed close to the vehicles.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications provided over the internet. MEC applications can run on MEC servers which
+are deployed at the LTE base station site to provide the roadside functionality. The MEC applications can
+receive local messages directly from the applications in the vehicles and the roadside sensors, analyse
+them and then propagate (with extremely low latency) hazard warnings and other latency-sensitive
+messages to other cars in the area (as depicted in Figure 5). This enables a nearby car to receive data in
+a matter of milliseconds, allowing the driver to immediately react.
+Figure 5: Connected Vehicles Service Scenario
+The roadside MEC application will be able to inform adjacent Mobile Edge Computing servers about the
+event(s) and in so doing, enable these servers to propagate hazard warnings to cars that are close to the
+affected area.
+The roadside application will be able to send local information to the applications at the connected car
+cloud for further centralized processing and reporting.
+Mobile Edge Computing - a key technology towards 5G
+10
+Internet of Things Gateway
+The Internet of Things (IoT) generates additional messaging on telecoms networks, and requires
+gateways to aggregate the messages and ensure low latency and security.  Because of the nature of
+some of the devices being connected, a real time capability is required and a grouping of sensors and
+devices is needed for efficient service.
+IoT devices are often resource constrained in terms of processor and memory capacity. There is a need
+to aggregate various IoT device messages connected through the mobile network close to the devices.
+This also provides an analytics processing capability and a low latency response time.
+Figure 6: IoT Gateway Service Scenario
+Various devices are connected over different forms of connectivity, such as 3G, LTE, Wi-Fi or other radio
+technologies. In general the messages are small, encrypted and come in different forms of protocols.
+There is a need for a low latency aggregation point to manage the various protocols, distribution of
+messages and for the processing of analytics. The MEC server provides the capability to resolve these
+challenges.
+Mobile Edge Computing can be used to connect and control devices remotely, analyse and provide real
+time provisioning and analytics.  MEC enables the aggregation and distribution of IoT services into the
+highly distributed mobile base station environment, and enable applications to respond in real-time.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications in the cloud. IoT applications can run on MEC servers which are deployed at
+the LTE base station site to provide this functionality.
+Deployment Scenarios
+Mobile Edge Computing servers can be deployed at multiple locations, such as at the LTE macro base
+station (eNodeB) site, at the 3G Radio Network Controller (RNC) site, at a multi-Radio Access Technology
+(RAT) cell aggregation site, and at an aggregation point (which may also be at the edge of the core
+network). The multi-RAT cell aggregation site can be located indoors within an enterprise (e.g. hospital,
+large corporate HQ), or indoors/outdoors for a special public coverage scenario (e.g. stadium, shopping
+mall) to control a number of local multi-RAT access points providing radio coverage to the premises. This
+deployment option enables the direct delivery of locally-relevant, fast services from base station
+clusters. Where a MEC platform is deployed may depend on a number of factors, including scalability,
+Mobile Edge Computing - a key technology towards 5G
+11
+physical deployment constraints, performance criteria (e.g. latency) and which network information will
+be exposed. Note that some MEC services may not be available / applicable in certain deployment
+options.
+MEC applications can be intelligently and flexibly deployed in a seamless manner on different MEC
+platforms based on technical and business parameters. The deployment of MEC applications on a
+particular MEC platform may depend on the availability of specific MEC services and on other
+parameters, such as latency requirements, required resources, availability of a particular VNF, scalability
+considerations, cost etc.
+MEC will utilise the NFV infrastructure. The NFV platform may be dedicated to MEC or shared with other
+network functions or applications. MEC will also use (as much as possible) the NFV management and
+orchestration entities and interfaces.
+ETSI Industry Specification Group on Mobile Edge
+Computing
+The ETSI Industry Specification Group (ISG) on Mobile Edge Computing (MEC) produces normative
+Group Specifications that will enable the hosting of third-party applications in a multi-vendor MEC
+environment. Launched in December 2014, the group plans to deliver the first set of specifications
+within 2 years.
+The initial scope of the ISG MEC focuses on use cases; it specifies the requirements and the reference
+architecture, including the components and functional elements that are the key enablers for MEC
+solutions.
+When the first documents reach the required maturity level, work on platform services, APIs and
+interfaces will commence. The MEC platform API will be application-agnostic and will allow the smooth
+porting of value-creating applications on every mobile-edge server with guaranteed SLA (see Figure 7).
+ Figure 7: MEC platform API
+In addition to the technical work, an industry-enabling working group (IEG WG) has been setup under
+the ISG MEC which is tasked with advancing Mobile Edge Computing in the industry and accelerating the
+Mobile Edge Computing - a key technology towards 5G
+12
+adoption of the concept and the standards. This will help to develop favourable market conditions for
+sustainable business for all players in the value chain.
+The IEG group is developing two Group Specifications:
+1.  ETSI GS MEC-IEG 005 [2] Proof of Concept Framework, specifying the process and criteria that a
+Proof of Concept demonstration must adhere to. This specification has already been published;
+2.  ETSI GS MEC-IEG 004 Service Scenarios, which presents a number of examples of service
+scenarios, business and consumer benefits which can be enabled by Mobile Edge Computing.
+The ETSI ISG is open to members and non-members of ETSI to participate and contribute towards this
+innovative technology. Industry players are invited to actively participate and contribute to the work on
+Mobile Edge Computing and to take part in the PoC activities. More information on how to participate is
+available at: http://www.etsi.org/mobile-edge-computing/get-involved-in-mec.
+Proofs of Concept
+In order to ensure the success and widespread deployment of Mobile Edge Computing, it is necessary to
+have more than just timely and high quality specifications. It is crucial to validate the specifications that
+are being developed, and to demonstrate that the use cases have been fulfilled. Furthermore, the MEC
+concept must be demonstrated to be feasible and valuable to all the major stakeholders in the value
+chain in order to appeal to the widest possible audience.
+To showcase the Mobile Edge Computing concept, the ISG MEC has developed a Proof of Concept
+process, specified in GS MEC-IEG 005 [2]. A PoC proposal can be submitted by a PoC team consisting of
+at least one Mobile Network Operator, at least one infrastructure vendor and at least one content or
+application provider. GS MEC-IEG 005 [2] specifies the process and criteria that a Proof of Concept
+demonstration must adhere to in order to be accepted as a MEC PoC. A wiki site http://mecwiki.etsi.org
+has been put in place to assist PoC teams. This site hosts the PoC project proposal templates and the list
+of PoC Topics, which are specific areas where input or feedback from PoCs is needed. One or several PoC
+Topics can be addressed by a single PoC project.
+The public demonstration of MEC Proofs of Concept helps to build commercial awareness and
+confidence in this technology, and helps to develop a diverse, open, MEC ecosystem.
+Mobile Edge Computing - a key technology towards 5G
+13
+Conclusions
+Mobile Edge Computing enables innovative service scenarios that can ensure enhanced personal
+experience and optimized network operation, as well as opening up new business opportunities. A few
+examples are described in this white paper to demonstrate how proximity to users and objects, together
+with network and context information can be leveraged by applications to create value. Mobile Edge
+Computing attracts a new value-chain and energized eco-system, where all players can benefit from
+tighter collaboration. Mobile operators can play a pivotal role within the new value chain and attract
+OTT service providers, developers and Internet players to innovate over a new cutting-edge technology,
+while enabling context-aware applications to run in close proximity to the mobile subscriber. Mobile
+subscribers can enjoy a unique, truly gratifying and personalized mobile-broadband experience which is
+tailored to their needs and preferences.
+Based on a virtualized platform, MEC complements NFV and is fully aligned with the emerging
+distributed cloud approach. It is recognised as a key technology of the future 5G era, satisfying the
+demanding requirements for ultra-low latency and stimulating innovation.
+The MEC technology is defined by the ETSI ISG MEC, which was launched in December 2014 with the
+intention to develop the first set of specifications within 2 years. The deliverables will include service
+scenarios, requirements, architecture and API specifications, complemented with a PoC Framework
+specification and White Papers which aim to accelerate the market adoption of the MEC technology.
+MEC supports different deployment options, as MEC Servers can be located at different places within
+the Radio Access Network depending on technical and business requirements.
+A MEC Proof-of-Concept (PoC) program has been established to demonstrate the viability of MEC
+implementations. The results and lessons learned by the MEC PoCs are fed back to the ISG MEC
+specification activities.
+The MEC ISG is developing the foundation to enable an open radio access network which can host third
+party innovative applications and content at the edge of the network. The ISG is open to members and
+non-members of ETSI to participate and contribute towards this innovative technology, and to take part
+in the PoC activities.
+Mobile Edge Computing - a key technology towards 5G
+14
+References
+[1]
+5G Vision: The 5G Infrastructure Public Private Partnership: the next generation of
+communication networks and services. From The 5G Infrastructure Public Private Partnership:
+https://5g-ppp.eu/wp-content/uploads/2015/02/5G-Vision-Brochure-v1.pdf
+ [2]
+ETSI GS MEC-IEG 005; Mobile Edge Computing (MEC); Proof of Concept Framework.
+Mobile Edge Computing - a key technology towards 5G
+15
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+ This White Paper is issued for information only. It does not constitute an official or agreed position of ETSI, nor of its Members. The
+views expressed are entirely those of the author(s).
+ETSI declines all responsibility for any errors and any loss or damage resulting from use of the contents of this White Paper.
+ETSI  also  declines  responsibility  for  any  infringement  of  any  third  party's  Intellectual  Property  Rights  (IPR),  but  will  be  pleased  to
+acknowledge any IPR and correct any infringement of which it is advised.
+Copyright Notification
+Copying or reproduction in whole is permitted if the copy is complete and unchanged (including this copyright statement).
+ © European Telecommunications Standards Institute 2015. All rights reserved.
+DECT™, PLUGTESTS™, UMTS™, TIPHON™, IMS™, INTEROPOLIS™, FORAPOLIS™, and the TIPHON and ETSI logos are Trade Marks of ETSI
+registered for the benefit of its Members.
+3GPP™ and LTE™ are Trade Marks of ETSI registered for the benefit of its Members and of the 3GPP Organizational Partners.
+GSM™, the Global System for Mobile communication, is a registered Trade Mark of the GSM Association.

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@@ -1,229 +1,560 @@
-Special Publication 800-145
-The NIST Definition of Cloud
-Computing
-Recommendations of the National Institute
-of Standards and Technology
-Peter Mell
-Timothy Grance
-NIST Special Publication 800-145
-The NIST Definition of Cloud Computing
-Peter Mell
-Timothy Grance
-C  O  M  P  U  T  E  R      S  E  C  U  R  I  T  Y
-Computer Security Division
-Information Technology Laboratory
-National Institute of Standards and Technology
-Gaithersburg, MD 20899-8930
-September 2011
-U.S. Department of Commerce
-Rebecca M. Blank, Acting Secretary
-National Institute of Standards and Technology
-Patrick D. Gallagher, Under Secretary for Standards and
-Technology and Director
-Reports on Computer Systems Technology
-The  Information  Technology  Laboratory  (ITL)  at  the  National  Institute  of  Standards  and  Technology
-(NIST) promotes the U.S. economy and public welfare by providing technical leadership for the nation’s
-measurement  and  standards  infrastructure.    ITL  develops  tests,  test  methods,  reference  data,  proof  of
-concept  implementations,  and  technical  analysis  to  advance  the  development  and  productive  use  of
-information  technology.    ITL’s  responsibilities  include  the  development  of  technical,  physical,
-administrative,  and  management  standards  and  guidelines  for  the  cost-effective  security  and  privacy  of
-sensitive  unclassified  information  in  Federal  computer  systems.    This  Special  Publication  800-series
-reports  on  ITL’s  research,  guidance,  and  outreach  efforts  in  computer  security  and  its  collaborative
-activities with industry, government, and academic organizations.
-National Institute of Standards and Technology Special Publication 800-145
-7 pages (September 2011)
-Certain  commercial  entities,  equipment,  or  materials  may  be  identified  in  this
-document  in  order  to  describe  an  experimental  procedure  or  concept  adequately.
-Such identification is not intended to imply recommendation or endorsement by the
-National Institute of Standards and Technology, nor is it intended to imply that the
-entities, materials, or equipment are necessarily the best available for the purpose.
-ii
-Acknowledgements
-The  authors  Peter  Mell  and  Timothy  Grance  of  the  National  Institute  of  Standards  and  Technology
-(NIST) would like to thank the many experts in industry and government who contributed their thoughts
-to  the  creation  and  review  of  this  definition.  We  especially  acknowledge  Murugiah  Souppaya  and  Lee
-Badger,  also  of  NIST,  and  Wayne Jansen  of  Booz  Allen  Hamilton,  whose  advice  and technical insight
-assisted this effort.
-Errata
-The following changes have been incorporated into Special Publication 800-145, as of the date indicated
-in the table.
-DATE
-4/27/2012
-TYPE
-Editorial
-Corrected page number from “2” to “1”
-CHANGE
-PAGE NUMBER
-1
-iii
-1.
-Introduction
-1.1  Authority
-The National Institute of Standards and Technology (NIST) developed this document in furtherance of its
-statutory  responsibilities  under  the  Federal  Information  Security  Management  Act  (FISMA)  of  2002,
-Public Law 107-347.
-NIST  is  responsible  for  developing  standards  and  guidelines,  including  minimum  requirements,  for
-providing  adequate  information  security  for  all  agency  operations  and  assets;  but  such  standards  and
-guidelines shall not apply to national security systems.  This guideline is consistent with the requirements
-of  the  Office  of  Management  and  Budget  (OMB)  Circular  A-130,  Section  8b(3),  “Securing  Agency
-Information  Systems,”  as  analyzed  in  A-130,  Appendix  IV:  Analysis  of  Key  Sections.    Supplemental
-information is provided in A-130, Appendix III.
-This  guideline  has  been  prepared  for  use  by  Federal  agencies.    It  may  be  used  by  nongovernmental
-organizations on a voluntary basis and is not subject to copyright, though attribution is desired.
-Nothing  in  this  document  should  be  taken  to  contradict  standards  and  guidelines  made  mandatory  and
-binding  on  Federal  agencies  by  the  Secretary  of  Commerce  under  statutory  authority,  nor  should  these
-guidelines be interpreted as altering or superseding the existing authorities of the Secretary of Commerce,
-Director of the OMB, or any other Federal official.
-1.2  Purpose and Scope
-Cloud computing is an evolving paradigm. The NIST definition characterizes important aspects of cloud
-computing and is intended to serve as a means for broad comparisons of cloud services and deployment
-strategies, and to provide a baseline for discussion from what is cloud computing to how to best use cloud
-computing.  The service and deployment models defined form a simple taxonomy that is not intended to
-prescribe or constrain any particular method of deployment, service delivery, or business operation.
-1.3  Audience
-The intended audience of this document is system planners, program managers, technologists, and others
-adopting cloud computing as consumers or providers of cloud services.
- 1
-2.
-The NIST Definition of Cloud Computing
-Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared
-pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that
-can be rapidly provisioned and released with minimal management effort or service provider interaction.
-This cloud model is composed of five essential characteristics, three service models, and four deployment
-models.
-Essential Characteristics:
-On-demand  self-service.  A  consumer  can  unilaterally  provision  computing  capabilities,  such  as
-server  time  and  network  storage,  as  needed  automatically  without  requiring  human
-interaction with each service provider.
-Broad network access. Capabilities are available over the network and accessed through standard
-mechanisms  that  promote  use  by  heterogeneous  thin  or  thick  client  platforms  (e.g.,
-mobile phones, tablets, laptops, and workstations).
-Resource  pooling.  The  provider’s  computing  resources  are  pooled  to  serve  multiple  consumers
-using  a  multi-tenant  model,  with  different  physical  and  virtual  resources  dynamically
-assigned  and  reassigned  according  to  consumer  demand.  There  is  a  sense  of  location
-independence in that the customer generally has no control or knowledge over the exact
-location of the provided resources but may be able to specify location at a higher level of
-abstraction  (e.g.,  country,  state,  or  datacenter).  Examples  of  resources  include  storage,
-processing, memory, and network bandwidth.
-Rapid  elasticity.  Capabilities  can  be  elastically  provisioned  and  released,  in  some  cases
-automatically, to scale rapidly outward and inward commensurate with demand. To the
-consumer, the capabilities available for provisioning often appear to be unlimited and can
-be appropriated in any quantity at any time.
-Measured service. Cloud systems automatically control and optimize resource use by leveraging
-a metering capability1 at some level of abstraction appropriate to the type of service (e.g.,
-storage,  processing,  bandwidth,  and  active  user  accounts).  Resource  usage  can  be
-monitored,  controlled,  and  reported,  providing  transparency  for  both  the  provider  and
-consumer of the utilized service.
-Service Models:
-Software  as  a  Service  (SaaS).  The  capability  provided  to  the  consumer  is to  use  the  provider’s
-applications  running  on  a  cloud  infrastructure2.  The  applications  are  accessible  from
-various client devices through either a thin client interface, such as a web browser (e.g.,
-web-based email), or a program interface. The consumer does not manage or control the
-underlying cloud infrastructure including network, servers, operating systems, storage, or
-even  individual  application  capabilities,  with  the  possible  exception  of  limited  user-
-specific application configuration settings.
-Platform as a Service (PaaS). The capability provided to the consumer is to deploy onto the cloud
-infrastructure  consumer-created  or  acquired  applications  created  using  programming
-1 Typically this is done on a pay-per-use or charge-per-use basis.
-2  A  cloud  infrastructure  is  the  collection  of  hardware  and  software  that  enables  the  five  essential  characteristics  of  cloud
-computing. The cloud infrastructure can be viewed as containing both a physical layer and an abstraction layer. The physical
-layer consists of the hardware resources that are necessary to support the cloud services being provided, and typically includes
-server,  storage  and  network  components.  The  abstraction  layer  consists  of  the  software  deployed  across  the  physical  layer,
-which manifests the essential cloud characteristics.  Conceptually the abstraction layer sits above the physical layer.
- 2
-languages,  libraries,  services,  and tools  supported  by  the  provider.3  The  consumer  does
-not  manage  or  control  the  underlying  cloud  infrastructure  including  network,  servers,
-operating systems, or storage, but has control over the deployed applications and possibly
-configuration settings for the application-hosting environment.
-Infrastructure  as  a  Service  (IaaS).  The  capability  provided  to  the  consumer  is  to  provision
-processing,  storage,  networks,  and  other  fundamental  computing  resources  where  the
-consumer  is  able  to  deploy  and  run  arbitrary  software,  which  can  include  operating
-systems and applications. The consumer does not manage or control the underlying cloud
-infrastructure but has control over operating systems, storage, and deployed applications;
-and possibly limited control of select networking components (e.g., host firewalls).
-Deployment Models:
-Private cloud. The cloud infrastructure is provisioned for exclusive use by a single organization
-comprising  multiple  consumers  (e.g.,  business  units).  It  may  be  owned,  managed,  and
-operated by the organization, a third party, or some combination of them, and it may exist
-on or off premises.
-Community  cloud.  The  cloud  infrastructure  is  provisioned  for  exclusive  use  by  a  specific
-community  of  consumers  from  organizations  that  have  shared  concerns  (e.g.,  mission,
-security  requirements,  policy,  and  compliance  considerations).  It  may  be  owned,
-managed,  and  operated  by  one  or  more  of  the  organizations  in  the  community,  a  third
-party, or some combination of them, and it may exist on or off premises.
-Public cloud. The cloud infrastructure is provisioned for open use by the general public. It may be
-owned, managed, and operated by a business, academic, or government organization, or
-some combination of them.  It exists on the premises of the cloud provider.
-Hybrid  cloud.  The  cloud  infrastructure  is  a  composition  of  two  or  more  distinct  cloud
-infrastructures (private, community, or public) that remain unique entities, but are bound
-together  by  standardized  or  proprietary  technology  that  enables  data  and  application
-portability (e.g., cloud bursting for load balancing between clouds).
-3 This capability does not necessarily preclude the use of compatible programming languages, libraries, services, and tools from
-other sources.
- 3

+ETSI White Paper No. 11
+Mobile Edge Computing
+A key technology towards 5G
+First edition – September 2015
+ISBN No. 979-10-92620-08-5
+Authors:
+Yun Chao Hu, Milan Patel, Dario Sabella, Nurit Sprecher and Valerie Young
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+About the authors
+Yun Chao Hu
+Contributor, Huawei, Vice Chair ETSI MEC ISG, Chair MEC IEG Working Group
+Milan Patel
+Contributor, Huawei
+Dario Sabella
+Contributor, Telecom Italia; Vice-Chair MEC IEG Working Group
+Nurit Sprecher
+Contributor, Nokia; Chair ETSI MEC ISG
+Valerie Young
+Contributor, Intel
+Mobile Edge Computing - a key technology towards 5G
+2
+Contents
+About the authors
+Contents
+Introduction
+Market Drivers
+Business Value
+Mobile Edge Computing Service Scenarios
+General
+Augmented Reality
+Intelligent Video Acceleration
+Connected Cars
+Internet of Things Gateway
+Deployment Scenarios
+ETSI Industry Specification Group on Mobile Edge Computing
+Proofs of Concept
+Conclusions
+References
+2
+3
+4
+5
+6
+7
+7
+8
+9
+9
+11
+11
+12
+13
+14
+15
+Mobile Edge Computing - a key technology towards 5G
+3
+Introduction
+Mobile Edge Computing (MEC) is a new technology which is currently being standardized in an ETSI
+Industry Specification Group (ISG) of the same name. Mobile Edge Computing provides an IT service
+environment and cloud-computing capabilities at the edge of the mobile network, within the Radio
+Access Network (RAN) and in close proximity to mobile subscribers. The aim is to reduce latency, ensure
+highly efficient network operation and service delivery, and offer an improved user experience.
+Mobile Edge Computing is a natural development in the evolution of mobile base stations and the
+convergence of IT and telecommunications networking. Based on a virtualized platform, MEC is
+recognized by the European 5G PPP (5G Infrastructure Public Private Partnership) research body as one
+of the key emerging technologies for 5G networks (together with Network Functions Virtualization (NFV)
+and Software-Defined Networking (SDN)) [1]. In addition to defining more advanced air interface
+technologies, 5G networks will leverage more programmable approaches to software networking and
+use IT virtualization technology extensively within the telecommunications infrastructure, functions, and
+applications. MEC thus represents a key technology and architectural concept to enable the evolution to
+5G, since it helps advance the transformation of the mobile broadband network into a programmable
+world and contributes to satisfying the demanding requirements of 5G in terms of expected throughout,
+latency, scalability and automation.
+MEC is based on a virtualized platform, with an approach complementary to NFV: in fact, while NVF is
+focused on network functions, the MEC framework enables applications running at the edge of the
+network. The infrastructure that hosts MEC and NFV or network functions is quite similar; thus, in order
+to allow operators to benefit as much as possible from their investment, it will be beneficial to reuse the
+infrastructure and infrastructure management of NFV to the largest extent possible, by hosting both
+VNFs (Virtual Network Functions) and MEC applications on the same platform.
+The environment of Mobile Edge Computing is characterized by low latency, proximity, high bandwidth,
+and real-time insight into radio network information and location awareness. All of this can be
+translated into value and can create opportunities for mobile operators, application and content
+providers enabling them to play complementary and profitable roles within their respective business
+models and allowing them to better monetize the mobile broadband experience.
+Mobile Edge Computing opens up services to consumers and enterprise customers as well as to adjacent
+industries that can now deliver their mission-critical applications over the mobile network. It enables a
+new value chain, fresh business opportunities and a myriad of new use cases across multiple sectors.
+The intention is to develop favourable market conditions which will create sustainable business for all
+players in the value chain, and to facilitate global market growth. To this end, a standardized, open
+environment needs to be created to allow the efficient and seamless integration of such applications
+across multi-vendor Mobile Edge Computing platforms. This will also ensure that the vast majority of the
+customers of a mobile operator can be served.
+The objectives of this white paper are to introduce the concept of Mobile Edge Computing and the
+related key market drivers, and to discuss the business and technical benefits of Mobile Edge
+Computing. A few examples of service scenarios that can benefit from the technology and possible
+deployment scenarios are presented. The white paper explains what is being standardized and how
+Mobile Edge Computing - a key technology towards 5G
+4
+innovation can be stimulated through using a standardized API. It outlines the specifications being
+produced by the Industry Specification Group on MEC.
+ETSI ISG MEC encourages Proofs of Concept (PoC) to demonstrate the viability of MEC implementations.
+PoCs help to build awareness and confidence in the technology, and to develop a diverse and open MEC
+ecosystem. This white paper describes the MEC PoC framework and calls for active participation.
+Market Drivers
+The growth of mobile traffic and pressure on costs are driving a need to implement several changes in
+order to maintain quality of experience, to generate revenue, and optimize network operations and
+resource utilization.  The Internet of Things is further congesting the network and network operators
+need to do local analysis to ease security and backhaul impacts.  Enterprises want the ability to enable
+and engage with their customers with more efficient, secure and low latency connections.  Application
+and content providers are challenged with the latency of the network when connecting to the cloud.
+These challenges need to be resolved.
+Mobile operators need to shorten the time to launch new revenue generating applications for current
+customers but also for specific industries and sectors, such as but not limited to automotive, industry
+automation and welfare industries.  Business transformation based on collaboration with the different
+players in the value chain can help in facing these challenges.
+Technology improvements which provide low latency, better flexibility, agility, usage of virtualization,
+network and context awareness, etc. can provide the opportunity to increase the Quality of Experience
+of end users and make network operation more cost effective and competitive.
+Smart phone applications and content are moving to the cloud. The access to the cloud needs to be
+optimised to guarantee a rich experience for consumers of an application or consumers of content and a
+tight collaboration is essential between network operators and application and content providers. This
+collaboration can lead to the deployment of applications/content at the edge of the mobile operator’s
+network, providing awareness of the network and context information.  Standardization will be essential
+to support this collaboration and the hosting of cloud or internet based applications within a multi-
+vendor environment.
+The market drivers of MEC include business transformation, technology integration and industry
+collaboration (as illustrated in Figure 1). All of these can be enabled by MEC and a wide variety of use
+cases can be supported for new and innovative markets, such as e-Health, connected vehicles, industry
+automation, augmented reality, gaming and IoT services.
+Mobile Edge Computing - a key technology towards 5G
+5
+Figure 1: MEC market drivers
+Business Value
+Mobile Edge Computing offers an IT service environment at a location considered to be a lucrative point
+in the mobile network: the Radio Access Network (RAN) edge. Characterized by proximity, low latency
+and high bandwidth, this environment will offer localized cloud computing capabilities as well as
+exposure to real-time radio network and context information.
+Opening up this IT service environment will allow applications and services from mobile operators,
+service and content providers to be efficiently and seamlessly integrated across multi-vendor, mobile
+edge computing platforms. The characteristics and capabilities offered by a MEC platform can be
+leveraged in a way that will allow proximity, context, agility and speed to be used for wider innovation
+that can be translated into unique value and revenue generation.
+Access to content and applications can be accelerated; their responsiveness can be increased,
+maximizing speed and interactivity. Popular and locally-relevant content can be delivered directly where
+users connect, limiting ingress bandwidth to the core and cloud.
+Knowledge of real-time radio network conditions and context information can be used to optimize the
+network and service operation (responding and adapting to changing network conditions). This would
+improve service experience and the utilization of network resources, enabling them to efficiently handle
+increased amounts of traffic. Real-time network and fine-granular context information (including
+Mobile Edge Computing - a key technology towards 5G
+6
+location) could be used to enrich the mobile broadband experience by creating highly personalized
+services which are tailored to individual needs and preferences.
+Operators can reposition themselves in the value chain and redefine personalized services. They can
+capitalize their networks and open them up to authorized third-parties (in a secure way), exposing
+capabilities to Over the Top (OTT) players and application developers to flexibly, agilely and rapidly
+deploy innovative applications and services towards mobile subscribers, enterprises and vertical
+segments. Operators will be able to create new revenue streams, delight their customers by developing
+a new breed of applications that provide incremental value, and open up new market opportunities. In
+addition, applications supporting tighter integration of network and service parameters will improve
+both service experience and utilization of the network resources.
+Application service providers, OTT players and independent software vendors will be able to translate
+proximity and context into value, and be able to generate new revenue.  Their applications and services
+can be enhanced and accelerated to provide a unique and unparalleled experience. Innovative
+applications can be deployed rapidly in a new standards-based environment, taking advantage of new
+levels of flexibility and agility. Applications will be able to expand their cloud into the mobile network
+and create a whole new set of services. They will be able to feel and react to end-user experience in real
+time, based on the actual radio conditions. The new MEC specifications will allow applications and
+services to be deployed on top of multi-vendor Mobile Edge Computing platforms, enabling them to be
+used by the vast majority of the customers of a single mobile operator. The mobile end user will enjoy a
+unique, gratifying and personalized mobile-broadband experience.
+The MEC initiative will help to develop favourable market conditions for all players in the value chain as
+well as facilitate economic growth with a myriad of new use cases across multiple sectors (see Figure 2).
+Figure 2: Improved QoE with Mobile Edge Computing in close proximity to end users
+Mobile Edge Computing Service Scenarios
+General
+The following sections describe a number of service scenarios that have been considered within ETSI ISG
+MEC. These illustrate various scenarios which can take advantage of Mobile Edge Computing to either
+Mobile Edge Computing - a key technology towards 5G
+7
+increase performance compared to providing such services through the cloud or through core network
+servers, or to utilize the unique capabilities offered by MEC platforms such as proximity to the user and
+network edge, serving a highly localized area. It should be noted these examples are non-exhaustive and
+further service scenarios are available in the ETSI ISG MEC specification for Mobile Edge Computing
+Service Scenarios, GS MEC 004. Other scenarios which can make use of MEC are also possible.
+Augmented Reality
+New services become possible when mobile networks supporting high data rates and low latency
+computation are deployed. One example of such services is Augmented Reality. Augmented reality (AR)
+is the combination of a view of the real-world environment and supplementary computer-generated
+sensory input such as sound, video, graphics or GPS data. Augmented reality can enhance the
+experience of a visitor to a museum or another point of interest. Consider a visitor to a museum, art
+gallery, city monument, music or sports event, holding their mobile device towards a particular point of
+interest with the application related to their visit activated (i.e., the museum application). The camera
+captures the point of interest and the application displays additional information related to what the
+visitor is viewing.
+Augmented reality services require an application to analyse the output from a device's camera and/or a
+precise location in order to supplement a user's experience when visiting a point of interest by providing
+additional information to the user about what they are currently experiencing. The application needs to
+be aware of a user's position and the direction they are facing, either through positioning techniques or
+through the camera view, or both. After analysing such information, the application can provide
+additional information in real-time to the user. If the user moves, the information needs to be
+refreshed. Hosting the Augmented Reality service on a MEC platform instead of in the cloud is
+advantageous since supplementary information pertaining to a point of interest is highly localised and is
+often irrelevant beyond the particular point of interest. Figure 3 shows how a MEC platform can be used
+to provide an Augmented Reality service.
+Figure 3: Augmented Reality Service Scenario
+Additionally, the processing of user location or camera view can be performed on a MEC platform rather
+than on a more centralized server. There may be a need to update information at a fast rate, depending
+on how the user moves, and the context in which the augmented reality service is used (e.g. in an art
+gallery, exhibits are positioned only a few metres apart and each piece is supplemented with additional
+text on the artist, the interpretation of the artwork, etc.) In other words, augmented reality data
+requires low latency and a high rate of data processing in order to provide the correct information to
+Mobile Edge Computing - a key technology towards 5G
+8
+the user's device depending on the location and orientation of the user. Performing such data
+processing on the MEC platform also has the advantage of collecting metrics, anonymized meta-data,
+etc., in order to analyse the service usage and help to improve the service in order to provide a better
+user experience.
+Intelligent Video Acceleration
+End user Quality of Experience (QoE) and utilization of radio network resources can be improved
+through intelligent video acceleration. Internet media and file delivery are typically streamed or
+downloaded today using Hypertext Transmission Protocol (HTTP) over the TCP protocol. Available
+capacity can vary by an order of magnitude within seconds (as a result of changes in radio channel
+conditions, devices entering/leaving network). TCP may not be able to adapt fast enough to rapidly-
+varying conditions in the radio access network (RAN). This may lead to under-utilisation of precious
+radio resources and to a sub-optimal user experience.
+Figure 4 shows an example of the intelligent video acceleration service scenario which attempts to
+overcome the challenges described above. In this scenario, a radio analytics application, which resides in
+a MEC server, provides the video server with an indication on the throughput estimated to be available
+at the radio downlink interface. This information can be used to assist the TCP congestion control
+decisions (for example in selecting the initial window size, setting the value of the congestion window
+during the congestion avoidance phase, and adjusting the size of the congestion window when the
+conditions on the "radio link" deteriorate). The information can also be used to ensure that the
+application-level coding matches the estimated capacity at the radio downlink.
+The video server may use this information to assist TCP congestion control decisions (for example by
+ensuring that the application level coding matches the estimated capacity at the radio downlink). The
+content’s time-to-start as well as video-stall occurrences can be reduced, enabling improved video
+quality and throughput.
+ Figure 4: Intelligent Video Acceleration Service Scenario
+Connected Cars
+The number of connected vehicles is rapidly growing and will continue to do so over the coming years.
+Communication of vehicles and roadside sensors with a roadside unit is intended to increase the safety,
+efficiency, and convenience of the transportation system, by the exchange of critical safety and
+Mobile Edge Computing - a key technology towards 5G
+9
+operational data. The communication can also be used to provide value added services, such as car
+finder, parking location and to support entertainment services (e.g. video distribution).
+As the number of connected vehicles increases and use cases evolve, the volume of data will continue to
+increase along with the need to minimize latency.  Whilst data stored and processed centrally may be
+adequate for some use cases, it can be unreliable and slow for others.
+LTE can significantly accelerate the deployment of connected vehicle communications.  LTE cells can
+provide “beyond the line of sight” visibility i.e. beyond the range of direct communication between
+vehicles of 300 – 500m. It can also satisfy the tight latency requirement of connected vehicle
+communications, below 100ms in some use cases. Messages could be distributed in real time over LTE,
+eliminating the need to build a countrywide Digital Short-Range Communications (DSRC) network. Cars
+can leverage their increasingly inbuilt LTE connectivity; in deployments where DSRC exists, LTE would be
+able complement it.
+Mobile Edge Computing can be used to extend the connected car cloud into the highly distributed
+mobile base station environment, and enable data and applications to be housed close to the vehicles.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications provided over the internet. MEC applications can run on MEC servers which
+are deployed at the LTE base station site to provide the roadside functionality. The MEC applications can
+receive local messages directly from the applications in the vehicles and the roadside sensors, analyse
+them and then propagate (with extremely low latency) hazard warnings and other latency-sensitive
+messages to other cars in the area (as depicted in Figure 5). This enables a nearby car to receive data in
+a matter of milliseconds, allowing the driver to immediately react.
+Figure 5: Connected Vehicles Service Scenario
+The roadside MEC application will be able to inform adjacent Mobile Edge Computing servers about the
+event(s) and in so doing, enable these servers to propagate hazard warnings to cars that are close to the
+affected area.
+The roadside application will be able to send local information to the applications at the connected car
+cloud for further centralized processing and reporting.
+Mobile Edge Computing - a key technology towards 5G
+10
+Internet of Things Gateway
+The Internet of Things (IoT) generates additional messaging on telecoms networks, and requires
+gateways to aggregate the messages and ensure low latency and security.  Because of the nature of
+some of the devices being connected, a real time capability is required and a grouping of sensors and
+devices is needed for efficient service.
+IoT devices are often resource constrained in terms of processor and memory capacity. There is a need
+to aggregate various IoT device messages connected through the mobile network close to the devices.
+This also provides an analytics processing capability and a low latency response time.
+Figure 6: IoT Gateway Service Scenario
+Various devices are connected over different forms of connectivity, such as 3G, LTE, Wi-Fi or other radio
+technologies. In general the messages are small, encrypted and come in different forms of protocols.
+There is a need for a low latency aggregation point to manage the various protocols, distribution of
+messages and for the processing of analytics. The MEC server provides the capability to resolve these
+challenges.
+Mobile Edge Computing can be used to connect and control devices remotely, analyse and provide real
+time provisioning and analytics.  MEC enables the aggregation and distribution of IoT services into the
+highly distributed mobile base station environment, and enable applications to respond in real-time.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications in the cloud. IoT applications can run on MEC servers which are deployed at
+the LTE base station site to provide this functionality.
+Deployment Scenarios
+Mobile Edge Computing servers can be deployed at multiple locations, such as at the LTE macro base
+station (eNodeB) site, at the 3G Radio Network Controller (RNC) site, at a multi-Radio Access Technology
+(RAT) cell aggregation site, and at an aggregation point (which may also be at the edge of the core
+network). The multi-RAT cell aggregation site can be located indoors within an enterprise (e.g. hospital,
+large corporate HQ), or indoors/outdoors for a special public coverage scenario (e.g. stadium, shopping
+mall) to control a number of local multi-RAT access points providing radio coverage to the premises. This
+deployment option enables the direct delivery of locally-relevant, fast services from base station
+clusters. Where a MEC platform is deployed may depend on a number of factors, including scalability,
+Mobile Edge Computing - a key technology towards 5G
+11
+physical deployment constraints, performance criteria (e.g. latency) and which network information will
+be exposed. Note that some MEC services may not be available / applicable in certain deployment
+options.
+MEC applications can be intelligently and flexibly deployed in a seamless manner on different MEC
+platforms based on technical and business parameters. The deployment of MEC applications on a
+particular MEC platform may depend on the availability of specific MEC services and on other
+parameters, such as latency requirements, required resources, availability of a particular VNF, scalability
+considerations, cost etc.
+MEC will utilise the NFV infrastructure. The NFV platform may be dedicated to MEC or shared with other
+network functions or applications. MEC will also use (as much as possible) the NFV management and
+orchestration entities and interfaces.
+ETSI Industry Specification Group on Mobile Edge
+Computing
+The ETSI Industry Specification Group (ISG) on Mobile Edge Computing (MEC) produces normative
+Group Specifications that will enable the hosting of third-party applications in a multi-vendor MEC
+environment. Launched in December 2014, the group plans to deliver the first set of specifications
+within 2 years.
+The initial scope of the ISG MEC focuses on use cases; it specifies the requirements and the reference
+architecture, including the components and functional elements that are the key enablers for MEC
+solutions.
+When the first documents reach the required maturity level, work on platform services, APIs and
+interfaces will commence. The MEC platform API will be application-agnostic and will allow the smooth
+porting of value-creating applications on every mobile-edge server with guaranteed SLA (see Figure 7).
+ Figure 7: MEC platform API
+In addition to the technical work, an industry-enabling working group (IEG WG) has been setup under
+the ISG MEC which is tasked with advancing Mobile Edge Computing in the industry and accelerating the
+Mobile Edge Computing - a key technology towards 5G
+12
+adoption of the concept and the standards. This will help to develop favourable market conditions for
+sustainable business for all players in the value chain.
+The IEG group is developing two Group Specifications:
+1.  ETSI GS MEC-IEG 005 [2] Proof of Concept Framework, specifying the process and criteria that a
+Proof of Concept demonstration must adhere to. This specification has already been published;
+2.  ETSI GS MEC-IEG 004 Service Scenarios, which presents a number of examples of service
+scenarios, business and consumer benefits which can be enabled by Mobile Edge Computing.
+The ETSI ISG is open to members and non-members of ETSI to participate and contribute towards this
+innovative technology. Industry players are invited to actively participate and contribute to the work on
+Mobile Edge Computing and to take part in the PoC activities. More information on how to participate is
+available at: http://www.etsi.org/mobile-edge-computing/get-involved-in-mec.
+Proofs of Concept
+In order to ensure the success and widespread deployment of Mobile Edge Computing, it is necessary to
+have more than just timely and high quality specifications. It is crucial to validate the specifications that
+are being developed, and to demonstrate that the use cases have been fulfilled. Furthermore, the MEC
+concept must be demonstrated to be feasible and valuable to all the major stakeholders in the value
+chain in order to appeal to the widest possible audience.
+To showcase the Mobile Edge Computing concept, the ISG MEC has developed a Proof of Concept
+process, specified in GS MEC-IEG 005 [2]. A PoC proposal can be submitted by a PoC team consisting of
+at least one Mobile Network Operator, at least one infrastructure vendor and at least one content or
+application provider. GS MEC-IEG 005 [2] specifies the process and criteria that a Proof of Concept
+demonstration must adhere to in order to be accepted as a MEC PoC. A wiki site http://mecwiki.etsi.org
+has been put in place to assist PoC teams. This site hosts the PoC project proposal templates and the list
+of PoC Topics, which are specific areas where input or feedback from PoCs is needed. One or several PoC
+Topics can be addressed by a single PoC project.
+The public demonstration of MEC Proofs of Concept helps to build commercial awareness and
+confidence in this technology, and helps to develop a diverse, open, MEC ecosystem.
+Mobile Edge Computing - a key technology towards 5G
+13
+Conclusions
+Mobile Edge Computing enables innovative service scenarios that can ensure enhanced personal
+experience and optimized network operation, as well as opening up new business opportunities. A few
+examples are described in this white paper to demonstrate how proximity to users and objects, together
+with network and context information can be leveraged by applications to create value. Mobile Edge
+Computing attracts a new value-chain and energized eco-system, where all players can benefit from
+tighter collaboration. Mobile operators can play a pivotal role within the new value chain and attract
+OTT service providers, developers and Internet players to innovate over a new cutting-edge technology,
+while enabling context-aware applications to run in close proximity to the mobile subscriber. Mobile
+subscribers can enjoy a unique, truly gratifying and personalized mobile-broadband experience which is
+tailored to their needs and preferences.
+Based on a virtualized platform, MEC complements NFV and is fully aligned with the emerging
+distributed cloud approach. It is recognised as a key technology of the future 5G era, satisfying the
+demanding requirements for ultra-low latency and stimulating innovation.
+The MEC technology is defined by the ETSI ISG MEC, which was launched in December 2014 with the
+intention to develop the first set of specifications within 2 years. The deliverables will include service
+scenarios, requirements, architecture and API specifications, complemented with a PoC Framework
+specification and White Papers which aim to accelerate the market adoption of the MEC technology.
+MEC supports different deployment options, as MEC Servers can be located at different places within
+the Radio Access Network depending on technical and business requirements.
+A MEC Proof-of-Concept (PoC) program has been established to demonstrate the viability of MEC
+implementations. The results and lessons learned by the MEC PoCs are fed back to the ISG MEC
+specification activities.
+The MEC ISG is developing the foundation to enable an open radio access network which can host third
+party innovative applications and content at the edge of the network. The ISG is open to members and
+non-members of ETSI to participate and contribute towards this innovative technology, and to take part
+in the PoC activities.
+Mobile Edge Computing - a key technology towards 5G
+14
+References
+[1]
+5G Vision: The 5G Infrastructure Public Private Partnership: the next generation of
+communication networks and services. From The 5G Infrastructure Public Private Partnership:
+https://5g-ppp.eu/wp-content/uploads/2015/02/5G-Vision-Brochure-v1.pdf
+ [2]
+ETSI GS MEC-IEG 005; Mobile Edge Computing (MEC); Proof of Concept Framework.
+Mobile Edge Computing - a key technology towards 5G
+15
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+ This White Paper is issued for information only. It does not constitute an official or agreed position of ETSI, nor of its Members. The
+views expressed are entirely those of the author(s).
+ETSI declines all responsibility for any errors and any loss or damage resulting from use of the contents of this White Paper.
+ETSI  also  declines  responsibility  for  any  infringement  of  any  third  party's  Intellectual  Property  Rights  (IPR),  but  will  be  pleased  to
+acknowledge any IPR and correct any infringement of which it is advised.
+Copyright Notification
+Copying or reproduction in whole is permitted if the copy is complete and unchanged (including this copyright statement).
+ © European Telecommunications Standards Institute 2015. All rights reserved.
+DECT™, PLUGTESTS™, UMTS™, TIPHON™, IMS™, INTEROPOLIS™, FORAPOLIS™, and the TIPHON and ETSI logos are Trade Marks of ETSI
+registered for the benefit of its Members.
+3GPP™ and LTE™ are Trade Marks of ETSI registered for the benefit of its Members and of the 3GPP Organizational Partners.
+GSM™, the Global System for Mobile communication, is a registered Trade Mark of the GSM Association.

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@@ -1,229 +1,560 @@
-Special Publication 800-145
-The NIST Definition of Cloud
-Computing
-Recommendations of the National Institute
-of Standards and Technology
-Peter Mell
-Timothy Grance
-NIST Special Publication 800-145
-The NIST Definition of Cloud Computing
-Peter Mell
-Timothy Grance
-C  O  M  P  U  T  E  R      S  E  C  U  R  I  T  Y
-Computer Security Division
-Information Technology Laboratory
-National Institute of Standards and Technology
-Gaithersburg, MD 20899-8930
-September 2011
-U.S. Department of Commerce
-Rebecca M. Blank, Acting Secretary
-National Institute of Standards and Technology
-Patrick D. Gallagher, Under Secretary for Standards and
-Technology and Director
-Reports on Computer Systems Technology
-The  Information  Technology  Laboratory  (ITL)  at  the  National  Institute  of  Standards  and  Technology
-(NIST) promotes the U.S. economy and public welfare by providing technical leadership for the nation’s
-measurement  and  standards  infrastructure.    ITL  develops  tests,  test  methods,  reference  data,  proof  of
-concept  implementations,  and  technical  analysis  to  advance  the  development  and  productive  use  of
-information  technology.    ITL’s  responsibilities  include  the  development  of  technical,  physical,
-administrative,  and  management  standards  and  guidelines  for  the  cost-effective  security  and  privacy  of
-sensitive  unclassified  information  in  Federal  computer  systems.    This  Special  Publication  800-series
-reports  on  ITL’s  research,  guidance,  and  outreach  efforts  in  computer  security  and  its  collaborative
-activities with industry, government, and academic organizations.
-National Institute of Standards and Technology Special Publication 800-145
-7 pages (September 2011)
-Certain  commercial  entities,  equipment,  or  materials  may  be  identified  in  this
-document  in  order  to  describe  an  experimental  procedure  or  concept  adequately.
-Such identification is not intended to imply recommendation or endorsement by the
-National Institute of Standards and Technology, nor is it intended to imply that the
-entities, materials, or equipment are necessarily the best available for the purpose.
-ii
-Acknowledgements
-The  authors  Peter  Mell  and  Timothy  Grance  of  the  National  Institute  of  Standards  and  Technology
-(NIST) would like to thank the many experts in industry and government who contributed their thoughts
-to  the  creation  and  review  of  this  definition.  We  especially  acknowledge  Murugiah  Souppaya  and  Lee
-Badger,  also  of  NIST,  and  Wayne Jansen  of  Booz  Allen  Hamilton,  whose  advice  and technical insight
-assisted this effort.
-Errata
-The following changes have been incorporated into Special Publication 800-145, as of the date indicated
-in the table.
-DATE
-4/27/2012
-TYPE
-Editorial
-Corrected page number from “2” to “1”
-CHANGE
-PAGE NUMBER
-1
-iii
-1.
-Introduction
-1.1  Authority
-The National Institute of Standards and Technology (NIST) developed this document in furtherance of its
-statutory  responsibilities  under  the  Federal  Information  Security  Management  Act  (FISMA)  of  2002,
-Public Law 107-347.
-NIST  is  responsible  for  developing  standards  and  guidelines,  including  minimum  requirements,  for
-providing  adequate  information  security  for  all  agency  operations  and  assets;  but  such  standards  and
-guidelines shall not apply to national security systems.  This guideline is consistent with the requirements
-of  the  Office  of  Management  and  Budget  (OMB)  Circular  A-130,  Section  8b(3),  “Securing  Agency
-Information  Systems,”  as  analyzed  in  A-130,  Appendix  IV:  Analysis  of  Key  Sections.    Supplemental
-information is provided in A-130, Appendix III.
-This  guideline  has  been  prepared  for  use  by  Federal  agencies.    It  may  be  used  by  nongovernmental
-organizations on a voluntary basis and is not subject to copyright, though attribution is desired.
-Nothing  in  this  document  should  be  taken  to  contradict  standards  and  guidelines  made  mandatory  and
-binding  on  Federal  agencies  by  the  Secretary  of  Commerce  under  statutory  authority,  nor  should  these
-guidelines be interpreted as altering or superseding the existing authorities of the Secretary of Commerce,
-Director of the OMB, or any other Federal official.
-1.2  Purpose and Scope
-Cloud computing is an evolving paradigm. The NIST definition characterizes important aspects of cloud
-computing and is intended to serve as a means for broad comparisons of cloud services and deployment
-strategies, and to provide a baseline for discussion from what is cloud computing to how to best use cloud
-computing.  The service and deployment models defined form a simple taxonomy that is not intended to
-prescribe or constrain any particular method of deployment, service delivery, or business operation.
-1.3  Audience
-The intended audience of this document is system planners, program managers, technologists, and others
-adopting cloud computing as consumers or providers of cloud services.
- 1
-2.
-The NIST Definition of Cloud Computing
-Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared
-pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that
-can be rapidly provisioned and released with minimal management effort or service provider interaction.
-This cloud model is composed of five essential characteristics, three service models, and four deployment
-models.
-Essential Characteristics:
-On-demand  self-service.  A  consumer  can  unilaterally  provision  computing  capabilities,  such  as
-server  time  and  network  storage,  as  needed  automatically  without  requiring  human
-interaction with each service provider.
-Broad network access. Capabilities are available over the network and accessed through standard
-mechanisms  that  promote  use  by  heterogeneous  thin  or  thick  client  platforms  (e.g.,
-mobile phones, tablets, laptops, and workstations).
-Resource  pooling.  The  provider’s  computing  resources  are  pooled  to  serve  multiple  consumers
-using  a  multi-tenant  model,  with  different  physical  and  virtual  resources  dynamically
-assigned  and  reassigned  according  to  consumer  demand.  There  is  a  sense  of  location
-independence in that the customer generally has no control or knowledge over the exact
-location of the provided resources but may be able to specify location at a higher level of
-abstraction  (e.g.,  country,  state,  or  datacenter).  Examples  of  resources  include  storage,
-processing, memory, and network bandwidth.
-Rapid  elasticity.  Capabilities  can  be  elastically  provisioned  and  released,  in  some  cases
-automatically, to scale rapidly outward and inward commensurate with demand. To the
-consumer, the capabilities available for provisioning often appear to be unlimited and can
-be appropriated in any quantity at any time.
-Measured service. Cloud systems automatically control and optimize resource use by leveraging
-a metering capability1 at some level of abstraction appropriate to the type of service (e.g.,
-storage,  processing,  bandwidth,  and  active  user  accounts).  Resource  usage  can  be
-monitored,  controlled,  and  reported,  providing  transparency  for  both  the  provider  and
-consumer of the utilized service.
-Service Models:
-Software  as  a  Service  (SaaS).  The  capability  provided  to  the  consumer  is to  use  the  provider’s
-applications  running  on  a  cloud  infrastructure2.  The  applications  are  accessible  from
-various client devices through either a thin client interface, such as a web browser (e.g.,
-web-based email), or a program interface. The consumer does not manage or control the
-underlying cloud infrastructure including network, servers, operating systems, storage, or
-even  individual  application  capabilities,  with  the  possible  exception  of  limited  user-
-specific application configuration settings.
-Platform as a Service (PaaS). The capability provided to the consumer is to deploy onto the cloud
-infrastructure  consumer-created  or  acquired  applications  created  using  programming
-1 Typically this is done on a pay-per-use or charge-per-use basis.
-2  A  cloud  infrastructure  is  the  collection  of  hardware  and  software  that  enables  the  five  essential  characteristics  of  cloud
-computing. The cloud infrastructure can be viewed as containing both a physical layer and an abstraction layer. The physical
-layer consists of the hardware resources that are necessary to support the cloud services being provided, and typically includes
-server,  storage  and  network  components.  The  abstraction  layer  consists  of  the  software  deployed  across  the  physical  layer,
-which manifests the essential cloud characteristics.  Conceptually the abstraction layer sits above the physical layer.
- 2
-languages,  libraries,  services,  and tools  supported  by  the  provider.3  The  consumer  does
-not  manage  or  control  the  underlying  cloud  infrastructure  including  network,  servers,
-operating systems, or storage, but has control over the deployed applications and possibly
-configuration settings for the application-hosting environment.
-Infrastructure  as  a  Service  (IaaS).  The  capability  provided  to  the  consumer  is  to  provision
-processing,  storage,  networks,  and  other  fundamental  computing  resources  where  the
-consumer  is  able  to  deploy  and  run  arbitrary  software,  which  can  include  operating
-systems and applications. The consumer does not manage or control the underlying cloud
-infrastructure but has control over operating systems, storage, and deployed applications;
-and possibly limited control of select networking components (e.g., host firewalls).
-Deployment Models:
-Private cloud. The cloud infrastructure is provisioned for exclusive use by a single organization
-comprising  multiple  consumers  (e.g.,  business  units).  It  may  be  owned,  managed,  and
-operated by the organization, a third party, or some combination of them, and it may exist
-on or off premises.
-Community  cloud.  The  cloud  infrastructure  is  provisioned  for  exclusive  use  by  a  specific
-community  of  consumers  from  organizations  that  have  shared  concerns  (e.g.,  mission,
-security  requirements,  policy,  and  compliance  considerations).  It  may  be  owned,
-managed,  and  operated  by  one  or  more  of  the  organizations  in  the  community,  a  third
-party, or some combination of them, and it may exist on or off premises.
-Public cloud. The cloud infrastructure is provisioned for open use by the general public. It may be
-owned, managed, and operated by a business, academic, or government organization, or
-some combination of them.  It exists on the premises of the cloud provider.
-Hybrid  cloud.  The  cloud  infrastructure  is  a  composition  of  two  or  more  distinct  cloud
-infrastructures (private, community, or public) that remain unique entities, but are bound
-together  by  standardized  or  proprietary  technology  that  enables  data  and  application
-portability (e.g., cloud bursting for load balancing between clouds).
-3 This capability does not necessarily preclude the use of compatible programming languages, libraries, services, and tools from
-other sources.
- 3

+ETSI White Paper No. 11
+Mobile Edge Computing
+A key technology towards 5G
+First edition – September 2015
+ISBN No. 979-10-92620-08-5
+Authors:
+Yun Chao Hu, Milan Patel, Dario Sabella, Nurit Sprecher and Valerie Young
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+About the authors
+Yun Chao Hu
+Contributor, Huawei, Vice Chair ETSI MEC ISG, Chair MEC IEG Working Group
+Milan Patel
+Contributor, Huawei
+Dario Sabella
+Contributor, Telecom Italia; Vice-Chair MEC IEG Working Group
+Nurit Sprecher
+Contributor, Nokia; Chair ETSI MEC ISG
+Valerie Young
+Contributor, Intel
+Mobile Edge Computing - a key technology towards 5G
+2
+Contents
+About the authors
+Contents
+Introduction
+Market Drivers
+Business Value
+Mobile Edge Computing Service Scenarios
+General
+Augmented Reality
+Intelligent Video Acceleration
+Connected Cars
+Internet of Things Gateway
+Deployment Scenarios
+ETSI Industry Specification Group on Mobile Edge Computing
+Proofs of Concept
+Conclusions
+References
+2
+3
+4
+5
+6
+7
+7
+8
+9
+9
+11
+11
+12
+13
+14
+15
+Mobile Edge Computing - a key technology towards 5G
+3
+Introduction
+Mobile Edge Computing (MEC) is a new technology which is currently being standardized in an ETSI
+Industry Specification Group (ISG) of the same name. Mobile Edge Computing provides an IT service
+environment and cloud-computing capabilities at the edge of the mobile network, within the Radio
+Access Network (RAN) and in close proximity to mobile subscribers. The aim is to reduce latency, ensure
+highly efficient network operation and service delivery, and offer an improved user experience.
+Mobile Edge Computing is a natural development in the evolution of mobile base stations and the
+convergence of IT and telecommunications networking. Based on a virtualized platform, MEC is
+recognized by the European 5G PPP (5G Infrastructure Public Private Partnership) research body as one
+of the key emerging technologies for 5G networks (together with Network Functions Virtualization (NFV)
+and Software-Defined Networking (SDN)) [1]. In addition to defining more advanced air interface
+technologies, 5G networks will leverage more programmable approaches to software networking and
+use IT virtualization technology extensively within the telecommunications infrastructure, functions, and
+applications. MEC thus represents a key technology and architectural concept to enable the evolution to
+5G, since it helps advance the transformation of the mobile broadband network into a programmable
+world and contributes to satisfying the demanding requirements of 5G in terms of expected throughout,
+latency, scalability and automation.
+MEC is based on a virtualized platform, with an approach complementary to NFV: in fact, while NVF is
+focused on network functions, the MEC framework enables applications running at the edge of the
+network. The infrastructure that hosts MEC and NFV or network functions is quite similar; thus, in order
+to allow operators to benefit as much as possible from their investment, it will be beneficial to reuse the
+infrastructure and infrastructure management of NFV to the largest extent possible, by hosting both
+VNFs (Virtual Network Functions) and MEC applications on the same platform.
+The environment of Mobile Edge Computing is characterized by low latency, proximity, high bandwidth,
+and real-time insight into radio network information and location awareness. All of this can be
+translated into value and can create opportunities for mobile operators, application and content
+providers enabling them to play complementary and profitable roles within their respective business
+models and allowing them to better monetize the mobile broadband experience.
+Mobile Edge Computing opens up services to consumers and enterprise customers as well as to adjacent
+industries that can now deliver their mission-critical applications over the mobile network. It enables a
+new value chain, fresh business opportunities and a myriad of new use cases across multiple sectors.
+The intention is to develop favourable market conditions which will create sustainable business for all
+players in the value chain, and to facilitate global market growth. To this end, a standardized, open
+environment needs to be created to allow the efficient and seamless integration of such applications
+across multi-vendor Mobile Edge Computing platforms. This will also ensure that the vast majority of the
+customers of a mobile operator can be served.
+The objectives of this white paper are to introduce the concept of Mobile Edge Computing and the
+related key market drivers, and to discuss the business and technical benefits of Mobile Edge
+Computing. A few examples of service scenarios that can benefit from the technology and possible
+deployment scenarios are presented. The white paper explains what is being standardized and how
+Mobile Edge Computing - a key technology towards 5G
+4
+innovation can be stimulated through using a standardized API. It outlines the specifications being
+produced by the Industry Specification Group on MEC.
+ETSI ISG MEC encourages Proofs of Concept (PoC) to demonstrate the viability of MEC implementations.
+PoCs help to build awareness and confidence in the technology, and to develop a diverse and open MEC
+ecosystem. This white paper describes the MEC PoC framework and calls for active participation.
+Market Drivers
+The growth of mobile traffic and pressure on costs are driving a need to implement several changes in
+order to maintain quality of experience, to generate revenue, and optimize network operations and
+resource utilization.  The Internet of Things is further congesting the network and network operators
+need to do local analysis to ease security and backhaul impacts.  Enterprises want the ability to enable
+and engage with their customers with more efficient, secure and low latency connections.  Application
+and content providers are challenged with the latency of the network when connecting to the cloud.
+These challenges need to be resolved.
+Mobile operators need to shorten the time to launch new revenue generating applications for current
+customers but also for specific industries and sectors, such as but not limited to automotive, industry
+automation and welfare industries.  Business transformation based on collaboration with the different
+players in the value chain can help in facing these challenges.
+Technology improvements which provide low latency, better flexibility, agility, usage of virtualization,
+network and context awareness, etc. can provide the opportunity to increase the Quality of Experience
+of end users and make network operation more cost effective and competitive.
+Smart phone applications and content are moving to the cloud. The access to the cloud needs to be
+optimised to guarantee a rich experience for consumers of an application or consumers of content and a
+tight collaboration is essential between network operators and application and content providers. This
+collaboration can lead to the deployment of applications/content at the edge of the mobile operator’s
+network, providing awareness of the network and context information.  Standardization will be essential
+to support this collaboration and the hosting of cloud or internet based applications within a multi-
+vendor environment.
+The market drivers of MEC include business transformation, technology integration and industry
+collaboration (as illustrated in Figure 1). All of these can be enabled by MEC and a wide variety of use
+cases can be supported for new and innovative markets, such as e-Health, connected vehicles, industry
+automation, augmented reality, gaming and IoT services.
+Mobile Edge Computing - a key technology towards 5G
+5
+Figure 1: MEC market drivers
+Business Value
+Mobile Edge Computing offers an IT service environment at a location considered to be a lucrative point
+in the mobile network: the Radio Access Network (RAN) edge. Characterized by proximity, low latency
+and high bandwidth, this environment will offer localized cloud computing capabilities as well as
+exposure to real-time radio network and context information.
+Opening up this IT service environment will allow applications and services from mobile operators,
+service and content providers to be efficiently and seamlessly integrated across multi-vendor, mobile
+edge computing platforms. The characteristics and capabilities offered by a MEC platform can be
+leveraged in a way that will allow proximity, context, agility and speed to be used for wider innovation
+that can be translated into unique value and revenue generation.
+Access to content and applications can be accelerated; their responsiveness can be increased,
+maximizing speed and interactivity. Popular and locally-relevant content can be delivered directly where
+users connect, limiting ingress bandwidth to the core and cloud.
+Knowledge of real-time radio network conditions and context information can be used to optimize the
+network and service operation (responding and adapting to changing network conditions). This would
+improve service experience and the utilization of network resources, enabling them to efficiently handle
+increased amounts of traffic. Real-time network and fine-granular context information (including
+Mobile Edge Computing - a key technology towards 5G
+6
+location) could be used to enrich the mobile broadband experience by creating highly personalized
+services which are tailored to individual needs and preferences.
+Operators can reposition themselves in the value chain and redefine personalized services. They can
+capitalize their networks and open them up to authorized third-parties (in a secure way), exposing
+capabilities to Over the Top (OTT) players and application developers to flexibly, agilely and rapidly
+deploy innovative applications and services towards mobile subscribers, enterprises and vertical
+segments. Operators will be able to create new revenue streams, delight their customers by developing
+a new breed of applications that provide incremental value, and open up new market opportunities. In
+addition, applications supporting tighter integration of network and service parameters will improve
+both service experience and utilization of the network resources.
+Application service providers, OTT players and independent software vendors will be able to translate
+proximity and context into value, and be able to generate new revenue.  Their applications and services
+can be enhanced and accelerated to provide a unique and unparalleled experience. Innovative
+applications can be deployed rapidly in a new standards-based environment, taking advantage of new
+levels of flexibility and agility. Applications will be able to expand their cloud into the mobile network
+and create a whole new set of services. They will be able to feel and react to end-user experience in real
+time, based on the actual radio conditions. The new MEC specifications will allow applications and
+services to be deployed on top of multi-vendor Mobile Edge Computing platforms, enabling them to be
+used by the vast majority of the customers of a single mobile operator. The mobile end user will enjoy a
+unique, gratifying and personalized mobile-broadband experience.
+The MEC initiative will help to develop favourable market conditions for all players in the value chain as
+well as facilitate economic growth with a myriad of new use cases across multiple sectors (see Figure 2).
+Figure 2: Improved QoE with Mobile Edge Computing in close proximity to end users
+Mobile Edge Computing Service Scenarios
+General
+The following sections describe a number of service scenarios that have been considered within ETSI ISG
+MEC. These illustrate various scenarios which can take advantage of Mobile Edge Computing to either
+Mobile Edge Computing - a key technology towards 5G
+7
+increase performance compared to providing such services through the cloud or through core network
+servers, or to utilize the unique capabilities offered by MEC platforms such as proximity to the user and
+network edge, serving a highly localized area. It should be noted these examples are non-exhaustive and
+further service scenarios are available in the ETSI ISG MEC specification for Mobile Edge Computing
+Service Scenarios, GS MEC 004. Other scenarios which can make use of MEC are also possible.
+Augmented Reality
+New services become possible when mobile networks supporting high data rates and low latency
+computation are deployed. One example of such services is Augmented Reality. Augmented reality (AR)
+is the combination of a view of the real-world environment and supplementary computer-generated
+sensory input such as sound, video, graphics or GPS data. Augmented reality can enhance the
+experience of a visitor to a museum or another point of interest. Consider a visitor to a museum, art
+gallery, city monument, music or sports event, holding their mobile device towards a particular point of
+interest with the application related to their visit activated (i.e., the museum application). The camera
+captures the point of interest and the application displays additional information related to what the
+visitor is viewing.
+Augmented reality services require an application to analyse the output from a device's camera and/or a
+precise location in order to supplement a user's experience when visiting a point of interest by providing
+additional information to the user about what they are currently experiencing. The application needs to
+be aware of a user's position and the direction they are facing, either through positioning techniques or
+through the camera view, or both. After analysing such information, the application can provide
+additional information in real-time to the user. If the user moves, the information needs to be
+refreshed. Hosting the Augmented Reality service on a MEC platform instead of in the cloud is
+advantageous since supplementary information pertaining to a point of interest is highly localised and is
+often irrelevant beyond the particular point of interest. Figure 3 shows how a MEC platform can be used
+to provide an Augmented Reality service.
+Figure 3: Augmented Reality Service Scenario
+Additionally, the processing of user location or camera view can be performed on a MEC platform rather
+than on a more centralized server. There may be a need to update information at a fast rate, depending
+on how the user moves, and the context in which the augmented reality service is used (e.g. in an art
+gallery, exhibits are positioned only a few metres apart and each piece is supplemented with additional
+text on the artist, the interpretation of the artwork, etc.) In other words, augmented reality data
+requires low latency and a high rate of data processing in order to provide the correct information to
+Mobile Edge Computing - a key technology towards 5G
+8
+the user's device depending on the location and orientation of the user. Performing such data
+processing on the MEC platform also has the advantage of collecting metrics, anonymized meta-data,
+etc., in order to analyse the service usage and help to improve the service in order to provide a better
+user experience.
+Intelligent Video Acceleration
+End user Quality of Experience (QoE) and utilization of radio network resources can be improved
+through intelligent video acceleration. Internet media and file delivery are typically streamed or
+downloaded today using Hypertext Transmission Protocol (HTTP) over the TCP protocol. Available
+capacity can vary by an order of magnitude within seconds (as a result of changes in radio channel
+conditions, devices entering/leaving network). TCP may not be able to adapt fast enough to rapidly-
+varying conditions in the radio access network (RAN). This may lead to under-utilisation of precious
+radio resources and to a sub-optimal user experience.
+Figure 4 shows an example of the intelligent video acceleration service scenario which attempts to
+overcome the challenges described above. In this scenario, a radio analytics application, which resides in
+a MEC server, provides the video server with an indication on the throughput estimated to be available
+at the radio downlink interface. This information can be used to assist the TCP congestion control
+decisions (for example in selecting the initial window size, setting the value of the congestion window
+during the congestion avoidance phase, and adjusting the size of the congestion window when the
+conditions on the "radio link" deteriorate). The information can also be used to ensure that the
+application-level coding matches the estimated capacity at the radio downlink.
+The video server may use this information to assist TCP congestion control decisions (for example by
+ensuring that the application level coding matches the estimated capacity at the radio downlink). The
+content’s time-to-start as well as video-stall occurrences can be reduced, enabling improved video
+quality and throughput.
+ Figure 4: Intelligent Video Acceleration Service Scenario
+Connected Cars
+The number of connected vehicles is rapidly growing and will continue to do so over the coming years.
+Communication of vehicles and roadside sensors with a roadside unit is intended to increase the safety,
+efficiency, and convenience of the transportation system, by the exchange of critical safety and
+Mobile Edge Computing - a key technology towards 5G
+9
+operational data. The communication can also be used to provide value added services, such as car
+finder, parking location and to support entertainment services (e.g. video distribution).
+As the number of connected vehicles increases and use cases evolve, the volume of data will continue to
+increase along with the need to minimize latency.  Whilst data stored and processed centrally may be
+adequate for some use cases, it can be unreliable and slow for others.
+LTE can significantly accelerate the deployment of connected vehicle communications.  LTE cells can
+provide “beyond the line of sight” visibility i.e. beyond the range of direct communication between
+vehicles of 300 – 500m. It can also satisfy the tight latency requirement of connected vehicle
+communications, below 100ms in some use cases. Messages could be distributed in real time over LTE,
+eliminating the need to build a countrywide Digital Short-Range Communications (DSRC) network. Cars
+can leverage their increasingly inbuilt LTE connectivity; in deployments where DSRC exists, LTE would be
+able complement it.
+Mobile Edge Computing can be used to extend the connected car cloud into the highly distributed
+mobile base station environment, and enable data and applications to be housed close to the vehicles.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications provided over the internet. MEC applications can run on MEC servers which
+are deployed at the LTE base station site to provide the roadside functionality. The MEC applications can
+receive local messages directly from the applications in the vehicles and the roadside sensors, analyse
+them and then propagate (with extremely low latency) hazard warnings and other latency-sensitive
+messages to other cars in the area (as depicted in Figure 5). This enables a nearby car to receive data in
+a matter of milliseconds, allowing the driver to immediately react.
+Figure 5: Connected Vehicles Service Scenario
+The roadside MEC application will be able to inform adjacent Mobile Edge Computing servers about the
+event(s) and in so doing, enable these servers to propagate hazard warnings to cars that are close to the
+affected area.
+The roadside application will be able to send local information to the applications at the connected car
+cloud for further centralized processing and reporting.
+Mobile Edge Computing - a key technology towards 5G
+10
+Internet of Things Gateway
+The Internet of Things (IoT) generates additional messaging on telecoms networks, and requires
+gateways to aggregate the messages and ensure low latency and security.  Because of the nature of
+some of the devices being connected, a real time capability is required and a grouping of sensors and
+devices is needed for efficient service.
+IoT devices are often resource constrained in terms of processor and memory capacity. There is a need
+to aggregate various IoT device messages connected through the mobile network close to the devices.
+This also provides an analytics processing capability and a low latency response time.
+Figure 6: IoT Gateway Service Scenario
+Various devices are connected over different forms of connectivity, such as 3G, LTE, Wi-Fi or other radio
+technologies. In general the messages are small, encrypted and come in different forms of protocols.
+There is a need for a low latency aggregation point to manage the various protocols, distribution of
+messages and for the processing of analytics. The MEC server provides the capability to resolve these
+challenges.
+Mobile Edge Computing can be used to connect and control devices remotely, analyse and provide real
+time provisioning and analytics.  MEC enables the aggregation and distribution of IoT services into the
+highly distributed mobile base station environment, and enable applications to respond in real-time.
+This can reduce the round trip time of data and enable a layer of abstraction from both the core
+network and applications in the cloud. IoT applications can run on MEC servers which are deployed at
+the LTE base station site to provide this functionality.
+Deployment Scenarios
+Mobile Edge Computing servers can be deployed at multiple locations, such as at the LTE macro base
+station (eNodeB) site, at the 3G Radio Network Controller (RNC) site, at a multi-Radio Access Technology
+(RAT) cell aggregation site, and at an aggregation point (which may also be at the edge of the core
+network). The multi-RAT cell aggregation site can be located indoors within an enterprise (e.g. hospital,
+large corporate HQ), or indoors/outdoors for a special public coverage scenario (e.g. stadium, shopping
+mall) to control a number of local multi-RAT access points providing radio coverage to the premises. This
+deployment option enables the direct delivery of locally-relevant, fast services from base station
+clusters. Where a MEC platform is deployed may depend on a number of factors, including scalability,
+Mobile Edge Computing - a key technology towards 5G
+11
+physical deployment constraints, performance criteria (e.g. latency) and which network information will
+be exposed. Note that some MEC services may not be available / applicable in certain deployment
+options.
+MEC applications can be intelligently and flexibly deployed in a seamless manner on different MEC
+platforms based on technical and business parameters. The deployment of MEC applications on a
+particular MEC platform may depend on the availability of specific MEC services and on other
+parameters, such as latency requirements, required resources, availability of a particular VNF, scalability
+considerations, cost etc.
+MEC will utilise the NFV infrastructure. The NFV platform may be dedicated to MEC or shared with other
+network functions or applications. MEC will also use (as much as possible) the NFV management and
+orchestration entities and interfaces.
+ETSI Industry Specification Group on Mobile Edge
+Computing
+The ETSI Industry Specification Group (ISG) on Mobile Edge Computing (MEC) produces normative
+Group Specifications that will enable the hosting of third-party applications in a multi-vendor MEC
+environment. Launched in December 2014, the group plans to deliver the first set of specifications
+within 2 years.
+The initial scope of the ISG MEC focuses on use cases; it specifies the requirements and the reference
+architecture, including the components and functional elements that are the key enablers for MEC
+solutions.
+When the first documents reach the required maturity level, work on platform services, APIs and
+interfaces will commence. The MEC platform API will be application-agnostic and will allow the smooth
+porting of value-creating applications on every mobile-edge server with guaranteed SLA (see Figure 7).
+ Figure 7: MEC platform API
+In addition to the technical work, an industry-enabling working group (IEG WG) has been setup under
+the ISG MEC which is tasked with advancing Mobile Edge Computing in the industry and accelerating the
+Mobile Edge Computing - a key technology towards 5G
+12
+adoption of the concept and the standards. This will help to develop favourable market conditions for
+sustainable business for all players in the value chain.
+The IEG group is developing two Group Specifications:
+1.  ETSI GS MEC-IEG 005 [2] Proof of Concept Framework, specifying the process and criteria that a
+Proof of Concept demonstration must adhere to. This specification has already been published;
+2.  ETSI GS MEC-IEG 004 Service Scenarios, which presents a number of examples of service
+scenarios, business and consumer benefits which can be enabled by Mobile Edge Computing.
+The ETSI ISG is open to members and non-members of ETSI to participate and contribute towards this
+innovative technology. Industry players are invited to actively participate and contribute to the work on
+Mobile Edge Computing and to take part in the PoC activities. More information on how to participate is
+available at: http://www.etsi.org/mobile-edge-computing/get-involved-in-mec.
+Proofs of Concept
+In order to ensure the success and widespread deployment of Mobile Edge Computing, it is necessary to
+have more than just timely and high quality specifications. It is crucial to validate the specifications that
+are being developed, and to demonstrate that the use cases have been fulfilled. Furthermore, the MEC
+concept must be demonstrated to be feasible and valuable to all the major stakeholders in the value
+chain in order to appeal to the widest possible audience.
+To showcase the Mobile Edge Computing concept, the ISG MEC has developed a Proof of Concept
+process, specified in GS MEC-IEG 005 [2]. A PoC proposal can be submitted by a PoC team consisting of
+at least one Mobile Network Operator, at least one infrastructure vendor and at least one content or
+application provider. GS MEC-IEG 005 [2] specifies the process and criteria that a Proof of Concept
+demonstration must adhere to in order to be accepted as a MEC PoC. A wiki site http://mecwiki.etsi.org
+has been put in place to assist PoC teams. This site hosts the PoC project proposal templates and the list
+of PoC Topics, which are specific areas where input or feedback from PoCs is needed. One or several PoC
+Topics can be addressed by a single PoC project.
+The public demonstration of MEC Proofs of Concept helps to build commercial awareness and
+confidence in this technology, and helps to develop a diverse, open, MEC ecosystem.
+Mobile Edge Computing - a key technology towards 5G
+13
+Conclusions
+Mobile Edge Computing enables innovative service scenarios that can ensure enhanced personal
+experience and optimized network operation, as well as opening up new business opportunities. A few
+examples are described in this white paper to demonstrate how proximity to users and objects, together
+with network and context information can be leveraged by applications to create value. Mobile Edge
+Computing attracts a new value-chain and energized eco-system, where all players can benefit from
+tighter collaboration. Mobile operators can play a pivotal role within the new value chain and attract
+OTT service providers, developers and Internet players to innovate over a new cutting-edge technology,
+while enabling context-aware applications to run in close proximity to the mobile subscriber. Mobile
+subscribers can enjoy a unique, truly gratifying and personalized mobile-broadband experience which is
+tailored to their needs and preferences.
+Based on a virtualized platform, MEC complements NFV and is fully aligned with the emerging
+distributed cloud approach. It is recognised as a key technology of the future 5G era, satisfying the
+demanding requirements for ultra-low latency and stimulating innovation.
+The MEC technology is defined by the ETSI ISG MEC, which was launched in December 2014 with the
+intention to develop the first set of specifications within 2 years. The deliverables will include service
+scenarios, requirements, architecture and API specifications, complemented with a PoC Framework
+specification and White Papers which aim to accelerate the market adoption of the MEC technology.
+MEC supports different deployment options, as MEC Servers can be located at different places within
+the Radio Access Network depending on technical and business requirements.
+A MEC Proof-of-Concept (PoC) program has been established to demonstrate the viability of MEC
+implementations. The results and lessons learned by the MEC PoCs are fed back to the ISG MEC
+specification activities.
+The MEC ISG is developing the foundation to enable an open radio access network which can host third
+party innovative applications and content at the edge of the network. The ISG is open to members and
+non-members of ETSI to participate and contribute towards this innovative technology, and to take part
+in the PoC activities.
+Mobile Edge Computing - a key technology towards 5G
+14
+References
+[1]
+5G Vision: The 5G Infrastructure Public Private Partnership: the next generation of
+communication networks and services. From The 5G Infrastructure Public Private Partnership:
+https://5g-ppp.eu/wp-content/uploads/2015/02/5G-Vision-Brochure-v1.pdf
+ [2]
+ETSI GS MEC-IEG 005; Mobile Edge Computing (MEC); Proof of Concept Framework.
+Mobile Edge Computing - a key technology towards 5G
+15
+ETSI (European Telecommunications Standards Institute)
+06921 Sophia Antipolis CEDEX, France
+Tel +33 4 92 94 42 00
+info@etsi.org
+www.etsi.org
+ This White Paper is issued for information only. It does not constitute an official or agreed position of ETSI, nor of its Members. The
+views expressed are entirely those of the author(s).
+ETSI declines all responsibility for any errors and any loss or damage resulting from use of the contents of this White Paper.
+ETSI  also  declines  responsibility  for  any  infringement  of  any  third  party's  Intellectual  Property  Rights  (IPR),  but  will  be  pleased  to
+acknowledge any IPR and correct any infringement of which it is advised.
+Copyright Notification
+Copying or reproduction in whole is permitted if the copy is complete and unchanged (including this copyright statement).
+ © European Telecommunications Standards Institute 2015. All rights reserved.
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+3GPP™ and LTE™ are Trade Marks of ETSI registered for the benefit of its Members and of the 3GPP Organizational Partners.
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