The first step of the immigration process on Ellis Island from 1892 to 1954 was the medical inspection. Migrants saw Manhattan through the glass windows of Ellis Island on one side, and the medical building on the other. On the one hand there were the “chosen ones” who would enter the city, and on the other the “damned” who were not admitted. At peak immigration level, only 2% to 3% percent of the people were turned away. Most of the immigrants would settle in New York, marking the beginning of a new life. The city was the biggest in the country, and the gateway to the United States.