For the fourth time, Simone Biles was the winner of the women’s all-around at the 2018 World Artistic Gymnastics Championships on Thursday, according to Team USA.

Competing in Doha, Qatar, Biles scored 57.491 — besting the silver medalist, Mai Murakami of Japan, by an impressive 1.7 points. The victory means Biles, 21, is the first woman to earn four all-around titles — winning every single time she’s competed.

According to Team USA, this is the eighth year in a row that an American has either won the world or Olympic all-around title (Biles accounts for five of those). She has a combined 21 Olympic or world medals.

Biles’ solo victory comes just days after the United States women’s gymnastics team won the world title and secured a spot in the Toyko Olympic Games in 2020.

With a commanding score of 171.629, Team USA was able to take home the gold medal with an 8.766 point lead over second place Russia. The United States has won every Olympic and world team title since 2011, and this is their largest lead at a major competition in that time, the team announced after their victory. China, who earned a 162.396, came in third.

RELATED VIDEO: Simone Biles Advances to Finals at World Championships 1 Day After Kidney Stone Sends Her to ER

This year’s team is made up of Biles, Morgan Hurd, Grace McCallum, Ragan Smith, Riley McCusker and Kara Eaker. The victories in Qatar were only made more impressive by news of Biles’ health scare.

Biles had been hospitalized just one day before the championships began, she revealed in a tweet last week.

“Nothing like a late night ER visit less than 24 hrs before world championships,” Biles wrote on Twitter. “This kidney stone can wait…. doing it for my team! I’ll be gucci girls!”

Alongside the message, the star shared two photos of herself in the hospital: one smiling selfie and another shot of her legs in the hospital bed.

She also shared the selfie to her Instagram and captioned the shot, “This kidney stone has nothing on world championships.”

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