X + Y Scheduling Models for Internal Medicine Residency Programs—A Look Back and a Look Forward

X + Y = Time for QI: Meaningful Engagement of Residents in Quality Improvement During the Ambulatory Block

“…In July 2015, the program adopted an ''X þ Y'' schedule, where ''X'' refers to inpatient rotations and ''Y'' to a designated ambulatory block. 11 We leveraged this opportunity to implement a new QI curriculum into residents' ambulatory block to address these barriers and engage all residents in QI. In this article, we describe the implementation, evaluation, and lessons learned from the first year of this ongoing curriculum.…”

A National Survey of Internal Medicine Primary Care Residency Program Directors

“…24 X + Y scheduling, a model that schedules residents' inpatient or non-ambulatory rotations (BX^blocks) in discrete periods with alternating ambulatory or BY^blocks, is instituted specifically to decrease the conflict between inpatient and outpatient patient care responsibilities. 25,26 Several studies of X + Y scheduling have found this model to be associated with less care fragmentation, increased perception of clinic continuity among residents, and higher resident satisfaction. [27][28][29] Our study unearthed the association that primary care programs using the X + Y scheduling model were less likely to have a majority of their program graduates pursue primary care at the time of graduation.…”

Creating a Satisfying Continuity Clinic Experience for Primary Care Trainees

“…Importantly, successful implementation of X+Y scheduling involves careful consideration, as transitioning to this model involves substantial scheduling and cultural changes. 58 Recommendation 8: Participation in clinic operations. Resident engagement in clinic operations is a hallmark of highly functioning residency clinic practices and meets an important training need.…”