Quantitative Outcomes of "Y" Scheduling in an Internal Medicine-Pediatrics Residency Program: First Year Data

Introduction Scheduling resident continuity clinic sessions and outpatient education in Internal Medicine-Pediatrics (Med-Peds) residency programs pose challenges. A minority of Med-Peds programs have switched to an "X + Y" schedule (each in weeks) specifically to separate inpatient rotations and other experiences ("X" schedule) from resident continuity clinics and other outpatient longitudinal clinical and educational experiences ("Y" schedule). Outside of focus groups, quantitative data from Med-Peds residents on overall and specific satisfaction with an outpatient "Y" schedule and its specific components have not been published. We analyzed our inception year (2022-2023) Med-Peds residents' satisfaction after transitioning to a new "Y" block of outpatient education and clinical experiences in an average-sized Med-Peds program. Methods In July 2022, the "X + Y" schedule was introduced into both our Med-Peds and Pediatrics residency programs with a "6 + 2" (each in weeks) frequency upon an existing "4 + 2" (each in weeks) frequency for Internal Medicine. All Med-Peds residents (n=18) were electronically surveyed at the end of the academic year on the general "Y" schedule, continuity clinics, other outpatient clinical experiences, academic half days, administrative time, patient management skills, and the ability to make personal appointments to support wellness. Results All Med-Peds residents (n=18) were highly satisfied/satisfied with their new "Y" schedule (4.7/5) and 92% (12/13) of the postgraduate year (PGY) 2-4 felt much better/slightly better with this schedule template compared to their previous outpatient education design (4.8/5). Clinical outpatient experiences (including continuity clinic), comfort in roles/responsibilities, interest in primary care, administrative time, desktop management, and the ability to make personal appointments to support wellness were highest rated (≥ 4.0/5.0). The Med-Peds residents' favorite "Y" session was "Cohort Time", an Academic Half Day with their Med-Peds "Y" cohort colleagues for group learning and socialization. Conclusions Despite its complexities, the introduction of the "X + Y" schedule with "Y" continuity clinics and outpatient education dissociated from inpatient and other rotations in our Med-Peds residency program has been widely accepted and highly rated by residents. There has only been the need for minimal modifications for subsequent years.