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Abstract Details

The impact of an X+Y schedule model on Neurology residency training
Education, Research, and Methodology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
7-003
There is a need for earlier outpatient exposure in neurology training. In 2017, 56% of residents on the AAN Graduating Resident Survey reported that they felt the fellowship process started too early and 46% did not feel they had adequate outpatient exposure prior to making a fellowship decision. 73% of trainees surveyed by the AAN in 2016 described at least one symptom of burnout.

We created an X+Y model within the UCLA Neurology residency program in the 2020-2021 academic year, with the hypothesis that handoffs would diminish, work hours would improve, resident satisfaction of inpatient and outpatient care, markers of well-being,  and fellowship decision-making would increase, and resident in-training examination (RITE) scores would improve. 

Work hours, handoffs, and number of clinic days were compared across each year via analysis of the resident schedule. Resident perceptions were obtained via an online survey at the end of their PGY-2 year. Resident In-Training Examination scores were compared across a variety of subspecialties.  
In the post-intervention year, handoffs were reduced by 6.13 (95% CI 4.73-7.54) per week. Average clinic half-days increased by 4.51 (95% CI 7.76-0.53). Resident responses regarding their outpatient experience improved from 42% to 93% positive responses and from 60% to 94% for their inpatient experience. There was no difference in average work hours per week before and after the intervention. Regarding resident well-being, responses improved from 42% positive in the traditional model to 96% in the X+Y model. Amongst the RITE subjects covering primarily outpatient subspecialties, scores improved in each category. 60% of respondents in the 2020-2021 class reported higher levels of confidence in making a fellowship decision compared with 0% in the 2019-2020 class.
The X + Y model reduced burnout and inpatient handoffs while improving outpatient exposure, learning and career satisfaction, and resident education on subspecialty topics.
Authors/Disclosures
Shuvro Roy, MD (University of Washington)
PRESENTER
Dr. Roy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon.
Katherine Fu, MD (University of California, Los Angeles) Dr. Fu has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology: Neurology Journal .
Timothy Edward Ryan, Jr., MD The institution of Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cognito Therapeutics . Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda Pharmaceuticals. Dr. Ryan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurelis.
Yvette Bordelon, MD, FAAN (UCLA Dept. of Neurology) The institution of Dr. Bordelon has received research support from Neuraly. The institution of Dr. Bordelon has received research support from AbbVie.
Charles C. Flippen, II, MD, FAAN (UCLA Goldberg Migraine Program) Dr. Flippen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AIM Specialty Health.
Adrienne M. Keener, MD (UCLA Neurology) Dr. Keener has nothing to disclose.