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Abstract Details

The impact of an X+Y schedule model on Neurology residency training
好色先生, Research, and Methodology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
7-003

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. 
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.
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 Amgen. 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 Genentech. 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 TG Therapeutics. 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 Alexion. The institution of Dr. Roy has received research support from The Siegel Rare Neuroimmune Association.
Katherine Fu, MD (University of California, Los Angeles) Dr. Fu has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生: Neurology Journal . Dr. Fu has received research support from 好色先生. Dr. Fu has received personal compensation in the range of $0-$499 for serving as a Edmond J. Safra Fellowship Reviewer with The Michael J. Fox Foundation.
Timothy E. 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 $5,000-$9,999 for serving on a Speakers Bureau for UCB. Dr. Ryan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Takeda Pharmaceuticals. Dr. Ryan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurelis.
Yvette Bordelon, MD, PhD, FAAN (Cedars-Sinai Medical Center) Dr. Bordelon has nothing to disclose.
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 Carelon. Dr. Flippen has a non-compensated relationship as a committee member with American Headache Society that is relevant to AAN interests or activities. Dr. Flippen has a non-compensated relationship as a committee/task force member with American Neurological Association that is relevant to AAN interests or activities.
Adrienne M. Keener, MD (UCLA Neurology) Dr. Keener has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie.