To improve outpatient neurology and continuity clinic experiences in a Neurology Residency program by designing an X+Y schedule.

Recent surveys have shown that many neurology residents report inadequate subspecialty exposure, feel unprepared to make fellowship decisions, and experience same-day conflict between inpatient and outpatient rotations. Similar challenges in the field of Internal Medicine (IM) led to the adoption of the X+Y schedule by many IM Residency programs. Increased use of the X+Y schedule by Neurology Residency Programs may help address the current challenges in outpatient neurology education.

The framework for the X+Y neurology curriculum was based on schemas originally created by IM residency programs and included “X” number of inpatient weeks followed by “Y” number of outpatient weeks. Practical considerations included securing enough clinic space, as well as ensuring faculty and ancillary staff availability for clinics to operate successfully.

The implementation of a 4+1 Neurology Residency schedule is feasible. The X+Y schedule may address challenges in outpatient neurology education by providing increased and earlier outpatient exposure while reducing same-day conflict with inpatient services. Additionally, these changes may improve resident wellness by dividing up long stretches of consecutive inpatient time. Pre and post-intervention surveys will help assess the impact of the X+Y schedule on various aspects of outpatient neurology education.