4+1 Programs?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Is this list exhaustive? Or are there many that are still not represented?
It is exhaustive of the programs mentioned. If my math is right (and it's probably not) there are at least as many IM programs not mentioned as are on the list.

Do with that information what you will.

Members don't see this ad.
 
RWJ UMinn
2+2

VCU

3+1
BU
OHSU
UVA

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
Case (after 1st year)
8+2

UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)

Unknown
UC-Davis

Traditional
Emory
Indiana
Downstate
UMinn

Coming soon...
Baylor College of Medicine (4+1)
Brown
Cedars
Hopkins
UChicago
URochester
UPMC
GWU
UTHSCSA (for summer 2014)
 
2+2
VCU

3+1
BU
OHSU
UVA

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
Case (after 1st year)

8+2

UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)

Traditional
Emory
Indiana
Downstate
UMinn
UCSD
USC

Coming soon...
Baylor College of Medicine (4+1)
Brown
Cedars
Hopkins
UChicago
URochester
UPMC
GWU
UTHSCSA (for summer 2014)
 
Members don't see this ad :)
so what are the arguments against going to an X+Y schedule? pure tradition? or is it just a nightmare to schedule when you're a smaller program?
 
so what are the arguments against going to an X+Y schedule? pure tradition? or is it just a nightmare to schedule when you're a smaller program?
Little from column A, little from column B.

The scheduling really is a nightmare, even in a mid sized program (30-35 per class).

And FWIW, I always felt like the end of the 3rd week of any rotation was when I was really nailing it. On a 3+1 schedule, I would lose that last week of mastery which I think is crucial. But that's just how I roll.
 
Some programs have a Long Block system (I remember U of Cincinnati from my interview trail, but I'm sure there are other programs as well). If someone is really interested in primary care and outpatient medicine, I think this long block system is the way to go as you can get the whole outpatient experience with complete patient ownership and management while you're still in residency. If you are thinking fellowship though, you probably don't want to be part of that. You can always opt out of the long block system as far as I remember.
 
Little from column A, little from column B.

The scheduling really is a nightmare, even in a mid sized program (30-35 per class).

And FWIW, I always felt like the end of the 3rd week of any rotation was when I was really nailing it. On a 3+1 schedule, I would lose that last week of mastery which I think is crucial. But that's just how I roll.
I find it funny that 30-35 is a mid-sized program. Mean IM program has ~15 categorical residents. There's only a double handful larger than 35.
 
I find it funny that 30-35 is a mid-sized program. Mean IM program has ~15 categorical residents. There's only a double handful larger than 35.

i would guess if you only look at university programs the mean would be closer to 30 right?
 
wait, so Kentucky residents get four straight golden weekends out of every 12?
 
Added NYU for starting 4+2 in summer 2015.
Moved UChicago to 4+2 schedule (I was under the impression they had already started)
Added UPenn to 6 + 2
Added BIDMC to 3+3 (this is only during PGY2 and PGY3 year).
Added UPMC starting 4+4 in summer 2014

2+2

VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis

4+2
UChicago

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)

8+2

UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)

Traditional
Emory
Indiana
Downstate
UMinn
UCSD
USC

Coming soon...
Baylor College of Medicine (4+1)
Brown
Cedars
Hopkins
URochester
UPMC
GWU
UTHSCSA (for summer 2014)
NYU (4+ 2 starting summer 2015)
UPMC (4+4 starting in summer 2014)
 
Added Newark Beth Israel to 4+1

2+2

VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel

4+2
UChicago

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)

8+2

UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)

Traditional
Emory
Indiana
Downstate
UMinn
UCSD
USC

Coming soon...
Baylor College of Medicine (4+1)
Brown
Cedars
Hopkins
URochester
UPMC
GWU
UTHSCSA (for summer 2014)
NYU (4+ 2 starting summer 2015)
UPMC (4+4 starting in summer 2014)
 
Anyone have any updates on new schools implementing these schedules?
 
Members don't see this ad :)
Vanderbilt is now 4+1 for everyone including interns
 
Minnesota is now 4 + 4
4+4 sounds like the worst of both worlds. In order to get what amounts to every other month outpatient, you're going to spend much more time as an R2/R3 on the inpatient service than you otherwise would.

And 4 weeks every other month of end stage fibromyalgia clinic (which is what most residency clinics outside of the VA amount to) sounds horrifying.
 
4+4 sounds like the worst of both worlds. In order to get what amounts to every other month outpatient, you're going to spend much more time as an R2/R3 on the inpatient service than you otherwise would.

And 4 weeks every other month of end stage fibromyalgia clinic (which is what most residency clinics outside of the VA amount to) sounds horrifying.
I can speak to Minnesota's 4+4 schedule (I assume Mayo's is similar):
The 4+4 structure has much less clinic time over the course of residency: 94 days versus 156 days. The schedule works like this: alternating periods of four weeks inpatient (Wards, ICU, Cards) and four weeks consult (electives) months with a single clinic day/week during consult months. So, you end up with 26 days/year of scheduled clinic versus 52 days/year (assuming 5 days of clinic on the +1 week). During intern year, there is a 4 week block of "clinic immersion" where you work 8am-4pm (often less). The down-side to this schedule is a few more inpatient months as a senior resident (but you still have less clinic time, a protected three months for research or electives abroad, and weekends off every other month). I'm happy to field more questions if anyone has them.
 
I can speak to Minnesota's 4+4 schedule (I assume Mayo's is similar):
The 4+4 structure has much less clinic time over the course of residency: 94 days versus 156 days. The schedule works like this: alternating periods of four weeks inpatient (Wards, ICU, Cards) and four weeks consult (electives) months with a single clinic day/week during consult months. So, you end up with 26 days/year of scheduled clinic versus 52 days/year (assuming 5 days of clinic on the +1 week). During intern year, there is a 4 week block of "clinic immersion" where you work 8am-4pm (often less). The down-side to this schedule is a few more inpatient months as a senior resident (but you still have less clinic time, a protected three months for research or electives abroad, and weekends off every other month). I'm happy to field more questions if anyone has them.

So during the the consult/elective months you get 4 golden weekends? Seems pretty nice.
 
So during the the consult/elective months you get 4 golden weekends? Seems pretty nice.
It is! It makes 80 hour weeks not seem as bad when you know you have a month of golden weekends on the horizon. The rigor is absolutely there -- just for one month at a time. There are lots of happy interns here and the program structure is a big part of it.
 
I can speak to Minnesota's 4+4 schedule (I assume Mayo's is similar):
The 4+4 structure has much less clinic time over the course of residency: 94 days versus 156 days. The schedule works like this: alternating periods of four weeks inpatient (Wards, ICU, Cards) and four weeks consult (electives) months with a single clinic day/week during consult months. So, you end up with 26 days/year of scheduled clinic versus 52 days/year (assuming 5 days of clinic on the +1 week). During intern year, there is a 4 week block of "clinic immersion" where you work 8am-4pm (often less). The down-side to this schedule is a few more inpatient months as a senior resident (but you still have less clinic time, a protected three months for research or electives abroad, and weekends off every other month). I'm happy to field more questions if anyone has them.

It is! It makes 80 hour weeks not seem as bad when you know you have a month of golden weekends on the horizon. The rigor is absolutely there -- just for one month at a time. There are lots of happy interns here and the program structure is a big part of it.

Are you sure that as a junior and senior resident you get a full month of golden weekends? Who provides weekend coverage when the team's resident has their day off then? Does each team have 2 residents?
 
Are you sure that as a junior and senior resident you get a full month of golden weekends? Who provides weekend coverage when the team's resident has their day off then? Does each team have 2 residents?
Yes, I am sure. Coverage depends on the site, but is predominantly done by respective fellows with occasional staff coverage. Sometimes, there are 2 residents on consult teams, but not always. It varies mostly on how busy the service is and if there is enough learning opportunity to support a large team.
 
Yes, I am sure. Coverage depends on the site, but is predominantly done by respective fellows with occasional staff coverage. Sometimes, there are 2 residents on consult teams, but not always. It varies mostly on how busy the service is and if there is enough learning opportunity to support a large team.

Yeah, I'm pretty sure he's talking about covering the ward team seniors, not other seniors who are on consults. At many programs when the wards seniors get days off they are covered by other seniors who are on consults/electives/ambulatory.
 
Yeah, I'm pretty sure he's talking about covering the ward team seniors, not other seniors who are on consults. At many programs when the wards seniors get days off they are covered by other seniors who are on consults/electives/ambulatory.
I gotchya. There aren't golden weekends on ward months (or ICU or cards). There is one day off per week for the senior and the intern. The intern runs the team when the senior is off and vice-versa. An exception to this is for night float teams which have residents (on consult months) cover them for a night to give 1 day off in 7. Every resident has a single weekend of this night coverage to perform over the course of the year.
 
I gotchya. There aren't golden weekends on ward months (or ICU or cards). There is one day off per week for the senior and the intern. The intern runs the team when the senior is off and vice-versa. An exception to this is for night float teams which have residents (on consult months) cover them for a night to give 1 day off in 7. Every resident has a single weekend of this night coverage to perform over the course of the year.
The intern runs the team?!
 
Runs is a relative term. "S***s their pants and answers pages while the attending writes the notes" is more like it.
"runs" could also be a descriptive term, particularly as you allude to.
 
  • Like
Reactions: 1 users
@gutonc definitely hit the nail on the head. I would say, though, that the intern should carry the majority of the team and be writing the majority of the notes on any given day, regardless of program structure. For us, the senior takes off a non-admitting day (which are also days with no cross cover responsibilities) which makes it much more manageable. Also, the attending is noticeably more hands-on and pharmacists and nursing are quick to point out mistakes and lapses in orders and patient care (thankfully in a pleasant Minnesota fashion).
 
Iowa - 4+1

2+2

VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic


4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC


6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)

8+2

UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)

Traditional
Emory
Indiana
Downstate
UCSD
USC

Coming soon...
Baylor College of Medicine (4+1)
Brown
Cedars
Hopkins
URochester
GWU
 
URochester 6+2, Wisconsin traditional, UIC 12+2 (????)

2+2
VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)

Traditional
Emory
Indiana
Downstate
UCSD
USC
Wisconsin-Madison
 
UMiami/Jackson Memorial Hospital - 4+2+2

2+2
VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale
UMiami/Jackson Memorial Hospital

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)

Traditional
Emory
Indiana
Downstate
UCSD
USC
Wisconsin-Madison
 
Is there one system that gives you more elective time than the others? It seems like 4+2+2 would do that for you but I'd like to see what others think.
 
Utah - Traditional
GW - 4 +1


2+2
VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic
George Washington

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale
UMiami/Jackson Memorial Hospital

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)

Traditional
Emory
Indiana
Downstate
UCSD
USC
Wisconsin-Madison
Utah
 
Duke - 4+1

2+2

VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic
George Washington
Duke

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale
UMiami/Jackson Memorial Hospital

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)

Traditional
Emory
Indiana
Downstate
UCSD
USC
Wisconsin-Madison
Utah
 
Any updates of other programs transitioning to the X+Y scheduling?
 
Last edited:
Does anybody have an updated list?
 
  • Like
Reactions: 1 user
2+2
VCU

3+1
BU
OHSU
UVA

3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
Mizzou
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic
George Washington
Duke

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale
UMiami/Jackson Memorial Hospital

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)
 
Wanted to correct a couple of people here that Duke is actually 4+2 for intern and JAR year and pretty close to 4+2 for SAR year to accommodate for longer electives
 
Columbia now has a hybrid 4+2 / 6+2 schedule. Maximum of 6 consecutive inpatient weeks, usually just 4. Still with one or two continuity clinic days a month on certain inpatient rotations.
 
2+2
VCU

3+1
BU
OHSU
UVA
Tufts
USC
Rush


3+3
BIDMC (PGY2 and PGY3)

4+1
Colorado
Loyola
NSLIJ
Stony Brook
Temple
Tulane
UTSW
Upstate
UCLA
Olive View - UCLA
Richmond University Medical Center
Stamford Hospital (kind of 4+1)
Allegheny General Hospital
SUNY Buffalo
RWJ
Mizzou
UCDavis
Newark Beth Israel
Iowa
Vanderbilt
UTHSCSA
Cleveland Clinic
George Washington
Duke

4+2
UChicago
NYU

4(inpt)+2(clinic)+2(elective)
WashU
Georgetown
Yale
UMiami/Jackson Memorial Hospital

4+4 (kind of)
Mayo
UAB (2nd/3rd year)
UMinn
UPMC

6+2
St Luke's-Roosevelt
Mount Sinai
AECOM
UPenn
Case (after 1st year)
URochester

8+2
UMDNJ-NJMS
Vanderbilt (intern year, 4+2 thereafter)

Other
Kentucky (2 mo. wards/consults/ICU + 1 month clinic)
WVU (alternate ward and elective months. No clinic during ward months, 1 day/week during elective months)
UIC (Kind of 12+2? Whatever that means? 1/2 day clinic on wards except for ICU, CCU, night float)[/QUOTE]
 
Top