The +1 Model

[DrVanNostran]

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So after interviewing, I have come to realize that I really like programs with a 4+1, 3+1, etc type of model. I was wondering if you guys could list programs that you interviewed at with similar structures or something that separates clinic from inpatient services.

Tulane: 4+1 (the model)
Loyola: 4+1
OHSU: 3+1
Cincinnati: The "Long Block"
Ohio State: I can't remember the exact structure, but they do separate.

 

[KatLady4eva]

Wake Forest (i think it goes like this): 4 + 1 + 1

 

[frisbee]

Cornell 6+2 (6 weeks is made up of two different services)
BIDMC 3+3 (for PGY 2 and 3)- I think 1 of the 3 weeks was continuity clinic and other two were subspecialty electives, but it has been awhile since that interview.

 

[StudentDoctor55]

I think BU does 3+1.

 

[MCATMAN45]

pretty sure penn was 6+2.

agreed - this is an awesome system.

 

[adagio]

whats a +1 model, and whats a Long Block? (excuse my ignorance)

 

[infarct]

So after interviewing, I have come to realize that I really like programs with a 4+1, 3+1, etc type of model. I was wondering if you guys could list programs that you interviewed at with similar structures or something that separates clinic from inpatient services.

Tulane: 4+1 (the model)
Loyola: 4+1
OHSU: 3+1
Cincinnati: The "Long Block"
Ohio State: I can't remember the exact structure, but they do separate.

temple 4+1

 

[UberGomez]

Stony Brook 4+1

 

[argencolts]

Oops wrong thread

 

[sacrament]

whats a +1 model, and whats a Long Block? (excuse my ignorance)

I'm still eagerly awaiting an answer to this, particularly since I actually did my residency at one of the programs listed above, and I have no idea what "+1" is or if it's something that I did.

 

[choirboy]

I'm still eagerly awaiting an answer to this, particularly since I actually did my residency at one of the programs listed above, and I have no idea what "+1" is or if it's something that I did.

It is something that Tulane started, basically 4 weeks of wards/elective and then 1 week of outpatient clinic (repeat 10 times and that's your year). You therefore never have continuity clinic during your wards months so you don't have to worry about leaving your patients at the hospital.

 

[adagio]

It is something that Tulane started, basically 4 weeks of wards/elective and then 1 week of outpatient clinic (repeat 10 times and that's your year). You therefore never have continuity clinic during your wards months so you don't have to worry about leaving your patients at the hospital.

Thanks a lot. Nice model.

 

[sacrament]

It is something that Tulane started, basically 4 weeks of wards/elective and then 1 week of outpatient clinic (repeat 10 times and that's your year). You therefore never have continuity clinic during your wards months so you don't have to worry about leaving your patients at the hospital.

Ah nice. Yeah, we weren't doing that when I was a resident but I would have loved it.

 

[gutonc]

Ah nice. Yeah, we weren't doing that when I was a resident but I would have loved it.

The residents seem to like it, those who have to create and manage the schedules OTOH hate it.

 

[frisbee]

Colorado is doing 4+1 next year (I was told 99% chance of this)

 

[gutonc]

Colorado is doing 4+1 next year (I was told 99% chance of this)

A ton of programs will likely switch to this in the next year or two as it is a relatively easy way to kill both the new work hours and increased clinic time requirement birds with one stone.

 

[StudentDoctor55]

I think the University of Washington is doing something where you get two days per month off from your wards to do outpatient. The rest of the team sees your patients as if you were on a day off and you can just focus on the outpatient side of things but you do not do this for a week like these other models. That still averages out to the 4 half day clinics per month.

 

[dd128]

UTSW said they're pretty sure they'll be switching to 4+1 next year if they can work out the logistical stuff. It sounds really appealing to me to know I'll have that guaranteed week at the end of every month to decompress a bit from a ward or ICU month.

 

[choirboy]

UTSW said they're pretty sure they'll be switching to 4+1 next year if they can work out the logistical stuff. It sounds really appealing to me to know I'll have that guaranteed week at the end of every month to decompress a bit from a ward or ICU month.

Brigham and Women's is also looking at switching according to the PD, don't know when.

 

[kirkland1984]

Does anyone know if UTSW will have 4+1 this coming year?

 

[gutonc]

Does anyone know if UTSW will have 4+1 this coming year?

Um...look up. Two posts above.

As I posted elsewhere, expect most programs to have some sort of a +1 system in the next year or so. It's the easiest way to comply with the ******* IM RRC regulations about increased clinic time (and prove that you're doing so).

Incidentally, I predict an even bigger exodus into hospitalist and subspecialty medicine with this recent change in training requirements. If this had been in place when I was applying (and I was aware of it), I would have seriously switched specialties.