Innovative Healthcare Today, Training the Physicians of Tomorrow
We recently rolled out the 4+1 schedule. Categorical residents are split into five groups, or "firms." Each firm has an ambulatory week every five weeks. On ambulatory weeks, residents see patients in various clinics and engage in other activities from Monday through Friday, equivalent to ten half-day sessions.
In the four weeks before and after each ambulatory week, residents rotate through inpatient services and some other outpatient core rotations and electives.
Each ambulatory week will include:
- Five half days of Primary Care Clinic.
- One half day of administrative time.
- One half day for an ambulatory academic curriculum.
- Three half days of subspecialty clinic experience.
Most of our residents have their primary care experience at the UCR Health Downtown Riverside Clinic. Some are assigned to perform primary care at the VA. Residents who have preference of one site over the other can make that request when they match and we will attempt to honor it.
Residents also have administrative time to handle emails, complete evaluations, record work hours, do tasks for QI or research, and take care of personal needs.
Half-Day Ambulatory Curriculum
| Time | Site | Description |
|---|---|---|
| 8 to 9:30 am | Journal Club | Review a landmark article and a recent research article in ambulatory medicine. |
| 9:30 to 10 am | Resident Lecture | Resident-led education on an ambulatory topic. |
| 10 to 10:30 | Faculty Lecture | Faculty-led education on an ambulatory topic. |
| 10:30 to noon | Evidence Based Medicine (EBM) Activity | Residents use the EBM process to research a clinical research question arising from patient care, then apply it to patient in question, and present it to colleagues. |
Regardless of where you do primary care, you will have the opportunity to rotate through the following subspecialty clinics at the UCR Health Downtown Riverside Clinic:
- Rheumatology
- Cardiology
- Geriatrics
- Women’s health
- Pulmonary medicine
Benefits of the 4+1 System
The 4+1 system enhances resident wellness by assuring a "golden weekend" (where both Saturday and Sunday are off work and free of backup call) every five weeks when rotating through their ambulatory week. The schedule also ensures residents can be present and can take advantage of learning opportunities as they present themselves.
The system was created as a direct result of resident feedback. Our trainees voiced a desire for greater schedule consistency and improved wellness and program leadership worked to implement these changes as part of our commitment to improving their experiences and ensuring an optimal balance between education, clinical exposure, and personal well-being.