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Ambulatory Immersion Schedule

In 2015, we initiated an exciting change in our block scheduling. Known as an "ambulatory immersion schedule" or, at Yale, 4+2+2, this method of scheduling allows our residents to spend uninterrupted time in both inpatient and outpatient settings. Core inpatient rotations, such as those on our wards and in our ICUs, span four weeks without disruption in patient care or team continuity. In turn, we offer dedicated two-week blocks of outpatient care that include continuity clinics, urgent visits, a dedicated primary care pediatric curriculum, administrative and patient advocacy time, and opportunities to rotate in local, community pediatric practices. While the primary goal of immersion scheduling is the enhancement of the ambulatory experience, this strategy leads to other positive consequences including significant decreases in the number of patient hand-offs, a reduced need to interrupt resident electives for continuity clinics, and an improved inpatient experience.