To The Editor:
In the December issue of JGIM, Ray et al. examined several models of ambulatory training including an X + Y block schedule, a full-day clinic, and a hybrid clinic model.1 Previous studies have also examined combination continuity clinics in search of a configuration that enhances patient and resident continuity, improves outcomes, and promotes high patient satisfaction.2 , 3 In Table 2 of their article, Ray and colleagues highlight possible advantages and disadvantages of the three systems. We question two elements in this table. First, one of the purported advantages of an X + Y block schedule is “numerous long gaps in residents’ outpatient presence.” We wonder whether this was meant to be designated as a disadvantage. Second, we would question whether “residents maintain[ing] primary ownership of patients including follow up results and response to patient calls” is actually a disadvantage, particularly in light of the authors’ statement that “residents should never be completely absent from their role as primary care physicians.”
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Conflict of Interest
The authors declare that they do not have a conflict of interest.
References
- 1.Ray A, Jones D, Palamara K, et al. Improving ambulatory training in internal medicine: X + Y (or why not?) J Gen Intern Med. 2016;31(12):1519–1522. doi: 10.1007/s11606-016-3808-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
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