Objective:

This study aims to evaluate whether this new model improves continuity of care, broadens the scope of outpatient neurology exposure, and enhances the resident educational experience. 

Background:

Although most neurological care is delivered in the outpatient setting, U.S. neurology residency programs remain predominantly inpatient-focused, leaving graduates with gaps in outpatient training. There is a need to strengthen outpatient neurology education to ensure comprehensive training of future neurologists. Our program adopted a new clinic structure to increase resident exposure to common outpatient neurology subspecialties and continuity of care.

Design/Methods:

During the 2024-2025 academic year, we implemented a redesigned outpatient continuity clinic model in which residents participate in a weekly clinic during non-core (non-inpatient) rotations. In addition, residents rotated through seven selective weeks in outpatient neurology subspecialties. We used preintervention and postintervention surveys to assess measures of resident satisfaction and well-being, as well as number of patient slots, fill rates, and no-show rates in resident continuity clinic. We hypothesized that resident satisfaction and well-being would improve, residents would see more patients in their continuity clinics, and no-show rates would decrease.

Results:

There was a significant increase in the number of continuity clinic slots available per resident (19 ± 3 slots per resident to 59 ± 11 slots per resident). The percentage of no-shows in the resident clinic decreased significantly by 12% (p =  0.002). Residents reported statistically significant improvement in the long-term continuity of care, preparation for outpatient practice, ability to follow a condition over time, responsibility and ownership of patient and personal reward at work. There was no significant increase in the level of stress or fatigue. The spectrum of conditions seen remained unchanged.

Conclusions:

Implementation of a weekly continuity clinic during non-core rotations and scheduled selective weeks in common outpatient neurology subspecialties resulted in an increase in outpatient exposure and positive resident experience.