The academic year is divided into 4-week blocks. Housestaff receive 3 weeks paid vacation and 1 week of paid educational leave annually. They intern schedule is a traditional 4-week block model. PGY2 and PGY3 residents take advantage of the new x+y model (JGIM 2013; 28(8): 1100-4). Our implementation of this model is 4 weeks inpatient training, followed by 2 weeks ambulatory training, followed by 2 weeks subspecialty training (4+2+2). This new model has been shown to increase resident satisfaction with ambulatory experiences, reduce fragmentations of care, and enhance learning.