This workshop will review the Why and How several residencies of differing makeups have changed their overall curriculum to a Clinic First Model. Based on Tom Bodenheimer’s 10 building Blocks of High Performing Primary Care, this model recognizes the importance of the clinic training site being the cornerstone of residents training for future practice. In order to do this several residencies will describe how they have moved to a 2x2 curriculum where trainees have dedicated inpatient and dedicated outpatient time in the same month. The session will review the benefits ; improved clinic continuity, increased regularity of residents in clinic, taking clinic seriously, less transitions of care, less fragmented learning and teaching, attention to the +3 resident building blocks of resident scheduling, engagement and work-life balance. Difficulties of making this large curricular change are many: manpower needed for scheduling changes, buy in from stakeholders who feel this is a departure from full spectrum training, buy in for other departments.