7 on 7 off: the hospitalist block schedule
Updated October 12, 2026 · with an example to try
On 7 on 7 off, a hospitalist works seven shifts in a row, usually 12 hours each, then has seven days off, so they work half the days of the year, 182 or 183. It is the most common hospitalist schedule: 56% of groups used it in 2020, by the Society of Hospital Medicine's count.
See a year of it
Example · runs in your browser; nothing you enter is sent
- Days worked
- 182
- Weekend days worked
- 52
- Holidays worked
- 7 of 13
Working Martin Luther King Jr. Day, Presidents' Day, Indigenous Peoples' Day, Veterans Day, Thanksgiving, Christmas Eve, Christmas Day.
Jan 2027
Feb 2027
Mar 2027
Apr 2027
May 2027
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Oct 2027
Nov 2027
Dec 2027
Jan 2028
- Working
- Weekend off
- Holiday
52 weeks from the first day on. Holidays are the US federal holidays plus Christmas Eve and New Year's Eve. A night is counted on the date it starts.
How common it is
The Society of Hospital Medicine's surveys show 7 on 7 off growing from 41.9% of groups in 2012 to 53.8% in 2014. It was the choice of 56% of adult-only groups in 2018 and of 56% of groups in 2020.
What studies found
In 114,777 Texas Medicare admissions, patients of hospitalists who mostly worked blocks of 7 or more days had lower 30-day mortality after discharge (adjusted odds ratio 0.88) and fewer readmissions (0.94) than patients of hospitalists who rarely did.
On one 7 on 7 off service, patients handed between more hospitalists cost slightly more, and a related study found no link with adverse events. At another hospital, staggering the hospitalists' start days cut handoffs.
The Society of Hospital Medicine's scheduling resource notes both sides: the pattern means fewer handoffs, and seven days in a row may add to burnout.
7 on 14 off
Some nocturnist groups work 7 nights, then have 14 days off: a third of the year, about 122 nights. The group then needs more people for the same nights, which the nocturnist calculator works out.
Weekends and holidays
Each person on 7 on 7 off works half the weekends. Which holidays fall in their weeks depends on the day their block starts: move the first day above and the holiday count changes. For ways to share holidays evenly, see holiday schedule rotation.
Common questions
- How many days a year is 7 on 7 off?
- 182: 26 weeks of 7 days, or 183 in some years, depending on where the year starts.
- How many hours is 7 on 7 off?
- With 12-hour shifts, 84 hours in a working week and about 2,184 hours a year: 42 hours a week averaged over 4 weeks.
- Is 7 on 7 off better for patients?
- In Texas Medicare data, patients of hospitalists who mostly worked blocks of 7 or more days had lower 30-day mortality and fewer readmissions, an association rather than proof. Other studies found modest cost differences and no change in adverse events.
Chart your own shifts over time.
Capillary Health makes scheduling software for hospitals and clinics. The free checks keep nothing; a free account is different. It saves your work calendar's shifts and charts your hours, nights and rest between shifts over time. No one in your department or hospital sees them (who can see what).
Sources
- Society of Hospital Medicine blog, October 29, 2014
- The Hospitalist, March 7, 2019 (2018 survey figures on scheduling)
- Society of Hospital Medicine, schedule management resource, February 2023
- Goodwin et al. JAMA Intern Med 2020
- Turner et al. J Gen Intern Med 2014
- O'Leary et al. J Hosp Med 2015
- O'Donnell et al. Am J Med Qual 2019
- The Hospitalist, May 11, 2017 (a nocturnist group on 7 on, 14 off)