How to build an ED physician schedule

Before the month starts

Start with the coverage template: the shifts the department needs each day, for physicians and for APPs (physician assistants and nurse practitioners). A common pattern is a day shift from 07:00 to 15:00, an evening shift from 15:00 to 23:00 and a night shift from 23:00 to 07:00, with staggered shifts adding coverage in the busy afternoon and evening.

Next, set each person's share. With 3 physician shifts a day, a 30-day month has 90 physician shifts, so 10 full-time physicians get 9 each, including 3 of the 30 nights. People with protected time or administrative work get fewer.

Then set a due date for requests, time off and preferences that leaves time to build and review. One academic group aims to finish each quarterly schedule at least 4 weeks before the previous quarter ends.

Build it in this order

1. 1

   Enter time off and requests

   Block approved time off first, then mark day requests and preferences so they are in view while you place shifts.

2. 2

   Place nights

   Place nights in runs that fit your group's limit (a 2020 expert consensus suggests no more than 3 in a row) and leave time off after each run. One self-scheduling group lets its night physicians go first to avoid split runs and every-other-night patterns.

3. 3

   Place weekends and holidays

   Use your holiday rotation and a running count of weekends so these shifts spread evenly. See holiday schedule rotation.

4. 4

   Fill days and evenings in forward order

   Within each person's week, move from days to evenings to nights rather than backward. ACEP prefers this order, and with 8-hour shifts it avoids 8-hour turnarounds.

5. 5

   Balance the counts

   Compare each person's shifts, hours, nights, weekends and holidays, and fix outliers before you publish.

6. 6

   Check every person

   Look for overlapping shifts, gaps under 11 hours, long runs of nights and backward switches, counting shifts at any other site the person works.

7. 7

   Publish and share

   Publish the final schedule and give everyone a calendar link so their phone calendar follows it. See subscribing to a work schedule calendar.

8. 8

   Treat changes as trades

   Run every swap or give-away through the same checks before it is agreed. See what a shift swap policy should check.

Where Capillary fits

Capillary scheduling follows this order. Clinicians send day requests, time off and weekly preferences before your due date. You build the month of physician and APP shifts as a private draft, and saving and publishing check role, overlapping shifts and minimum rest, including shifts the person works at another site. After publishing, clinicians see their shifts at every site in one list and in their phone calendar, and can give away or swap shifts with rest and overlap checked before anyone agrees. You approve time off and, if you choose, trades. Try it in the demo.

Common questions

Should physicians pick their own shifts?

Some groups self-schedule. One academic group of 15 physicians gives each person a set number of each shift type, lets night physicians place first and moves everyone one spot down the picking order each quarter. NIOSH's training suggests pairing self-scheduling with limits that prevent risky patterns.

How much rest should the checks require?

The EU minimum and expert recommendations both use 11 hours between shifts. The sources are in quick returns and rest between shifts.

How do APP shifts fit in?

Build them as their own coverage line in the same schedule, so the role check keeps each shift with the right kind of clinician and everyone's rest is checked the same way. More in scheduling APPs in the ED.

Sources

1. ACEP policy resource and education paper: Circadian Rhythms and Shift Work (revised July 2026)
2. ACEP policy statement: Emergency Physician Shift Work (approved June 2017; Ann Emerg Med 2017)
3. London S, Dahn C, Fuller R. JACEP Open 2023
4. Garde AH, et al. Scand J Work Environ Health 2020
5. EU Working Time Directive 2003/88/EC (EUR-Lex)
6. NIOSH Training for Nurses on Shift Work and Long Work Hours, Module 5 (schedule design guidelines)

Related

• Shift schedulingSchedule request due dates
• Shift schedulingED shift swap policy: what to check before a trade
• Shift schedulingHoliday schedule rotation for physician groups
• Shift schedulingED shift patterns: day, evening, night and overlap