Building a residency block and call schedule
Updated October 12, 2026 · with an example to try
For chief residents and coordinators: start with the year, 13 blocks of 4 weeks or 12 months, each with one rotation. Then build call one block at a time: leave out vacations and the nights each resident can't take, share calls, Friday and Saturday nights and holidays evenly, keep in-house call to every third night averaged over the block, and leave 14 hours free after 24-hour call.
Build a month of call
Example · runs in your browser; nothing you enter is sent
30 nights, Sun, Nov 1 to Mon, Nov 30, one person on call each night.
- Calls each
- 6
- Friday or Saturday nights each
- 1 to 2
- Holidays each
- 0 to 1
- Nights with nobody on call
- 0
- Meets the ACGME limit for in-house call: no more often than every third night, averaged over each month. The closest is Resident A, with 6 of the 10 calls allowed in November.Not checked here: the 80-hour week, one day off in seven, and time off after 24-hour call.
November 2026
| Monday | Tuesday | Wednesday | Thursday | Friday | Saturday | Sunday |
|---|---|---|---|---|---|---|
| 1, Resident A | ||||||
| 2, Resident B | 3, Resident C | 4, Resident D | 5, Resident E | 6, Resident A | 7, Resident B | 8, Resident C |
| 9, Resident D | 10, Resident E | 11, Resident A | 12, Resident B | 13, Resident C | 14, Resident D | 15, Resident E |
| 16, Resident A | 17, Resident B | 18, Resident C | 19, Resident D | 20, Resident E | 21, Resident A | 22, Resident B |
| 23, Resident C | 24, Resident D | 25, Resident E | 26, Resident A, Thanksgiving | 27, Resident B | 28, Resident C | 29, Resident D |
| 30, Resident E |
Grey: Friday and Saturday nights. Dark circle: a holiday that counts. Dashed amber: nobody on call.
Each person's calls
| Person | Calls | Friday or Saturday nights | Holidays | Closest two calls | Farthest apart |
|---|---|---|---|---|---|
| Resident A | 6 | 2 | 1 | q5 (4 nights between) | q5 (4 nights between) |
| Resident B | 6 | 2 | 0 | q5 (4 nights between) | q5 (4 nights between) |
| Resident C | 6 | 2 | 0 | q5 (4 nights between) | q5 (4 nights between) |
| Resident D | 6 | 1 | 0 | q5 (4 nights between) | q5 (4 nights between) |
| Resident E | 6 | 1 | 0 | q5 (4 nights between) | q5 (4 nights between) |
Everyone gets the same number of calls, give or take one, even after leave, so leave puts someone's calls closer together. Sharing Friday, Saturday and holiday nights evenly can do the same, but never closer than you chose.
A spreadsheet with the date, weekday, person and call type for each night.
Add your residents, the nights each one can't take and the holidays you count. Vacation nights come out of the q3 average; nights they're working somewhere else stay in. Everyone's calls, Friday and Saturday nights and holidays stay within one of each other, calls are spaced as far apart as they can be, and in-house call stays within the limit.
Averaging by rotation
Programs average duty hours by rotation, as the ACGME's rules set out: over 4 weeks, a month, or the rotation if it's shorter, with leave days left out. To lay out the year's rotations, see the block schedule.
Call within the limits
- In-house call no more often than every third night, averaged over 4 weeks (6.27): at most 9 calls in a 28-day block.
- At most 24 hours of continuous scheduled work, plus up to 4 hours for handoffs and education, with no new patients (6.22).
- At least 14 hours free after 24 hours of in-house call (6.21.a).
- One day in seven free of clinical work and education, averaged over 4 weeks; home call can't fall on it (6.21.b, 6.28).
- 80 hours a week, averaged over 4 weeks, counting in-house work, clinical work from home and moonlighting (6.20).
Steps
- 1
Fix the dates that can't move
Vacations, conferences, required rotations and each resident's nights they can't take, before any call goes in.
- 2
Check each block
80 hours a week, days off and call frequency, block by block, after every change.
- 3
Recount after swaps
Swaps move calls and Friday and Saturday nights between people, so count them again after each swap, not only as first scheduled.
Common questions
- How many in-house calls can a resident take in 4 weeks?
- At most 9 in a 28-day block: every third night, averaged over 4 weeks. A strict q3 rotation puts 9 or 10 calls in a block, depending on where it starts, so it's allowed only when it comes to 9.
- Does vacation count in the average?
- No. The ACGME takes leave days out of the average, so a block with a week of vacation is averaged over its other days.
Check your own schedule against these rules.
Use the free duty-hour check with your calendar link, the subscribe link your scheduling app gives you, or a calendar file. Our server reads a link once, sends back only the shift times and keeps nothing; a file never leaves your device. No account needed (what the checks see).