Call schedules: in-house, home call, q3 and q4
Updated October 12, 2026 · with an example to try
q4 call means taking call every fourth night, usually because four residents share it. In-house call means staying in the hospital overnight; home call means being reachable from home and coming in when needed. The ACGME limits in-house call to every third night, averaged over four weeks. Home call can't fall on a day off, and its patient care time counts toward the 80 hours.
Build a month of call
Example · runs in your browser; nothing you enter is sent
| Person | Nights on call | Friday or Saturday | Holidays |
|---|---|---|---|
| A | 7 | 2 | 0 |
| B | 8 | 3 | 1 |
| C | 8 | 3 | 0 |
| D | 8 | 2 | 0 |
In-house q4 call puts each person on call 7 or 8 nights in January. Every third night, averaged over its 31 nights, allows 10 (ACGME 6.27). Programs that average over 4 weeks allow 9 in 28 days. After 24 hours of in-house call, residents need at least 14 hours free (6.21.a).
A simple rotation, continuing from month to month. Every team size here but seven moves each person through the days of the week, so Friday and Saturday nights even out over a few weeks; with seven (q7), each person keeps the same night of the week. Holidays counted, as in the call schedule maker: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Christmas Eve, Christmas Day and New Year's Eve.
Choose how many people share call. The month shows who is on each night, each person's count, and their Friday and Saturday nights. To build a real one, with the nights each person can't take, use the call schedule maker.
What the number after q means
The number is how often one person takes call, in nights: q2 is every second night, q3 every third and q4 every fourth. In a simple rotation, a team of four gives q4 call, and a team of three gives q3.
A fixed q3 or q4 rotation moves each person through every day of the week, so weekends even out over a few weeks, as the month above shows. A weekly pattern doesn't: with one call night a week, each person keeps the same weekday, and whoever has Friday has every Friday. Programs often run a separate weekend rotation to even it out.
The limits on in-house call
- In-house call no more often than every third night, averaged over four weeks (6.27). q3 sits right at the limit: a 4-week block holds 9 or 10 calls, depending on where it starts, and 10 is over. q2 is over it.
- At most 24 hours of continuous scheduled clinical work, plus up to 4 hours for handoffs and education, with no new patients in those hours (6.22).
- At least 14 hours free of clinical work and education after 24 hours of in-house call (6.21.a).
- At most 80 hours a week, averaged over four weeks, counting all in-house work, clinical work done from home and moonlighting (6.20).
Home call
Home call is not held to the every-third-night limit. Time spent on patient care while on home call counts toward the 80 hours, including phone calls and notes written from home (6.20, 6.28).
Home call cannot be assigned on a resident's day off, and residents still need one day in seven free, averaged over four weeks (6.21.b, 6.28). It also must not be so frequent or taxing that it leaves no time for rest (6.28.a).
Common questions
- Is q3 call allowed for residents?
- For in-house call, yes: the ACGME limit is every third night, averaged over four weeks, so q3 sits right at the limit (a 4-week block holds 9 or 10 calls, and 10 is over) and q2 is over it.
- Does home call count toward the 80 hours?
- The time you spend on patient care while on home call counts, whether you come in or work from home. Home call is not limited to every third night, but it cannot fall on your day off.
- What is a post-call day?
- The time after a 24-hour in-house call. Residents must have at least 14 hours free of clinical work and education after it.
- Does a post-call day count as a day off?
- Only if 24 hours in a row are free. A resident who leaves at 11:00 after call and is back at 07:00 the next day has had 20 hours off: not a day off.
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).