Medical Interns Shift Pattern

This shift schedule supports a combination of 14-hr day shift , 15.5-hr cross-cover shift , and a 14-hr night shift for medical interns. The day shift and the cross-cover shift have the same start time (7:00AM). The night shift starts at around 10:00PM and ends at 12:00PM on the next day. This combination allows a day intern and night intern to be present at the same time in the morning rounds so they can discuss with the attending physicians the treatments for patients in the next 24-hr period. This plan requires 4 teams with each team rotating through the following shift sequence over a 4 day period: 1 day shift, 1 cross-cover shift, 1 night shift, one day off. The day off is actually a recovery day since the night shift does not end until 12:00PM.

Medical Interns Shift Pattern


The above grid shows working and non-working days for each team in one repeat cycle. Day 1 usually starts on a Monday but it can be any day of the week. At the end of the cycle, the entire sequence starts over. Color coded blocks represent assigned shifts (working days) while underlines represent non-working days.
  • The required shifts and shift lengths are shown in the Shifts column. Shift names, start times, and end times are shown as examples only. They can be changed to match the requirements of your operation.
  • The teams required by the plan are shown in the first column. The total working hours for each team over the repeat cycle are shown in the Hours column, assuming one employee per team.
  • The last row, Hours, shows the hours worked by all teams in each date range block (leg), assuming one employee per team.


Plan ID C4TR1415-1
Name ICU Interns Plan
Applicability 24/7 operations
Teams Required 4
Shifts Day (14-hr), Cross-cover (15.5-hr), Night (14-hr)
Repeat Cycle 4 days
Rotation Fast rotation from day shift to cross-cover shift to night shift
Average Hours per Week 76.5
Staffing Fluctuation Balanced from day to day
  • Only 1 night shift every 4 days
  • Too many work hours per week
Common Usage Scheduling medical interns at hospitals in the United States
Notes This plan is based on the “14-Hr Shift Schedule for Medical ICU Interns” model developed by Akhil Vallabhaneni, MD, et al. and published in the December 2006 issue of the Chest journal, an official publication of the American College of Chest Physicians.


  • Plan ID: A code used to uniquely identify the shift plan in Snap Schedule employee scheduling software.
  • Name: The name of the shift plan.
  • Applicability: The type of operations this shift configuration is designed for.
  • Teams Required: The number of teams (crews) required by this plan. A team may consist of one or more employees.
  • Shifts: The different shifts used in this shift pattern. For each shift, only the shift description and shift length are shown. The shift start or end time can be adjusted to fit your business operations so long as the shift length stays the same.
  • Repeat Cycle: The number of days required for each team to complete its assigned shift sequence in a schedule plan. At the end of each repeat cycle, the team starts the same shift sequence over again.
  • Rotation: For rotating shift configurations, a team rotates from one shift to another according to a specific arrangement. In a forward rotation, the team rotates from a shift that starts earlier in the day to a shift that starts later in the day, e.g. Day to Swing to Night. In a backward rotation, the reverse is true. Many studies suggest that forward rotation is better than backward rotation since our body adjusts much better to changes in work shifts from earlier to later. The rotation speed is the speed at which the shifts are rotated. In a "fast" rotation, a team rotates from one shift to another once every few days or less. In a "slow" rotation, a team works the same shift for many days or weeks before rotating to another shift.
  • Average Hours Per Week: This is the average number of hours worked by each employee per week based on the shift lengths and shift sequences for this plan.
  • Staffing Fluctuation: The fluctuation in staffing level as the plan progresses from shift to shift and day to day. A shift configration is "balanced from shift to shift" if the new shift will be staffed by the same number of employees as the old shift. A shift configuration is "balanced from day to day" if each day is staffed by the same number of employees. Note that by default, each team contains the same number of employees.
  • Pluses: Positive aspects of the shift configuration.
  • Minuses: Negative aspects of the shift configuration.
  • Common Usage: Typical users of the shift configuration.