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Template · Block schedules

# Free resident block schedule templates for 2026–27

Four spreadsheets to lay out your academic year: 13 four-week blocks, a 4+1 and a 6+2 X+Y schedule with the clinic weeks already staggered, and a sheet for the coverage each service needs.

Jackson Cantrell · Updated October 8, 2026 · 6 min read

**Short answer** Download the template that matches how your year is built, fill in rotations resident by resident, and use the coverage sheet to check every block has enough people on every service. The dates for 2026–27 are already in. A template lays the year out; making it pass every coverage minimum, vacation cap and rotation requirement at once is the hard part, and that part is what jacks does with you.

## Which structure fits your program

Most residencies divide the academic year one of two ways. **Thirteen four-week blocks** keep every rotation the same length and line up neatly with weekly call. **Twelve calendar months** are easier to read but run 28 to 31 days. The ACGME accepts either on a block diagram as long as the block length is stated, and some programs mix them, with four-week blocks for interns and months for seniors.

Internal medicine, pediatrics and med-peds programs often use **X+Y scheduling** instead: X weeks of inpatient, elective or other traditional rotations, then Y weeks of ambulatory care, usually continuity clinic. Residents are split into groups that take their clinic weeks in turn, so the clinic is staffed every week and clinic never collides with a ward month. Common patterns are 4+1, 3+1, 6+2 and 8+2.

## 1. Thirteen four-week blocks

Twelve residents, PGY-1 to PGY-3, across 13 blocks. Block 1 starts Wednesday, July 1, 2026; blocks 1 to 12 are 28 days each and block 13 takes the one extra day, ending June 30, 2027. Below the grid, a coverage check counts how many residents you have on each rotation in every block as you type.

### Preview: the first rows

Type a rotation name in each cell. The counts below the grid match names exactly, so use the same spelling every time.

| Resident | PGY | Block 1 · Jul 1 - Jul 28 | Block 2 · Jul 29 - Aug 25 | Block 3 · Aug 26 - Sep 22 | … |
|---|---|---|---|---|---|
| R1 | 1 |  |  |  |  |
| R2 | 1 |  |  |  |  |
| R3 | 1 |  |  |  |  |
| R4 | 1 |  |  |  |  |

[Download the 13-block template](https://jacks.med/templates/block-schedule-13-blocks.csv) CSV · opens in Excel or Google Sheets · 12 residents, 13 blocks

## 2. A 4+1 X+Y schedule

Fifteen residents in five groups, A to E, three per group with one of each PGY. Every five weeks each group spends four weeks on X rotations and one week in clinic, and the groups take turns, so exactly one fifth of the program is in clinic every week of the year and about 20 percent of each resident’s year is ambulatory. The clinic weeks are filled in; you fill in the X weeks.

### Preview: who is in clinic, weeks 1 to 10

Weeks run Monday to Sunday. Week 1 starts June 29, the week that contains July 1; week 52 runs through June 30, 2027.

| Group | Wk 1 | Wk 2 | Wk 3 | Wk 4 | Wk 5 | Wk 6 | Wk 7 | Wk 8 | Wk 9 | Wk 10 |
|---|---|---|---|---|---|---|---|---|---|---|
| A | Clinic | X | X | X | X | Clinic | X | X | X | X |
| B | X | Clinic | X | X | X | X | Clinic | X | X | X |
| C | X | X | Clinic | X | X | X | X | Clinic | X | X |
| D | X | X | X | Clinic | X | X | X | X | Clinic | X |
| E | X | X | X | X | Clinic | X | X | X | X | Clinic |

**    **

[Download the 4+1 template](https://jacks.med/templates/block-schedule-4plus1.csv) CSV · opens in Excel or Google Sheets · 15 residents, 52 weeks

## 3. A 6+2 X+Y schedule

Twelve residents in four groups, A to D. Each group spends six weeks on X rotations and two in clinic, staggered so one group is always in clinic, which puts a quarter of the year in ambulatory care. Longer X stretches suit programs with four-week ward blocks plus a short elective.

### Preview: who is in clinic, weeks 1 to 8

Each group’s two clinic weeks come every eight weeks.

| Group | Wk 1 | Wk 2 | Wk 3 | Wk 4 | Wk 5 | Wk 6 | Wk 7 | Wk 8 |
|---|---|---|---|---|---|---|---|---|
| A | Clinic | Clinic | X | X | X | X | X | X |
| B | X | X | Clinic | Clinic | X | X | X | X |
| C | X | X | X | X | Clinic | Clinic | X | X |
| D | X | X | X | X | X | X | Clinic | Clinic |

**   **

[Download the 6+2 template](https://jacks.med/templates/block-schedule-6plus2.csv) CSV · opens in Excel or Google Sheets · 12 residents, 52 weeks

## 4. Coverage minimums

The sheet most programs keep in their heads: how many residents each service needs, by level, in every block, and the most you can let go on vacation at once. Set a default minimum, then override it for the blocks that differ, such as a heavier July or a holiday block. The numbers in it are examples; replace them with yours.

### Preview: the first rows

A blank block cell means “use the default”.

| Service | Level | Minimum | Maximum | Block 1 | … |
|---|---|---|---|---|---|
| Wards | PGY-1 | 2 |  |  |  |
| Wards | PGY-2+ | 2 |  |  |  |
| ICU | PGY-1 | 1 |  |  |  |
| ICU | PGY-2+ | 1 |  |  |  |
| Night float | PGY-1 | 1 |  |  |  |

[Download the coverage minimums sheet](https://jacks.med/templates/block-coverage-minimums.csv) CSV · opens in Excel or Google Sheets · services × 13 blocks

## How to fill in a block schedule

1. **Start with what is fixed.** Required rotations for each PGY, off-site months, and anyone starting or leaving off-cycle.

1. **Place vacation next.** Collect requests early, cap how many residents can be away in one block, and favor lighter services.

1. **Fill the services to their minimums.** Work block by block from the coverage sheet, with the right mix of interns and seniors on each team.

1. **Add electives last.** They are the flexible part of the year, so they absorb whatever is left.

1. **Check every block, then every resident.** Each block meets its minimums; each resident’s year meets their rotation requirements.

1. **Publish it with a key.** State the block length and spell out local names like “Blue Team”, so residents and reviewers read it the same way.

## Where block schedules go wrong

- **Vacation clusters.** Everyone wants late June and the winter holidays. Without a per-block cap, one block is short-staffed and the rest are padded.

- **July holes.** New interns all start at once. Put experienced seniors on the heaviest services in the first blocks, not wherever they happened to land.

- **The wrong PGY mix.** A service can meet its headcount and still have no senior on it. Count by level, not just by bodies.

- **A broken X+Y stagger.** One swap or one vacation placed in a clinic week leaves a clinic understaffed and a resident months between clinic visits. Keep vacation in X weeks.

- **Two schedules that disagree.** When blocks and call are built in separate files, someone ends up post-call on a clinic day or on nights during an off-site month.

- **Changes in the middle of the year.** Parental leave, an off-cycle resident or one swapped block ripples through coverage for months, and in a spreadsheet nobody rechecks the whole year.

## Where jacks fits

A template gives you the shape of the year. jacks builds the year itself, with you.

- **Setup, together.** We sit down with you, start from your current spreadsheet if you have one, and turn your rotation requirements, coverage minimums and vacation rules into settings.

- **It builds the block year.** Every block meets every minimum, every resident gets their required rotations, and the X+Y stagger holds. Everyone is balanced against their own targets.

- **One schedule, not two.** Blocks and call live together, so a call shift never lands on a clinic week or an off-site month.

- **It runs the year.** Move a block or approve a leave and jacks rechecks the whole year, then tells everyone affected on their phone and calendar.

Building call on top of your blocks? See [how to build a fair residency call schedule](https://jacks.med/notes/fair-residency-call-schedule), or compare tools in [the best residency scheduling software in 2026](https://jacks.med/notes/best-residency-scheduling-software).

## Questions programs ask

### What is a 4+1 schedule in residency?

A 4+1 schedule alternates four weeks of inpatient, elective or other traditional rotations with one week of ambulatory care, usually continuity clinic. Residents are split into five groups that take their clinic week in turn, so one fifth of the program is in clinic every week and about 20 percent of the year is ambulatory.

### Should a residency use 13 four-week blocks or 12 calendar months?

Either works, and the ACGME accepts both on a block diagram as long as the block length is stated. Thirteen four-week blocks keep every rotation the same length and line up with weekly call; calendar months are easier to read but run 28 to 31 days. Some programs use four-week blocks for interns and months for seniors.

### How should vacation be placed on a block schedule?

Set a maximum number of residents on vacation per block, then place requests against it, ideally on lighter services. On an X+Y schedule, put vacation in X weeks next to a clinic week rather than splitting the clinic cycle, so nobody goes a long stretch between continuity clinics.

### Can I bring this template into jacks?

Yes. If you have a block schedule in a spreadsheet, bring it to setup: we turn the rules behind it into settings with you, and jacks builds the next version with every coverage minimum and rotation requirement checked.

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Source: https://jacks.med/notes/resident-block-schedule-templates · jacks, scheduling for residency programs and attending groups · hello@jacks.med
