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A common question when planning a site clinic is: how many doctors and nurses do we need to hire? The quick answer, "one doctor and two nurses", usually only tells you how many people must be on duty at one time. The number you need to employ is much larger, because the site runs day and night and medical staff also rotate on and off site with the roster.
This article walks through the reasoning step by step. The numbers in it are illustrations only. Each site's needs should be worked out from that site's own conditions.
What a 10:2 roster means
A roster is the rotating pattern of work and leave common at mine sites and remote projects. In this article, a 10:2 roster means 10 weeks working on site, then 2 weeks of leave off site. Some companies count in days or use other patterns, such as 6:2 or 8:2. The method stays the same; only the numbers change.
Agree early on whether travel days to and from site count as leave or as work. Where the journey takes one or two days, this makes a real difference to the calculation.
Step 1: set service hours and posts
Start with the question: when must the clinic be ready? A site that runs 24 hours needs a clinic that is also ready 24 hours, because accidents can happen at any time. These hours are then split into shifts, for example two 12-hour shifts or three 8-hour shifts.
Check whether there are posts outside the main clinic, such as a first aid post in a distant work area or medical cover for high-risk activities. Count each post separately.
Step 2: decide staff per shift
Next, decide how many doctors, nurses, and other staff each shift needs. Things to weigh include:
- the number of workers served and daily visits;
- the hazards on site and the likelihood of emergencies;
- distance and travel time to the referral hospital;
- whether staff must escort patients during evacuation, leaving the site for a while.
Regulations also set a floor. The occupational health clinic standard in Indonesia's Minister of Health Regulation No. 11 of 2025 sets minimum staffing for the clinic as a whole, not per shift: one doctor, one nurse, and one administrator for Type 1; two doctors (or one doctor plus one doctor with occupational medicine competence), one nurse, one occupational health officer, and one administrator for Type 2. The standard also says staff numbers can be increased to match workload and operating hours. Clinic types are explained in our article on mine site clinics.
Step 3: multiply by the number of shifts
Staff per shift multiplied by shifts per day gives the number of people who must be on site at any time. With 12-hour shifts, each person works one shift a day. So covering one position around the clock needs two people on site.
Step 4: apply the roster factor
Because everyone takes turns on leave, the number employed must be larger than the number on site. The multiplier comes from the roster pattern:
Roster factor = (weeks on + weeks off) ÷ weeks on
For a 10:2 roster, the factor is 12 ÷ 10 = 1.2. Multiply the on-site number by 1.2 and round up.
Step 5: add cover
The roster calculation assumes everyone is always present outside their leave. In reality, people fall ill, need urgent leave, attend mandatory training, or escort a patient on evacuation. So add cover suited to your site.
Worked example (illustration)
For example, suppose a site runs 24 hours on two 12-hour shifts, and the company decides each shift will have one doctor and two nurses. These numbers only show the method; they are not a recommendation for any particular site.
| Role | Per shift | Shifts per day | On site at any time | × factor 1.2 | Rounded up |
|---|---|---|---|---|---|
| Doctor | 1 | 2 | 2 | 2.4 | 3 |
| Nurse | 2 | 2 | 4 | 4.8 | 5 |
In this example, the site needs at least three doctors and five nurses just to cover the roster. Cover comes on top. For instance, if nurses often escort evacuations, the company might add one more nurse, making six.
For doctors, three means no slack while one of them is on leave. If the site doctor must also escort patients to the referral hospital, the company needs to decide: add a fourth doctor, or set up another clear arrangement, such as a relief doctor from outside the site. Make this decision before an incident, not during an evacuation.
Check the schedule, not just the numbers
Test the result by drawing up a real leave schedule. The goal is to make sure the number on site never drops below what is needed.
Staying with the example, a 10:2 roster runs in 12-week cycles. The three doctors can take leave in turn, for example the first in weeks 1–2, the second in weeks 5–6, and the third in weeks 9–10. That way only one doctor is away at a time, and two stay on site. The five nurses can be scheduled the same way, each taking two weeks of leave in sequence, so four nurses are always on site.
If you cannot build a schedule like this, for example because two people would have to be on leave at the same time, you do not yet have enough people.
Things that are easy to miss
A few small details often turn a count that looks sufficient into a shortfall on the ground:
- Shift handover. Overlap time to hand over patients and medicine stock needs to be in the schedule.
- Daytime services. Periodic medicals, pre-shift checks, and occupational health programs usually run during office hours. If this workload is large, you may need extra day-only staff.
- Fatigue among medical staff. Medical staff working weeks of night shifts are also at risk of fatigue. The same control principles apply as for other workers, as covered in our article on fatigue in roster workers.
- Practice licences. Every doctor and health worker needs a practice licence (SIP) to practise at that clinic. Processing takes time, so start before the person is due on site.
- Employment rules. Rosters and working hours for medical staff must still comply with applicable employment regulations.
Working out staff numbers and roster schedules is part of our onsite clinic service, alongside facility planning and day-to-day clinic operations.
