Thrawn Launches First Mathematically Optimized Scheduling Service for Residency Programs

Key Takeaways

Residency scheduling is a manual, high-stakes process that consumes hundreds of chief resident hours in spreadsheets while risking ACGME violations and perceived unfairness.
Most scheduling tools are built on rule-based engines that only flag conflicts, forcing residents to continue doing the hard work of resolving tradeoffs manually.
Thrawn uses mathematical optimization to solve all schedules—Block, Call, Clinic, and Attending—simultaneously, delivering a complete, compliant, and equitable final schedule.
As a done-for-you service, Thrawn allows chief residents to skip the build process entirely and simply review finished, optimized schedules.

SAN FRANCISCO, CALIFORNIA – Startup addresses hundreds of hours of manual physician scheduling with a done-for-you service delivering finished, ACGME-compliant schedules, now serving 19 departments across 14 hospitals.

Chief residents at academic medical centers know the feeling well: you've spent weeks building the annual schedule in Excel, color-coded tabs for block rotations, call distribution, and clinic assignments. Then one vacation request comes in. One swap. And suddenly you're rebuilding a house of cards.

Accreditation Council for Graduate Medical Education (ACGME) duty hour compliance is tracked by hand. Fairness is impossible to prove. And every July, the incoming chief inherits the same spreadsheets and the same learning curve — because the outgoing chief's institutional knowledge walks out the door with them.

Thrawn, founded in 2024 by a team of MIT-trained mathematicians, computer scientists, and logistics experts, is eliminating this workflow entirely. The company built a proprietary Scheduling Programming Language (SPL) — a domain-specific optimization engine rooted in mathematical programming and operations research — that produces complete, mathematically optimal Block, Call, Clinic, and Attending schedules from a program's constraints. No spreadsheets. No rule-based suggestions that still need human tweaking. Finished schedules, delivered for review.

According to Thrawn, the company currently serves 19 departments across 14 hospitals at multiple top-20 academic health systems spanning the East Coast, West Coast, and Southwest.

The Problem: Residency Scheduling Is Broken

Physician scheduling in Graduate Medical Education (GME) is one of the most time-consuming administrative workflows in academic medicine. As one chief resident put it, it's "an absolute beast to conquer." Every academic year, chief residents and program directors must build four interconnected schedule types:

Block schedules. Assigning residents to clinical rotations across the full year.
Call schedules. Distributing primary call and backup calls fairly while maintaining ACGME duty hour compliance.
Clinic schedules. Balancing educational requirements with patient care coverage.
Attending schedules. Meeting faculty contractual obligations and coverage needs.

Most programs build these in separate spreadsheets — rotation scheduling in one tab, on-call shifts in another, clinic assignments on a third. A change in one cascades across the others. Chiefs describe this as rebuilding a house of cards — labor-intensive work that pulls them away from studying and clinical duties.

ACGME compliance compounds the problem. ACGME duty hour rules include a maximum of 80 duty hours per week averaged over four weeks, at least 10 hours of rest between shifts, one full 24-hour period free from clinical duties per week, and continuous duty limits that vary by PGY level — all tracked manually in most programs. A missed violation can jeopardize a program's accreditation. Most chiefs are doing this math by hand.

Fairness is just as fraught. Without mathematical proof of equity, any schedule is defensible in theory and disputable in practice. As one chief noted in r/Residency, algorithm-based scheduling would be ideal — "I could simply say it's what an algorithm decided and not favoritism or bias at all." A study on resident scheduling found that even without a statistically significant increase in overall satisfaction, 78% of residents felt more involved in their scheduling when a systematic approach was used — and 77% would recommend it. The perception of fairness matters, and it's hard to manufacture from a spreadsheet.

Why Existing Tools Haven't Solved It

The tools available haven't delivered on the promise. Enterprise physician scheduling platforms like QGenda, used by an estimated 86% of U.S. health systems, are built for all provider types across entire institutions — powerful at the enterprise level, but complex and often expensive for the focused workflow of a chief resident building an annual residency schedule.

Legacy systems like Amion display and publish call schedules but don't create or optimize them. Self-serve residency scheduling tools like Chiefly and Intrigma automate parts of the process but still require the chief or coordinator to operate the software and resolve conflicts manually. One chief resident shared that after trying multiple platforms — "not the easiest UX" — they ended up going back to Excel. A sentiment echoed across r/healthcare by teams who tried modern tools and concluded: "not much diff."

The root cause is architectural. Rule-based engines — the technology underlying most scheduling tools — flag conflicts and suggest assignments. But a human must still resolve the tradeoffs. The output isn't a finished schedule; it's a draft that needs work. As schedule optimization research from AltexSoft notes, optimal scheduling requires defining decision variables, hard constraints, soft constraints, and objective functions simultaneously — a level of mathematical rigor that rule-based systems don't reach.

How Thrawn Works

Thrawn operates as a done-for-you managed scheduling service. The workflow is deliberately simple:

Programs send their constraints. Resident preferences, rotation requirements, ACGME duty hour rules, vacation requests, educational goals, PGY-level requirements, and any program-specific rules.
Thrawn's SPL optimizes everything simultaneously. All four schedule types — block, call, clinic, and attending — are treated as one interconnected optimization problem. The domino effect is eliminated by design.
Programs review finished schedules. Chief residents and program directors receive complete, ACGME-compliant schedules for review. Adjustments trigger re-optimization, not manual patching.

The architectural difference is fundamental. Where rule-based engines generate suggestions that require human intervention to resolve conflicts, Thrawn's optimization engine generates complete solutions from constraints. Schedule optimization at this level treats hard constraints (ACGME rules, coverage requirements) and soft constraints (resident preferences, vacation requests) as inputs — not manual checkboxes. ACGME duty hour compliance is a generation constraint, meaning violations are prevented at schedule creation time, not detected after.

Fairness is an objective function, not a judgment call. The SPL can distribute desirable rotations, nights, weekends, and holidays with mathematically provable equity — removing both actual bias and the perception of it.

Cross-schedule simultaneous optimization is the capability no competitor replicates. Most programs build block, call, clinic, and attending schedules independently, then spend weeks manually resolving the conflicts between them. Thrawn's SPL treats all four as a single scheduling problem — so a change in one doesn't cascade and break the others.

The managed service model also solves a problem that software alone cannot: institutional knowledge retention. Because Thrawn's scheduling specialists learn each program's rules, constraints, and quirks, that knowledge is retained across the annual chief resident transition. The incoming chief doesn't inherit a spreadsheet and a steep learning curve. They inherit a working system.

The Founding Team

Thrawn's founding team brings deep expertise in mathematical optimization, computer science, and logistics — with personal connections to healthcare.

Marcus Chen, Co-Founder and CEO. A published mathematician with degrees in mathematics and operations research from MIT, and additional training in applied mathematics at a leading European research university. He received a government research grant for logistics optimization algorithm development, with prior experience in athletic conference scheduling and defense logistics research.
Daniel Park, Co-Founder and CTO. Holds degrees in computer science and economics from MIT. He previously built optimization software at a major technology company deployed across government and commercial clients, and holds AWS certification. His entire immediate family are physicians — giving him firsthand exposure to the scheduling burden in academic medicine.
Ava Restrepo, Co-Founder and COO. Studied economics with a minor in computer science at MIT. She brings operations and logistics experience from major global supply chain companies, along with NLP research on healthcare misinformation. Her mother is a practicing physician.

What Makes Thrawn Different

Thrawn's competitive positioning rests on two structural advantages that are difficult for incumbents to replicate:

Mathematical optimization vs. rule-based scheduling. The SPL is architecturally different from the rule-based engines that power QGenda, Lightning Bolt, Intrigma, and most other scheduling tools. Rebuilding a scheduling engine from rules to mathematical optimization is a multi-year effort — this isn't a feature gap that can be patched with an update.
Done-for-you service vs. software-you-operate. Programs don't learn, configure, or operate scheduling software. They describe their constraints and receive finished schedules. This collapses the adoption barrier to near zero and makes switching from spreadsheets painless — directly addressing the UX frustrations and fear of technology adoption that keep many programs in Excel.

Combined, these advantages mean programs get better scheduling outcomes with zero operational lift. Chief residents become schedule reviewers, not schedule builders.

Early Traction and Client Impact

According to Thrawn, the company currently serves 7+ programs across 19 departments at 14 hospitals, including multiple top-20 academic health systems. Specialties served include Neurocritical Care, Neurology, and Family Medicine, with active expansion into additional specialties.

Dr. R. Kapoor, a Clinical Fellow in a Neurocritical Care Fellowship at a leading academic medical center, described the experience: "Scheduling can be one of the most stressful and time-consuming parts of the role, but Thrawn made the entire process seamless. I would highly recommend their services to any program looking for a reliable and efficient way to build equitable schedules!"

On the process side, Dr. Kapoor noted: "We provided the team with the vacation requests of our clinical fellows and scheduling requirements for various rotations, and Thrawn quickly followed up with a couple of clarifying questions. Within such a short time, our yearly block fellowship schedule was complete!"

Thrawn was also a gold sponsor at the APPD Pediatric Medical Education Conference, reflecting its growing presence in the GME community.

Beyond Scheduling: A Healthcare Logistics Platform

Thrawn's longer-term vision extends beyond physician scheduling. The company is extending its optimization engine into clinical care coordination — patient triaging, provider management, and resource allocation — with design partnerships at major academic health systems.

The thesis: healthcare inefficiency is a supply-side problem. The bottleneck isn't patient demand — it's the inability to efficiently match patients with available providers and resources. Manual workflows across scheduling, triaging, and care coordination contribute to what the company estimates is $760 billion in annual healthcare operational inefficiency.

Scheduling is the entry point. Care coordination is the platform play.

Who Thrawn Serves

Thrawn's managed scheduling service is built for:

Chief residents and chief fellows who are responsible for building the annual schedule and want to eliminate hundreds of hours of spreadsheet work.
Program directors and associate program directors who need defensible ACGME compliance and fair, auditable schedules for their programs.
Program coordinators and GME administrators who manage schedule changes, swap requests, and compliance documentation.

Programs interested in exploring optimization-based scheduling can get a free scheduling consult to discuss their program's needs and constraints. Most programs onboard in one to two weeks.

Stop Building. Start Reviewing.

The chief year shouldn't be defined by spreadsheet work. Programs at multiple top-20 academic health systems have already moved their scheduling workflows to Thrawn — where residency and fellowship scheduling is handled entirely by the managed service, and chief residents spend their time reviewing schedules instead of building them.

If your program is still managing block, call, clinic, and attending schedules across separate spreadsheets, a free scheduling consult is worth the conversation.

Frequently Asked Questions

What is a Scheduling Programming Language?

Thrawn's SPL is a domain-specific optimization engine built on mathematical programming. It models scheduling as a constraint satisfaction and optimization problem — producing complete solutions rather than suggestions that require human intervention.

How is Thrawn different from QGenda or Amion?

QGenda is a rule-based enterprise scheduler and Amion is a legacy call schedule viewer. Thrawn is a done-for-you service that uses mathematical optimization to deliver finished Block, Call, Clinic, and Attending schedules specifically for GME programs, with no software for your team to operate.

How does Thrawn ensure ACGME duty hour compliance?

Thrawn builds ACGME rules directly into its optimization engine as hard constraints. This prevents violations from being generated in the first place, rather than just flagging them after the fact. Your program receives a schedule that is compliant by design, saving you from manual checks.

How does Thrawn handle last-minute schedule changes?

Thrawn handles changes through rapid re-optimization. When an unplanned absence or swap request occurs, we update the constraints and our engine generates a new, fully optimized schedule. This avoids the manual effort of resolving cascading conflicts across spreadsheets.

Does Thrawn work for all medical specialties?

Yes. Thrawn's SPL is designed to handle the constraint structures of any GME program. We currently serve specialties like Neurocritical Care, Neurology, and Family Medicine, and are actively expanding.

How long does onboarding take?

Most programs onboard in one to two weeks. Our specialists gather your program's constraints and deliver finished schedules for review. There is no software to install or training required for your team.

What does Thrawn cost?

Thrawn offers personalized pricing based on program size and complexity. You can schedule a free consultation to discuss your program's specific requirements and receive a quote.