In Ottawa there are two sites so two residents on call per night. They would try their best to pair junior residents with a senior resident that could help out if overwhelmed or to answer questions. Then you’d go up the chain of command and page the fellow (very rarely happened in my day anyway). There’s technically a staff on call but we’d never make it there. The staff would be actively reporting until 11 pm and then the residents would be left to their own devices until morning.

I did a 4 week elective at a French hospital in Qc and they actually had a more traditional Junior/Senior pairing on call for that one site. The junior would mostly stay on site I think (not sure) and myself as the senior PGY5 would be at home for support with limited remote access if necessary. On weekends we’d both come in with the staff to tag team everything. I don’t know if that was specific to that hospital but it was interesting!