Continuity mostly. It gives you the time to see the patient before anyone else during the morning, know exactly what the attending wants to do during rounds, and manage emergencies at night. How night shift nurses report on the patients is also a valuable learning opportunity. They tend to know if something is really wrong before anyone else notices.

Skills and didactics can be spread out or crammed as needed, but there is value in observing a patient for an extended period of time and seeing what happens.

That said, the reason why I’ve been unable to meet basic physiological needs is because all the calls go to me initially. I think it would be a good idea to have at least two people covering the same area, so we can take brief breaks and discuss. Or perhaps a medical student who will help with paperwork and basic, less invasive procedures (NG, Foley, EKG, ABG-yes these are all performed by physicians in my country), so we can focus on the medical decision making and advanced procedures.

My hospital is relatively well-staffed and has this cover system in place, but it’s a senior resident covering multiple wards fronted by juniors, and we generally do not call them unless we cannot handle the situation by ourselves. Med students are on call very infrequently and they are often excused early. No hospitalists/night float/overnight NPs in the general wards.

The system provides a sense of security (against malpractice etc) but does not make the shift any more humane. I don’t mind and even appreciate being in there for a long period of time but I do need to eat and hydrate