I remember one on-all night as a first year medical intern at 4 AM. My first year teammate was exhausted and our senior resident looked worn out. After working a straight 20 hour shift with no breaks, we were beat. In my twenties, I looked fresh, and could continue to work in the Emergency Room like the Energizer Bunny. I knew I could go on all night without sleep but would also feel my speech would be somewhat off the next day. This was more of a subjective observation as others told me I looked just fine. My head would feel heavy and full, I felt my speech was not as clear as usual, and I'd still work the whole next day. This schedule went on for months. There is a caveat, though. My fellow intern and I had a brilliant idea which we put into effect the first few weeks: she had a hard time staying awake after midnight and, instead, I felt better if I went on through the night and then got a few hours of sleep before the next workday. She would go to bed at midnight and I would take care of all hospital needs until 4 AM. We would then switch places, she would take care of all consults and I would try to get some sleep from 4 AM to 8 AM. The deal was in place as long as the other one didn't feel overwhelmed with all the admissions and consults. We never called the other one for back-up; we took the hectic schedule as those hours made a great difference in our performance the following day. We usually worked weekends and had a full free weekend every few months. My colleague and I were married to doctors and we both had young children.

This was almost two decades ago. At the time, residents stayed awake and worked all night long for months and even years. Doctors took pride of their ability - whether because of a genetic-based capability or an ability to adapt to an environmental demand. The idea was: if you wanted to be a doctor, you first needed to live up to the challenge.

While practicing physicians understand that reducing errors and improving working conditions are of essence, many of us have also observed some new attitudes. Not that there weren't ever senior residents taking advantage of the younger ones. And yet, some of the younger physicians will now say their time is up and they may be more reluctant to seeing any more patients although there may be a need. Other doctors would present a smoother transition before their shift is up. Many experienced physicians miss the old days with a bitter-sweet taste. Many believe they chose the challenges of being available to serve in extreme circumstances. Medicine has been a profession of service although the current practicing scenario has converted into more of a commodity.

If these young doctors are burning out when they haven't even started practicing medicine, what will happen next? There is a well-anticipated shortage of physicians expected in the coming years. Add the younger generation's expectations to live a better life with less work and many young women doctors already planning a part-time practice.

Food for thought: Do you share long work hours? Do you believe both male and female physicians should have similar opportunities? Do you believe physicians who train less hours or who work less hours than their counterparts can develop a similar degree of expertise as their counterparts?