The original change to restricted resident and medical school work hours was done for legal reasons and not due to evidence based studies. It has not led to better patient care. Quite frankly being on call does not require brilliance but a solid foundation of medical knowledge and common sense. Don’t do anything stupid is a good mantra. There are in my experience always another intern or resident or fellow or attending or nurse that can answer your question when necessary. This is especially true nowadays as everyone has a cell phone and you don’t have to go looking for people. Your cell phone is also a mini computer with lots of information. Call used to be about 36 hours every 2 to 4 days and it was the every 2 day call that caused fatigue. The downside of restricted hours is less experience for the trainees and more cost to the hospitals. Many physicians feel that recent graduates are not as good as the result of their more limited training. One should also understand that you are not that good when you finish your formal training and there is little supervision of new physicians in the work force. Takes probably another 5-10 years on your own before you get good at what you do.