This is me hijacking the thread a bit to soapbox, but honestly, it’s the “standards” that are the problem in medicine, not that some people cannot meet them. This is not about just about having a disability. No one should be required to work shifts longer than 16 hours, ever, and even 12 is pushing it. Pilots and nurses are not allows to do that, because of liability and error risk after being awake for too long. It’s a grave failure on the medical field’s part that this does not apply to doctors who carry extensive responsibility. Trust me, hardly anyone is providing “adequate care” when exhausted, so patients are only harmed by this. There is nothing to be learned or gained by the person doing the long shift either, except maybe how to manage distress.
If I were a residency director I would not demand or even allow people to work those kinds of shifts. There is a beautiful thing called night float, where people take turns working nights for a week, and more residencies should use it.
In my residency, we unfortunately had 24 hour call but sometimes people split them—one person did day and the other night. It was not common but the admin did not care as long as someone was there to do the work.