Hmm, so just to clarify, you say start at 7AM Monday, work through 11AM Tues, have the rest of Tues off, and then work in clinic all day Wed, then repeat on Thurs? Total hrs aren't too bad, but that schedule would be a pain for me. Constantly having to go back and forth with clinic, having the service likely change quite a bit when you're off, etc.
The value of nightfloat is often that the buck stops with you. There's less staffing, you actually have time to review people, admit them, learn how the hospital works, etc. Even doing a 24+4 if you're handing off to other residents for 1.5-2 days, you're going to do some level of "let the day shift take care of that" because in the end, they are the ones that are dealing with those actions when you're gone. Plus, things run differently at night than they do during the day, so you have to weigh the benefit of doing something that may require further intervention without the necessary staff.
I definitely get the life-balance, but like I said, I personally wouldn't like all my inpatient experience to be like that.
It doesn't sound like abuse, but to be a bit of a devil's advocate, I question the "patient care" side. When you have the same teams in the AM and PM, that means that each patient has basically 2 residents taking care of them usually throughout the length of their stay (assuming most inpatient stays are on average 4-6 days). Switch that to a system where 3 residents trade 28s, and you already have more residents taking care of the same patient. I hope hand-off and documentation are good enough to account for that.
The other issue I see is continuity. Chances are you're not admitting people for a day and a half, if you are, that sounds like an Obs unit. So to me, you'd be missing out on a lot of their longitudinal management. You'd admit someone, and then the next time you see them they'd be stable and ready to DC. You don't see how they were managed day-to-day. Now if your service is such that you have a ton of time to delve into everything that happened when you were gone and learn why certain decisions were made, great, but that's not how our service runs with how busy and acute it tends to be, during the day its kind of a sprint.
That all said, its still only several months of 2nd year, so its not like its the entire time. Plus, if it means you don't have call outside of say holiday call, great! It probably also depends a lot on how busy those nights are. If most people are able to sleep a few hrs each night, that's one thing, but on our service you're lucky if you sleep 1 hr. Everyone is also different, so while I would hate 28s, you may not. Ultimately, you have to decide what you would like best. You could potentially get good training in each system, but you have to be truthful to yourself and decide what system will fit most with your learning style.
