The pilot comparison reminded me of an article in the Washington Post Magazine a few years ago. The B-2 bomber is only based in the US (and possibly on Diego Garcia) for security reasons. Therefore any combat mission is most of 24 hours long or longer. How can the B-2’s crew of two deal with the sleep deprivation, and still be at peak, combat-ready efficiency when the action starts? The Air Force studied this and came up with naps.
The article was titled “WAR and SLEEP; Why an $8 chaise lounge became a prized accessory on the B-2 during the bombing of Yugoslavia” by Dana Priest, Washington Post Nov 19, 2000. That was longer ago than I thought! My insomnia must be futzing with my memory. 
No wonder it was so hard to find via google! The article does not appear to be available on line. 
I guess the millennium did not start until 01/01/01.
I think the medical profession needs to look at issues of wakefulness and attention, and leave the machismo games to the college fraternities. How can the experience and career filtering aspects of long shifts be kept without compromising patient care?
This is no longer true.
In the past decade, the ACGME (the organization that accredits residency programs in the United States) restricted work hours to 160 hours every two weeks (i.e. an average of 80/week over two weeks) and 30 hours of direct patient care in a single shift.
More that you"ll ever want to read on the issue:
http://www.acgme.org/acWebsite/dutyHours/dh_articles2.pdf
Docs work 10 hour shifts in my ER (in theory, the mid-shift often gets hosed), nurses 12.
When I worked in the ER we had some sort of crazy rolling shift system. The longest shift was 13hours, but the shifts were very anti-social. Two weekends on, two off, leave built into the rota, not family friendly at all.
Legally here, doctors can work no more than 56 hours per average week (48 from August). That does mean that you can work 112 hours every other week and still be legal though…
My ER rota:
Week 1: 8am-5pm mon-sun
Week 2: OFF mon-fri, 10am-11pm sat&sun
Week 3: 10am-6pm mon-fri
Week 4: OFF sat- thursday
Week 5: 5pm-2am fri-thursday
week 6: 11pm-8am fri-thursday
Week 7: OFF fri-fri
Week 8: 2pm-11pm mon-fri
There is a difference between resident shifts (when you have to be in the hospital) and non resident shifts (when you’re at home with a beeper…as long as “home” is 20mins or less from the hospital).
Non-resident shifts only the time you’re actually answering the phone or in the hospital count as work- so a 24, 48 or 72 hour “on-call” is usually do-able.
For resident shifts you can legally only work 13 hours straight, so most rotas have switched to night/day shift systems similar to nursing rotas. Usually for doctors this means seven 13 hour night shifts every 4-6 weeks with 5-7 days off afterwards to make the rota legal.
Personally, I’m thrilled to only have 6 months more of hospital medcine when I get back fom maternity leave, after that I’m out in the (mostly) mon-fri 8am-6pm world of GP…yeay!