Preparing physicians for the real world

I read with interest the article by Christopher Parshuram and associates¹ about fellowship training. My question is this: How do you prepare a 60-year-old physician to work 30 hours continuously with no sleep, in a job where he or she is the most responsible referral physician for a population of 130 000, without doing something similar in the residency program? That is the reality of life for older physicians in the area where I work.

John C. Acres Cape Breton Regional Hospital Sydney, NS