As a R2 I'm the senior doctor available at my small community hospital at nights, and is responsible for the rapid response team and CPR calls. When those shifts end I've been on for 25hrs, without any guaranteed sleep. 18hrs? That's a normal night with a free day before and after, how often do you get that?

Most of my life and death decisions are made between the hours of 11pm and 5am. Not a one has been questioned later on, but some of them have been questionable.

I also don't agree with the statement that attendings disregard junior physicians statements. My attendings listen to me and respect my judgement, and if they disagree with my assessment of course they are free to overrule me but usually try to explain their reasoning.

Do I make mistakes? Yes. 2 patients are dead because of it, and 1 patient is lacking a testicle (nr 1 was dying and in the ICU and I got a call about him but didn't think he should be transferred to our service and he wasn't treated for meningitis, nr 2 had necrotizing fasciitis but the ortopods said it wasn't and we treated the pt for a skin infection and nr 3 had testis torsion and I didn't push for an operation because both on-call urologists said it wasn't).

It's not something I'll ever forget. Saying I don't make mistakes is ridiculous. I've ordered the wrong tests, on the wrong patient, and the wrong drugs to the wrong patient. Why? Mostly because I was stressed out and didn't have the time to make sure I did it right.

In theory our error analysis is system wide, but it's done by a specific person denoted "Quality control specialist" or something like that. They almost never get back to you about what happened unless formal charges are brought against you.

We can report mistakes using a webform anonymously at all hospitals I've worked at, so I'd say it's simple enough nowadays.