As a surgical resident in an academic medical center, I start the day at 4 am and I am working at full speed until around 6pm when things slow down (assuming no traumas come to the ER), and then I usually get most work done by 8pm. Anything left over goes to the resident on call. I am the resident on-call every third or fourth night, which means I don't sleep for 30 hours or more for that period. I never have time to eat during the day, and I have to make time to even pee. I think about quitting every day, but in the end I've invested way too much to leave it all now. The rules say I'm not supposed to work more than 80 hours a week, but I am consistently at 90-110 hours a week. There is just way too much to do and not enough surgeons to handle all the patients who need to be taken care of. I work at least 6 days a week, sometimes 12 days in a row, and I've done this for about 4 years now after med school, and this is pretty typical for any surgeon, so the idea of a 4 day work week, or any work week under 80 hours, is an absolute joke to me. If anyone says surgeons make too much money, they clearly have no idea what a surgeon goes through or how the medical system works.