Having trained at a very forward-thinking medical school (the University of South Alabama, Mobile, Alabama), my own night float experience was in March of my internship year, '91-'92. It was without a doubt the most horrible month of a year that is traditionally hell on a popsicle stick. Not only were the all-night hours severely disruptive of anything like a normal sleep-wake cycle (and just as we adjusted, it was time to change back), but the problems of less than optimal check out were a nightly occurrence. Also, in addition to covering 'the house' (all of the Medicine patients in the hospital) myself and one resident were also responsible for all admissions to the Medicine service from the ER. Fortunately, I had a good resident, and by that time, 8 months of experience as an intern. (The medical year runs July 1--June 30.) I don't think we killed anyone with mistakes that month, but I may never know for sure as communication the next morning was sometimes as sketchy as the previous evening, as we wanted to GO HOME. However, night float in many ways mirrors the reality of life after medical school, when you're frequently called upon to make snap decisions with little or no background on a patient. In a busy practice with several doctors, there is often no check out at all during the week, and only minimal checkout over the weekends. Like everything else, with experience it gets to be routine, and by the time I had entered practice middle of the night phone calls were not great sources of anxiety...and 10 years later, basically none at all.

To sum up: night float is usually a horrible, terrifying experience...but can be just as useful in the education of a good physician as more traditional long-hour methods. If anything could improve the learning experience, I would recommend having an Attending (Senior) physician join the Resident and Intern on the night float team--but I suspect that'll happen only after pigs fly.