It's fairly inelastic. You're in training into your thirties, you've given up your entire twenties, and your average social cohort aimed at things like finance

It's fairly inelastic. You're in training into your thirties, you've given up your entire twenties, and your average social cohort aimed at things like finance and big law, and has been making for several years what you won't be making for several years more. Try telling that person "you know, you could have a reasonable middle class life if you just give up on the idea that all that work and sacrifice should have had any ROI." Administration also prefers docs to work those hours for the fact that the entire hospital is built around these shifts, operationally, and a good deal rides on a doc carrying all his patients in his head for their entire course of stay. Hand-overs are disruptive and inefficient. If you offer a hospital "I don't want to work 10 on and 10 off, how about I work 10 days on, 20 days off, and you prorate my salary accordingly?" the hospital might agree, but they'll get rid of you in favor of a full-timer as quickly as they can.