A bit confused about being "on call" means...

[smq123]

Well I might be in the minority but I'd be happy to do 4-5 years of residency if I could work fewer than 60 hours a week, compared to 3 years at 80+ hours a week.

Saying that you'd be "okay" with doing several more years of residency is easy in the abstract. After 6 months of intern year, though, you're eagerly waiting for the end of the tunnel.

When I was a med student, I was all gung-ho about doing a fellowship. But I don't know, now, if I want to wait an extra 2-3 years before making real money and being a "real" doctor.

And you have to be careful interpreting world-wide health statistics; there are many factors, including the US's tendency to treat at the extremes of life (and have unsuccessful outcomes) which in other countries would not be done.

Yep - when I was in the ICU, I worked with a PA who was from Poland. We had a 90 year old man in the ICU, hooked up to CVVHD (constant low-level hemodialysis), which is very expensive. He wasn't a good 90, either - he was very frail, delicate, and pretty much comatose. She just shook her head and said that, in Poland, they would have let him go home and die peacefully....not torture him with IVs and procedures and needlesticks and 24 hours of dialysis.

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[45408]

This may all be true, but you still have to have physicians functioning at a certain level of competency (a fairly high level, I would think) to achieve the outcomes reported by the high statistics in these countries. So my point still stands.

I disagree. Most of the improvements in population-wide health metrics are a result of public health measures, and many countries have benefited from the US's (and a few other leaders') research and development. Clean water, vaccines, antibiotics for simple [outpatient] bacterial infections, basic prenatal care, education, birth control and things like that will make a much bigger difference than placing the 17th stent in a vasculopath's acutely threatened limb. The latter takes a much more highly trained clinician, but the impact is much less.

Just one example on how little medicine impacted the mortality of TB compared to research, education and awareness: