In terms of answers, sorry if I'm going to shy away from it, but I think the problems or the issues are complex. For instance, right now there are efforts under way in various jurisdictions to look at resident duty hours, the amount of time that is allowable to have a resident doing a shift, and this exacerbates the problem, to some extent.
That said, for instance in Quebec, there are some very elegant solutions to this problem in terms of looking at how the hand-offs work, the transitions from one shift to the next, and how to readjust the schedule. The point I would make is that I think there are successes and solutions that are happening at a very local level.
McGill has looked at how they're going to adjust their resident shifts in internal medicine to address the fact that they can only have residents working for a maximum of 16 hours. I would look to those examples—