Before the European Union Working Time Directive3 placed restrictions on junior doctors’ working hours some brutal on-call rotas were commonplace (1 in 2, 1 in 3, or 1 in 4), including continuous 80 hour weekend and 36 hour weekday blocks, with no sleep guaranteed.4 Tired doctors put patients’ and their own health at risk.5 On the other hand, the exhaustion came with free (if basic) onsite accommodation, camaraderie, peer support, and the continuity of a firm structure, and we quickly gained vast amounts of hands-on experience. Care was arguably far more regimented, institutional, and paternalistic—and patients more deferential The historical switch, in Modernising Medical Careers,8 to run through higher specialty medical training from previously more meandering routes has also attracted much adverse comment, as has the botched introduction of the Medical Training Application Service9 in 2007 or more recent findings that junior doctors often feel rushed or pressurised to decide on a specialty stem too early in their career.1011 On the other hand, back in the day many senior registrars, long qualified to become consultants, waited endlessly for consultant posts to become vacant. ...not for nothing did the Department of Health report that led to Modernising Medical Careers call senior house officers “the lost tribe,”12 as so many doctors were stuck or drifting at that grade and sometimes trying to enter a specialty they weren’t suited to or, realistically, able to enter.13 Nor did we have today’s transparency and scrutiny around preferential selection based on sex, race, or patronage. Yet patient case mix and healthcare were far less acute and complex; pressure and throughput on beds was lower; and a far more limited range of interventions was available for nurses to carry out, let alone as independent advanced practitioners or prescribers.