88 hours for neurosurgical residents. And, speaking as someone who is married to one, that hypothetical "20 hour week" never happens.

Also, you are expected to be active researching and publishing and studying for certification; figure another few hours a day outside of the hospital when you're not on call.

Good point. It used to be like that here in the UK too, thankfully we now have the https://en.wikipedia.org/wiki/Working_Time_Directive

Unfortunately the working time directive for doctors in the UK is also averaged over a longer time period. So my wife has just come off an 80+ hour week of night shifts

You waive that when you work for an investment bank.

Don't pretty much all employers ask you to waive that for anything other than the lowest level jobs?

Back here (Netherlands), GP's (local doctors, they get all the booboos for a certain area) as well as pharmacists would get called out of bed in the middle of the night in case of emergencies. (I was carried off to the doctor at night when I developed pneumonia once, got diagnosed, penicillin from the pharmacy, etc in a matter of an hour or so). I'm guessing that happened frequently, so I'm sure doctors would miss quite some sleep from time to time, especially during flu epidemics and the like.

Nowadays, they have a new system, "Doctor's Watch", where the GP's from a certain area operate at night in rotation. It's a bit more official and less personal, but it does allow those not on rotation to get a proper night's sleep. Pretty sure they'd compensate that by working less hours during the day / week.

Yes, and that's why my doctor friends have given me a bunch of times of week where they won't go to hospital unless they're literally about to die. Any amount of pain/worry/discomfort is, for them, better than seeing a colleague at the end of their shift if they want their problem fixed.