This coming Friday will be the third where I leave the hospital early to observe Shabbos. I don't do this without mixed feelings. Observing Shabbos is one thing when one is a tradesman and puts down the tools of one's trade (or picks them up) on one's own recognizance. But the modern workplace, where one is part of a team (or a cog in a machine, depending on how you look at it) is something else again. One's actions affect others. In fact, entire chapters of Jewish socioeconomic history have been written on the turmoil which ensued when Jewish factory owners (never mind the non-Jews) collided with the Sabbath observance of their Jewish workers.
The fact that I have been able, more or less, to pursue my Sabbath observance without undue harm to my career or earning power says not so much about my religious asceticism or Will to Frumkeit, and more about the benefits accruing to me by virtue of my class (by birth) and the expenditure in my education invested by my parents. The fact that hyper-rigorous Sabbath observance has become the norm of the American Orthodox community, by the same token, says a lot about the economic success of that community.
But that's by the way. What I wanted to point out is that the issues in my case (that of a medical student) are slightly more complicated. Most folks in my vast readership (no longer the Daily Dozen, but certainly not yet the Daily Century, either) know that saving a life, in Jewish law, takes precedence over the Sabbath. (This statement is rough; there are many exceptions; but the general idea is valid.) I'm just a student, and not involved (yet) in saving any lives, so one might think that I could leave early with a light heart. But an inner doubter asks: isn't it possible that the extra clinical exposure, available to me if I worked Shabbos, is necessary to train me to be the best life-saver I can be?
Possible, but not actually the case, I think, in the current system of medical education, or at least the one I'm part of. The inner doubter raises an important point, though. After some stage of one's medical education, the activity of medical care must be construed as some sort of gross life-saving even if one is not actually saving lives at every moment. Otherwise medical practice for the Shabbos observer would be impracticable and a shayle would have to be asked every minute of every Saturday. That is to say, once I become a resident, I will have to act like a doctor -- cause I'll be one. And doctors can't get out of working Saturdays if they are the primary caregivers for their patients.
There are, I know, residency programs which do not require the students to work on Shabbos. How this functions I don't know; perhaps the patients are helpful enough to get sick Sunday through Friday?
Qualifications, hems and haws, and corrections to this are sure to follow.