Maybe this makes me a delicate little snowflake, but I think 4 days off per month is nowhere near enough. Especially when the other 26-27 days of the month, you are waking up super early, leaving super late, and sometimes spending the night in the hospital. I remember one resident said she got a simple cold and it lasted for two months because she was so overworked that she couldn't shake it.
Is it any wonder residents are so burned out?
There was one month during internship when I was feeling really depressed and burned out, and I was going into a stretch of working nearly two weeks nonstop with two overnights wedged in there. I asked my lovely (not) senior resident if there was any way I could have even a half day off in there. In retrospect, I'm embarrassed I asked because the answer was so obviously no. She let me have it: "If you get a day off, that means someone else has to cover for you!"
The solution, in my mind, is that we need to train more physicians so the ones we have aren't so overworked and miserable. Yet I doubt that the four days off per month policy will ever change.