Anyone else have 18+ hour days - how to manage diet/workout timing?

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Hi all - I work as a resident physician, and my workday usually begins around 0500, I get home usually around 1800, and then I have to study when I get home (in addition to all the other various life responsibilities). I feel like I am handling my daily schedule OK because I'm pretty regimented, but looking for ways to further optimize schedule. Should I try waking up around 0400 and getting a workout in before I go to work? How should I space my meals out during the day to maintain energy and still have enough mental capacity when I get home to work a little more? I am a surgeon in training so having energy throughout the day is important, because on surgery days I sweat a lot. I appreciate any help.

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Edit: I have lost a pretty good amount of weight in the past few years, but trying to squeeze out the last 10-20 pounds, which I know is primarily diet related, but having a hard time staying on it with the stressors of work and lack of sleep.

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source https://www.reddit.com/r/loseit/comments/z5mv5v/anyone_else_have_18_hour_days_how_to_manage/

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