Sexual HealthMust We Keep Depriving Residents Of Sleep?
Before reducing or changing working hours for medical residents in Canada, a thorough evaluation of the impact on the educational experience and acquisition of skills should be conducted, write Dr. Diane Kelsall and the CMAJ editorial team. This will ensure that Canadians will benefit from the skills of a healthy, well-trained resident workforce.
Residency agreements are negotiated provincially in Canada and most provinces do not have a maximum work week, meaning residents may work 24 or more continuous hours. Other jobs, such as truck drivers, railway crews and pilots have regulated maximum work hours and rest periods.
Medical residents are at increased risk of making medical errors, getting into car accidents or jabbing themselves with a needle after working long shifts. Changes in the US and Europe designed to reduce working hours for residents helped improve quality of life for them, although educational satisfaction remained neutral or even dropped.
As workloads shift from residents, staff doctors in many hospitals have experienced increased stress and more work. Some institutions have created non-teaching wards and have hired staff such as nurse practitioners and physician assistants to augment or replace residents.
However, "those who believed that patient safety would be greatly improved by well-rested residents have been disappointed" write the authors. "Patient adverse events are usually multi-factorial in origin, and resident fatigue is only one component." The benefits of happier, healthier residents with a more humane work-life balance is reason enough to look at adjusting or reducing resident duty hours.
Canadian Medical Association Journal