02 Sep Resident Doctor Rosters, the marathon of work rosters
Barger et al. recently published a study in the Journal of Sleep that looked at resident doctors work hours and sleep under two different work rosters. The first was the Extended Duration Work Roster (EDWR) with extended-duration (≥24 hr) shifts or a Rapidly Cycling Work Roster (RCWR), in which scheduled shift lengths were limited to 16 or fewer consecutive hours. These roster hours for most of us are almost eye wateringly long.
During the study, sleep was measured with actigraphy (movement sensors). What they found was that with the rapidly cycling roster, the doctors worked about 6.5hrs less per week (between 57-67hrs per week) then those on the extended roster, and obtained about 4hrs extra sleep per week. Still, some of their findings are still surprising for us 9-5’ers:
- Dr’s on the RCWR still worked over 16hr shifts 27% of the time, but this was 62% of the time on the extended roster
- The percentage of 24hr intervals with less than 4hrs sleep was 25% of the time on the extended roster! And still 9% on the RCWR
They concluded that RCWRs were effective in reducing weekly work hours and the occurrence of >16 consecutive hour shifts, and improving sleep duration of resident physicians. Additional research is needed to optimise scheduling practices allowing for sufficient sleep prior to all work shifts.
Laura K Barger, Jason P Sullivan, Terri Blackwell, Conor S O’Brien, Melissa A St. Hilaire, Shadab A Rahman, Andrew J K Phillips, Salim Qadri, Kenneth P Wright, Jeffrey L Segar, John K McGuire, Michael V Vitiello, Horacio O de la Iglesia, Sue E Poynter, Pearl L Yu, Phyllis Zee, Amy L Sanderson, Ann C Halbower, Steven W Lockley, Christopher P Landrigan, Katie L Stone, Charles A Czeisler, ROSTERS Study Group, Effects on resident work hours, sleep duration, and work experience in a randomized order safety trial evaluating resident-physician schedules (ROSTERS), Sleep, Volume 42, Issue 8, August 2019, zsz110, https://doi.org/10.1093/sleep/zsz110