Impact of work hours and sleep on well‐being and burnout for physicians‐in‐training: the Resident Activity Tracker Evaluation Study

• Published in: Medical education 2019-03, Vol.53 (3), p.306-315
• Main Authors: Mendelsohn, Daniel, Despot, Ivan, Gooderham, Peter A, Singhal, Ashtush, Redekop, Gary J, Toyota, Brian D
• Format: Article
• Language: English
• Subjects: Accelerometry - instrumentation; Accelerometry - methods; Adult; Burnout; Burnout, Professional - prevention & control; Female; General Surgery - education; Humans; Internal Medicine - education; Internship and Residency - statistics & numerical data; Job satisfaction; Male; Medical education; Personnel Staffing and Scheduling - statistics & numerical data; Prospective Studies; Self Report; Sleep; Sleep - physiology; Surveys and Questionnaires; Well being; Work Schedule Tolerance - physiology; Working hours
• ISSN: 0308-0110; 1365-2923
• DOI: 10.1111/medu.13757

Objective The Resident Activity Tracker Evaluation (RATE) is a prospective observational study evaluating the impact of work hours, sleep and physical activity on resident well‐being, burnout and job satisfaction. Background Physician burnout is common and its incidence is increasing. The impact of work hours and sleep on resident well‐being and burnout remains elusive. Activity trackers are an innovative tool for measuring sleep and physical activity. Methods Residents were recruited from (i) general surgery and orthopaedics (SURG), (ii) internal medicine and neurology (MED) and (iii) anaesthesia and radiology (RCD). Groups 1 and 2 do not enforce restrictions on the duration of being on‐call, and group 3 had restricted the duration of being on‐call to 12 hours. Participants wore FitBit trackers for 14 days. Total hours worked, daily sleep, sleep on‐call and daily steps were recorded. Participants completed validated surveys assessing self‐reported well‐being (Short‐Form Health Survey), burnout (Maslach Burnout Inventory), and satisfaction with medicine. Results Surgical residents worked the most hours per week, followed by medical and RCD residents (SURG, 84.3 hours, 95% CI, 80.2–88.5; MED, 69.2 hours, 95% CI, 65.3–73.2; RCD, 52.2 hours, 95% CI, 48.2–56.1; p < 0.001). Surgical residents obtained fewer hours of sleep per day (SURG, 5.9 hours, 95% CI, 5.5–6.3; MED, 6.9 hours, 95% CI, 6.5–7.3; RCD, 6.8 hours, 95% CI, 5.6–7.2; p < 0.001). Nearly two‐thirds of participants (61%) scored high burnout on the Maslach depersonalisation subscore. Total steps per day and well‐being, burnout and job satisfaction were comparable between groups. Total hours worked, daily sleep and steps per day did not predict burnout or well‐being. Conclusions Work hours and average daily sleep did not affect burnout. Physical activity did not prevent burnout. Work hour restrictions may lead to increased sleep but may not affect resident burnout or well‐being. Despite significant variation in work‐hours and average daily sleep across medical and surgical residents with restricted call‐durations, the authors demonstrate similarity in measures of burnout, well‐being and job satisfaction.