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Study shows long medical shifts could be as dangerous as drinking

A study appearing in The Journal of the American Medical Association reports long hours and frequent overnight work shifts may have the same effect on new doctors as a few cocktails.

Articles continue to question whether rigorous training involving long work shifts prepare new doctors should an extreme emergency occur or if the practice itself puts patients at risk.

The small study of 34 pediatrics residents around the ages of 28 years old were given tests after a 44-hour work week, or a “light call,” and after a 90-hour work week with frequent overnight shifts, or a “heavy call.” The test involving driving simulation and reaction time was given four times.

Some doctors were also given a few alcoholic drinks after finishing a light call schedule as well as some on the heavy call schedule. Other doctors received no drinks and some of the heavy call schedule was given drinks with no alcohol, though they were not aware the drinks were nonalcoholic.

The last component of the test involved sleep time. Doctors on the heavy call schedule got just three hours of sleep, and doctors on the lighter schedule got more than twice as much sleep, about 6.5 hours. Devices checked sleep and activity around the clock.

The main finding revealed test performance was as bad after a heavy work schedule as after drinking alcohol on a shorter shift. Reaction times in light call with alcohol, heavy call and heavy call with placebo were 7% to 10%. There was no difference between light call with alcohol and heavy call with placebo.

The driving simulation tests showed speed variability was 29% greater during heavy call with placebo than light call with alcohol. Speed variability was also 34% to 75% higher in light call with alcohol, heavy call with placebo and heavy call when compared with light call.

Although researchers did not directly test medical skills, the study's findings, according to the researchers, support limiting extreme hours for new doctors. However, the researchers' conclusions were not supported by all experts believing restricting working hours could have overall greater risks in other aspects, such as limited health care access.


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