The metabolic demands of internal medicine residency
- PDF / 618,453 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 19 Downloads / 178 Views
(2019) 14:14
RESEARCH
Open Access
The metabolic demands of internal medicine residency Sarah Sy1*† , Karanvir Sall1†, Erika Dempsey2, Gale Tedder1 and Kenneth Michael Madden1
Abstract Background: North American and European accreditation bodies have legislated progressively more strict work hour restrictions for residents in light of evidence that sleep deprivation leads to increased medical errors and decreased wellbeing. The purpose of the study is to determine the physiologic demands of internal medicine training during residency as well as document average sleep (on- and off-call) and physical activity performed using accelerometers. Methods: A total of 40 internal medicine residents working on the clinical teaching unit at a single center were enrolled in the study from November 2011 to March 2016. There were 22 subjects that completed the study and were included in the analysis. SenseWear PRO 2 armband monitors were worn for 5 consecutive days including one call day. The primary outcomes of the study were to quantify and compare the calories per day, steps per day, METs per hour, hours of activity, hours of sleep, and sleep efficiency for on call versus post-call and non-call days. Results: The average activity per day, calories per day, steps per day and METs per hour for the call day were 7.6 ± 7.6 h, 2647.0 ± 541.1, 11,261.1 ± 2355.9, and 1.7 ± 0.2 respectively. Each of these parameters had a statistically significant F statistic compared to post-call and non-call days. The subjects had a mean of 1.8 ± 2.0 h of sleep per day with a sleep efficiency of 77.3 ± 23.8% for the call day. The F statistic for sleep per day was significant with a p value < 0.001. Conclusion: This study shows that overnight call has a substantial impact on multiple metabolic parameters. These findings have potentially important implications on future resident working hour restrictions. Keywords: Metabolic parameters of residency, Work hours, Sleep efficiency, Internal medicine
Background Over the past decade, there has been increasing pressure on health systems to decrease resident work hours. The original push to reform resident working hours derived from the case of Libby Zion, an 18-year-old woman who passed away under the care of exhausted residents [1]. There has been increasing evidence that sleep deprivation leads to increased medical errors and threatens resident safety [2–5]. North American and European accreditation bodies have legislated progressively more strict work hour restrictions. In the United States, the Accreditation Council for Graduate Medical Education (ACGME) * Correspondence: [email protected] † Sarah Sy and Karanvir Sall are co-authors. 1 Department of Geriatric Medicine, 2775 Laurel Street, 7th Floor, Vancouver, BC V6H 0A5, Canada Full list of author information is available at the end of the article
implemented on July 1, 2017 changes to resident duty-hours based on recent studies that showed non-inferiority of flexible, less-restrictive duty hours compared to standard duty hour policy [6, 7].
Data Loading...
