title: Differences in the perceived impact of sleep deprivation among surgical and non-surgical residents.
abstract: OBJECTIVE
  Resident work hour restrictions have been mandated in the USA largely out of concern that sleep deprivation compromises doctor performance and patient care. However, individuals' ability to recognise the effects of sleep deprivation has not been studied in medical education. We examined the perceived impact of sleep deprivation among different groups of postgraduate medical trainees.
  
  
  METHODS
  A survey addressing work hours, sleepiness and daily functioning was mailed to all residents in the internal medicine, surgery and psychiatry programmes at the University of Toronto who were working at 6 different teaching hospitals. The mailing included the Epworth Sleepiness Scale (ESS), measuring acute sleepiness, and a new Sleep Deprivation Impact (SDI) scale, consisting of 12 items designed to measure the perceived impact of sleep deprivation on an individual's own performance.
  
  
  RESULTS
  Overall, 62.5% of surgery (95/152) and 59.5% of non-surgery residents (194/326) completed the survey. Surgery residents reported working longer hours per week (83.0 versus 62.5 hours; P < 0.01), and scored higher on the ESS (12.8 versus 9.2; P < 0.01) compared with other residents. Surgery residents scored significantly lower than others on the SDI scale (45.2 versus 51.5, P < 0.01), indicating less perceived impact of sleep deprivation on performance.
  
  
  CONCLUSIONS
  These results are consistent with the presence of an underlying culture within surgery in which individuals may be less willing to accept a natural limitation of individual performance. Whether these findings represent an actual resilience to sleep deprivation among surgery residents or a misperception within this group remains to be determined.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Woodrow
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Murray
authors.forename: Calvin
authors.initials: C
authors.lastname: Wang
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
authors.forename: Richard K
authors.initials: RK
authors.lastname: Reznick
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009864:Ontario; D010465:Perception; D012892:Sleep Deprivation / Q000523:psychology*