A gender-based analysis of work patterns, fatigue, and work/life balance among physicians in postgraduate training.
OBJECTIVE
To document fatigue in New Zealand junior doctors in hospital-based clinical training positions and identify work patterns associated with work/life balance difficulties. This workforce has had a duty limitation of 72 hours/week since 1985. The authors chose a gender-based analytical approach because of the increasing proportion of female medical graduates.


METHODS
The authors mailed a confidential questionnaire to all 2,154 eligible junior doctors in 2003. The 1,412 respondents were working > or = 40 hours/week (complete questionnaires from 1,366: response rate: 63%; 49% women). For each participant, the authors calculated a multidimensional fatigue risk score based on sleep and work patterns.


RESULTS
Women were more likely to report never/rarely getting enough sleep (P < .05), never/rarely waking refreshed (P < .001), and excessive sleepiness (P < .05) and were less likely to live with children up to 12 years old (P < .001). Fatigue risk scores differed by specialty but not by gender.Fatigue risk scores in the highest tertile were an independent risk factor for reporting problems in social life (odds ratio: 3.83; 95% CI: 2.79-5.28), home life (3.37; 2.43-4.67), personal relationships (2.12; 1.57-2.86), and other commitments (3.06; 2.23-4.19).Qualitative analyses indicated a common desire among men and women for better work/life balance and for part-time work, particularly in relation to parenthood.


CONCLUSIONS
Limitation of duty hours alone is insufficient to manage fatigue risk and difficulties in maintaining work/life balance. These findings have implications for schedule design, professional training, and workforce planning.
Gander
Philippa
P
Sleep/Wake Research Centre, Massey University, Wellington, New Zealand. p.h.gander@massey.ac.nz
Briar
Celia
C
Garden
Alexander
A
Purnell
Heather
H
Woodward
Alistair
A
D002055:Burnout, Professional / Q000453:epidemiology / Q000517:prevention & control; D016009:Chi-Square Distribution; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D016272:Occupational Health; D016487:Parenting; D010820:Physicians / Q000523:psychology*; D010822:Physicians, Women / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012892:Sleep Deprivation / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance; D016526:Workload