Strategies Resident-Physicians Use to Manage Sleep Loss and Fatigue

Our purpose is to examine strategies or countermeasures resident-physicians used in dealing with the effects of sleep loss and fatigue during residency training. A total of 149 residents across five sites and six specialty areas were recruited for the study. Focus groups consisted of an average of 7 individuals in the same year of training and residency program, and included 60 interns and 89 senior residents. Trained moderators conducted focus groups using a semi-structured discussion guide. Transcripts were analyzed using the grounded theory tradition. The range of strategies adopted was: Chemical, Dietary, Sleep Management, Behavioral, and Cognitive. Residents exhibited a trial-and-error approach to identifying management strategies. None mentioned searching the scientific literature or consulting local sleep medicine experts. Residents relied on putative countermeasures even when they were aware of their negative effects. Our results document the need to educate resident physicians on self-care strategies during residency training.