Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature
Abstract
Extended work hours, interrupted sleep, and shift work are integral parts of medical training among all specialties. The need for 24-hour patient care coverage and economic factors have resulted in prolonged work hours for resident physicians. This has traditionally been thought to enhance medical educational experience. These long and erratic work hours lead to acute and chronic sleep deprivation and poor sleep quality, resulting in numerous adverse consequences. Impairments may occur in several domains, including attention, cognition, motor skills, and mood. Resident performance, professionalism, safety, and well-being are affected by sleep deprivation, causing potentially adverse implications for patient care. Studies have shown adverse health consequences, motor vehicle accidents, increased alcohol and medication use, and serious medical errors to occur in association with both sleep deprivation and shift work. Resident work hour limitations have been mandated by the Accreditation Council for Graduate Medical Education in response to patient safety concerns. Studies evaluating the impact of these regulations on resident physicians have generated conflicting reports on patient outcomes, demonstrating only a modest increase in sleep duration for resident physicians, along with negative perceptions regarding their education. This literature review summarizes research on the effects of sleep deprivation and shift work, and examines current literature on the impact of recent work hour limitations on resident physicians and patient-related outcomes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Shift work makes workers change their bed time frequently, which leads to sleeping problems like poor sleep quality, followed by disturbance of chronobiological rhythms.
“Second, shift work makes the workers change their bed time frequently, 41 which leads to sleeping problems like poor sleep quality, followed by the disturbance of the chronobiological rhythms.42 43”
From Shift work and diabetes mellitus: a meta-analysis of observational studies (2015) · cites this paper as [42]
Cites
Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003) · Sleep · doi:10.1093/sleep/26.2.117 · Cited by 3,173 · see citing works
Adverse metabolic and cardiovascular consequences of circadian misalignment
Scheer, F. A. J. L., Hilton, M. F., Mantzoros, C. S., & Shea, S. A. (2009) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0808180106 · Cited by 2,351 · see citing works
Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
Landrigan, C. P., Rothschild, J. M., Cronin, J. W., Kaushal, R., Burdick, E., Katz, J. T., Lilly, C. M., Stone, P. H., Lockley, S. W., Bates, D. W., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa041406 · Cited by 1,760 · see citing works
Effects of Sleep Deprivation on Performance: A Meta-Analysis
Pilcher, J. J., & Huffcutt, A. I. (1996) · Sleep · doi:10.1093/sleep/19.4.318 · Cited by 1,549 · see citing works
Behavioral and Physiological Consequences of Sleep Restriction
Banks, S., & Dinges, D. F. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26918 · Cited by 1,505 · see citing works
Fatigue, alcohol and performance impairment
Dawson, D., & Reid, K. (1997) · Nature · doi:10.1038/40775 · Cited by 1,199 · see citing works
Rotating night shifts and risk of breast cancer in women participating in the nurses׳ health study
Schernhammer, E. S., Laden, F., Speizer, F. E., Willett, W. C., Hunter, D. J., Kawachi, I., & Colditz, G. A. (2001) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/93.20.1563 · Cited by 1,142 · see citing works
Communication Failures: An Insidious Contributor to Medical Mishaps
Sutcliffe, K. M., Lewton, E., & Rosenthal, M. M. (2004) · Academic Medicine · doi:10.1097/00001888-200402000-00019 · Cited by 1,069 · see citing works
Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns
Barger, L. K., Cade, B. E., Ayas, N. T., Cronin, J. W., Rosner, B., Speizer, F. E., & Czeisler, C. A. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa041401 · Cited by 928 · see citing works
Effect of sleep deprivation on surgeons' dexterity on laparoscopy simulator
Taffinder, N. J., McManus, I. C., Gul, Y., Russell, R. C. G., & Darzi, A. W. (1998) · The Lancet · doi:10.1016/s0140-6736(98)00034-8 · Cited by 498 · see citing works
Neurobehavioral Performance of Residents After Heavy Night Call vs After Alcohol Ingestion
Arnedt, J. T., Owens, J., Crouch, M., Stahl, J., & Carskadon, M. A. (2005) · JAMA · doi:10.1001/jama.294.9.1025 · Cited by 419 · see citing works
Extended Work Duration and the Risk of Self-reported Percutaneous Injuries in Interns
Ayas, N. T., Barger, L. K., Cade, B. E., Hashimoto, D. M., Rosner, B., Cronin, J. W., Speizer, F. E., & Czeisler, C. A. (2006) · JAMA · doi:10.1001/jama.296.9.1055 · Cited by 411 · see citing works
BROWN, I. D. (1994) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/001872089403600210 · Cited by 402 · see citing works
The Impact of the 80-Hour Resident Workweek on Surgical Residents and Attending Surgeons
Hutter, M. M., Kellogg, K. C., Ferguson, C. M., Abbott, W. M., & Warshaw, A. L. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000220042.48310.66 · Cited by 397 · see citing works
Consequences of Inadequate Sign-out for Patient Care
Horwitz, L. I., Moin, T., Krumholz, H. M., Wang, L., & Bradley, E. H. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.16.1755 · Cited by 384 · see citing works
Sleep Loss and Performance in Residents and Nonphysicians: A Meta-Analytic Examination
Philibert, I. (2005) · Sleep · doi:10.1093/sleep/28.11.1392 · Cited by 361 · see citing works
Burnout and Internal Medicine Resident Work-Hour Restrictions
Gopal, R., Glasheen, J. J., Miyoshi, T. J., & Prochazka, A. V. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.22.2595 · Cited by 333 · see citing works
Papp, K. K., Stoller, E. P., Sage, P., Aikens, J. E., Owens, J. A., Avidan, A. Y., Phillips, B. A., Rosen, R. C., & Strohl, K. P. (2004) · Academic Medicine · doi:10.1097/00001888-200405000-00007 · Cited by 307 · see citing works
Laparoscopic performance after one night on call in a surgical department: prospective study
Grantcharov, T., Bardram, L., Funch-Jensen, P. M., & Rosenberg, J. (2001) · BMJ · doi:10.1136/bmj.323.7323.1222 · Cited by 307 · see citing works
Baldwin, D. C., & Daugherty, S. R. (2004) · Sleep · doi:10.1093/sleep/27.2.217 · Cited by 280 · see citing works
Goitein, L., Shanafelt, T. D., Wipf, J. E., Slatore, C. G., & Back, A. L. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.22.2601 · Cited by 264 · see citing works
Shift work and disturbed sleep/wakefulness
Åkerstedt, T. (1998) · Sleep Medicine Reviews · doi:10.1016/s1087-0792(98)90004-1 · Cited by 252 · see citing works
Risks of Complications by Attending Physicians After Performing Nighttime Procedures
Rothschild, J. M. (2009) · JAMA · doi:10.1001/jama.2009.1423 · Cited by 248 · see citing works
Kairys, J. C., McGuire, K. P., Crawford, A. G., & Yeo, C. J. (2008) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2007.12.055 · Cited by 246 · see citing works
Volpp, K. G., Rosen, A. K., Rosenbaum, P. R., Romano, P. S., Even-Shoshan, O., Canamucio, A., Bellini, L., Behringer, T., & Silber, J. H. (2007) · JAMA · doi:10.1001/jama.298.9.984 · Cited by 228 · see citing works
Volpp, K. G. M., Rosen, A. K., & Rosenbaum, P. R. (2008) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2007.11.035 · Cited by 223 · see citing works
Moonesinghe, R., Lowery, J., Shahi, N. N., Millen, A., & Beard, J. D. (2011) · BMJ · doi:10.1136/bmj.d1580 · Cited by 223 · see citing works
The Risks and Implications of Excessive Daytime Sleepiness in Resident Physicians
Howard, S. K., Gaba, D. M., Rosekind, M. R., & Zarcone, V. P. (2002) · Academic Medicine · doi:10.1097/00001888-200210000-00015 · Cited by 207 · see citing works
Neuropsychological Effects of Sleep Loss: Implication for Neuropsychologists
Waters, F., & Bucks, R. S. (2011) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617711000610 · Cited by 207 · see citing works
The Occupational Risk of Motor Vehicle Collisions for Emergency Medicine Residents
Steele, M. T., Ma, O. J., Watson, W. A., Thomas, H. A., & Muelleman, R. L. (1999) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.1999.tb01191.x · Cited by 175 · see citing works
Effect of Sleep Deprivation on Driving Safety in Housestaff
Marcus, C. L., & Loughlin, G. M. (1996) · SLEEP · doi:10.1093/sleep/19.10.763 · Cited by 170 · see citing works
Changes in Hospital Mortality Associated with Residency Work-Hour Regulations
Shetty, K. D., & Bhattacharya, J. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-2-200707170-00161 · Cited by 170 · see citing works
Meta-Analysis of the Relationship Between Total Sleep Deprivation and Performance
Koslowsky, M., & Babkoff, H. (1992) · Chronobiology International · doi:10.3109/07420529209064524 · Cited by 158 · see citing works
Interns' Compliance With Accreditation Council for Graduate Medical Education Work-Hour Limits
Landrigan, C. P., Barger, L. K., Cade, B. E., Ayas, N., & Czeisler, C. A. (2006) · JAMA · doi:10.1001/jama.296.9.1063 · Cited by 152 · see citing works
Work patterns and fatigue-related risk among junior doctors
Gander, P., Purnell, H., Garden, A., & Woodward, A. (2007) · Occupational and Environmental Medicine · doi:10.1136/oem.2006.030916 · Cited by 147 · see citing works
The Effects of On-Duty Napping on Intern Sleep Time and Fatigue
Arora, V. M., Dunphy, C., Chang, V. Y., Ahmad, F., Humphrey, H. J., & Meltzer, D. O. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-11-200606060-00005 · Cited by 144 · see citing works
Peptic ulcer is prevalent among shift workers
Segawa, K., Nakazawa, S., Tsukamoto, Y., Kurita, Y., Goto, H., Fukui, A., & Takano, K. (1987) · Digestive Diseases and Sciences · doi:10.1007/bf01296025 · Cited by 143 · see citing works
Cost Implications of Reduced Work Hours and Workloads for Resident Physicians
Nuckols, T. K., Bhattacharya, J., Wolman, D. M., Ulmer, C. C., & Escarce, J. J. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0810251 · Cited by 131 · see citing works
Mortality of shift and day workers 1956-68
Taylor, P. J., & Pocock, S. J. (1972) · Occupational and Environmental Medicine · doi:10.1136/oem.29.2.201 · Cited by 126 · see citing works
Shift work and reproductive health.
Nurminen, T. (1998) · PubMed · Cited by 126 · see citing works
Leonard, C., Fanning, N., Attwood, J., & Buckley, M. (1998) · Irish Journal of Medical Science (1971 -) · doi:10.1007/bf02937548 · Cited by 117 · see citing works
Cohen‐Gadol, A., Piepgras, D. G., Krishnamurthy, S., & Fessler, R. D. (2005) · Neurosurgery · doi:10.1227/01.neu.0000147999.64356.57 · Cited by 116 · see citing works
Sleep Deprivation, Physician Performance, and Patient Safety
Olson, E. J., Drage, L. A., & Auger, R. R. (2009) · CHEST Journal · doi:10.1378/chest.08-1952 · Cited by 116 · see citing works
Revisiting Duty-Hour Limits — IOM Recommendations for Patient Safety and Resident Education
Iglehart, J. K. (2008) · New England Journal of Medicine · doi:10.1056/nejmp0808736 · Cited by 115 · see citing works
Lingenfelser, T., Kaschel, R., WEBER, A., Zaiser-Kaschel, H., Jakober, B., & KÜPER, J. (1994) · Medical Education · doi:10.1111/j.1365-2923.1994.tb02737.x · Cited by 106 · see citing works
Antiel, R. M., Thompson, S. M., Hafferty, F. W., James, K. M., Tilburt, J. C., Bannon, M. P., Fischer, P. R., Farley, D. R., & Reed, D. A. (2011) · Mayo Clinic Proceedings · doi:10.4065/mcp.2010.0635 · Cited by 97 · see citing works
Myers, J. S., Bellini, L. M., Morris, J. B., Graham, D., Katz, J. T., Potts, J. R., Weiner, C., & Volpp, K. G. M. (2006) · Academic Medicine · doi:10.1097/01.acm.0000246687.03462.59 · Cited by 94 · see citing works
Changes in Outcomes for Internal Medicine Inpatients after Work-Hour Regulations
Horwitz, L. I., Kosiborod, M., Lin, Z., & Krumholz, H. M. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-2-200707170-00163 · Cited by 90 · see citing works
An Elusive Balance — Residents' Work Hours and the Continuity of Care
Okie, S. (2007) · New England Journal of Medicine · doi:10.1056/nejmp078085 · Cited by 84 · see citing works
Cappuccio, F. P., Bakewell, A. B., Taggart, F. M., Ward, G., Ji, C., Sullivan, J. P., Edmunds, M. E., Pounder, R. E., Landrigan, C. P., Lockley, S. W., et al. (2009) · QJM · doi:10.1093/qjmed/hcp004 · Cited by 83 · see citing works
Effect of the 80-Hour Work Week on Cases Performed by General Surgery Residents
McElearney, S. T., Saalwachter, A. R., Hedrick, T. L., Pruett, T. L., Sanfey, H. A., & Sawyer, R. G. (2005) · The American Surgeon · doi:10.1177/000313480507100703 · Cited by 78 · see citing works
US public opinion regarding proposed limits on resident physician work hours
Blum, A. B., Raiszadeh, F., Shea, S. L., Mermin, D., Lurie, P. G., Landrigan, C. P., & Czeisler, C. A. (2010) · BMC Medicine · doi:10.1186/1741-7015-8-33 · Cited by 65 · see citing works
Arora, V. M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.16.1738 · Cited by 63 · see citing works
Impact of the 80-Hour Workweek on Patient Care at a Level I Trauma Center
Salim, A. (2007) · Archives of Surgery · doi:10.1001/archsurg.142.8.708 · Cited by 60 · see citing works
Baldwin, K. D., Namdari, S., Donegan, D. J., Kamath, A. F., & Mehta, S. D. (2011) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.j.00367 · Cited by 60 · see citing works
Adler, M., Vozenilek, J. A., Trainor, J. L., Eppich, W., Wang, E. E., Beaumont, J. L., Aitchison, P. R., Pribaz, P. J., Erickson, T. B., Edison, M. I., et al. (2011) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0b013e318201aa90 · Cited by 53 · see citing works
Effects of duty hours and time of day on surgery resident proficiency
Brandenberger, J., Kahol, K., Feinstein, A., Ashby, A., Smith, M., & Ferrara, J. J. (2010) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2010.06.009 · Cited by 52 · see citing works
Prasad, M., Iwashyna, T. J., Christie, J. D., Kramer, A. A., Silber, J. H., Volpp, K. G. M., & Kahn, J. M. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181a93468 · Cited by 49 · see citing works
Rosen, I. M., Bellini, L. M., & Shea, J. A. (2004) · Academic Medicine · doi:10.1097/00001888-200405000-00009 · Cited by 37 · see citing works
Effect of the Night Float System on Operative Case Volume for Senior Surgical Residents
Kelly, R. J., & Senkowski, C. K. (2009) · Journal of surgical education · doi:10.1016/j.jsurg.2009.07.009 · Cited by 35 · see citing works
Alshekhlee, A., Walbert, T., DeGeorgia, M. A., Preston, D. C., & Furlan, A. J. (2009) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2008.10.006 · Cited by 33 · see citing works
Personal time off and residents’ career satisfaction, attitudes and emotions
Cedfeldt, A. S., Bower, E. A., English, C., Grady-Weliky, T. A., Girard, D. E., & Choi, D. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03773.x · Cited by 31 · see citing works
Emergency medicine resident related auto accidents-Is sleep deprivation a risk factor?
Kowalenko, T., Kowalenko, J., Gryzbowski, M., & Rabinovich (2000) · PubMed · Cited by 29 · see citing works
Modafinil and Zolpidem Use by Emergency Medicine Residents
McBeth, B. D., McNamara, R. M., Ankel, F., Mason, E. J., Ling, L. J., Flottemesch, T. J., & Asplin, B. R. (2009) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2009.00586.x · Cited by 25 · see citing works
Sleep and Well-Being of ICU Housestaff
Parthasarathy, S., Hettiger, K., Budhiraja, R., & Sullivan, B. L. (2007) · CHEST Journal · doi:10.1378/chest.06-1398 · Cited by 23 · see citing works
Persistent Noncompliance With the Work-Hour Regulation
Tabrizian, P. (2011) · Archives of Surgery · doi:10.1001/archsurg.2010.337 · Cited by 23 · see citing works
Perceived Impact of the 80-Hour Workweek: Five Years Later
Dozois, E. J., Holubar, S. D., Tsikitis, V. L., Malireddy, K., Cima, R. R., Farley, D. R., & Larson, D. W. (2009) · Journal of Surgical Research · doi:10.1016/j.jss.2009.02.003 · Cited by 18 · see citing works
Afrin, L. B., Arana, G. W., Medio, F. J., Ybarra, A. F. N., & Clarke, H. S. (2006) · Academic Medicine · doi:10.1097/01.acm.0000222258.55266.6a · Cited by 16 · see citing works
Surgical Training and Simulation Laboratory at Baystate Medical Center
Earle, D. (2006) · Surgical Innovation · doi:10.1177/155335060601300109 · Cited by 13 · see citing works
Proposed ACGME Change in Length of Radiology Residency Training Before Independent Call
Berger, W. G., Gibson, S. W., Krupinski, E. A., & Morais, J. D. (2007) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2007.04.018 · Cited by 11 · see citing works
Yaghoubian, A. T., de Virgilio, C., Destro, L., Kaji, A. H., Putnam, B. A., & Neville, A. L. (2010) · The American Surgeon · doi:10.1177/000313481007601002 · Cited by 8 · see citing works
Flagged first, then by citations
1 of the 73 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Health consequences of shift work and insufficient sleep
Kecklund, G., & Axelsson, J. (2016) · BMJ · doi:10.1136/bmj.i5210 · Cited by 1,195 · see citing works
Shift work and diabetes mellitus: a meta-analysis of observational studies
Gan, Y., Yang, C., Tong, X., Sun, H., Cong, Y., Yin, X., Li, L., Cao, S., Dong, X., Gong, Y., et al. (2015) · Occupational and Environmental Medicine · doi:10.1136/oemed-2014-102150 · Cited by 526 · see citing works
Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors
Trockel, M., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R. H., Lu, M., Kim, P. K., Quinn, M. A., Lawrence, E., Marchalik, D., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.28111 · Cited by 263 · see citing works
Adapting Maslow's Hierarchy of Needs as a Framework for Resident Wellness
Hale, A. J., Ricotta, D. N., Freed, J., Smith, C. C., & Huang, G. C. (2019) · Teaching and Learning in Medicine · doi:10.1080/10401334.2018.1456928 · Cited by 174 · see citing works
Gandhi, K. D., Mansukhani, M. P., Silber, M. H., & Kolla, B. P. (2021) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2020.08.033 · Cited by 175 · see citing works
Self-citationThe Effects of Shift Work on Sleeping Quality, Hypertension and Diabetes in Retired Workers
Guo, Y., Liu, Y., Huang, X., Rong, Y., He, M., Wang, Y., Yuan, J., Wu, T., & Chen, W. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071107 · Cited by 153 · see citing works
Qiu, D., Yu, Y., Li, R., Li, Y., & Xiao, S. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.01.047 · Cited by 139 · see citing works
Improving surgeon wellness: The second victim syndrome and quality of care
Marmon, L. M., & Heiss, K. F. (2015) · Seminars in Pediatric Surgery · doi:10.1053/j.sempedsurg.2015.08.011 · Cited by 129 · see citing works
Acute and chronic sleep deprivation in residents: Cognition and stress biomarkers
Choshen‐Hillel, S., Ishqer, A., Mahameed, F., Reiter, J. M., Gozal, D., Gileles‐Hillel, A., & Berger, I. (2020) · Medical Education · doi:10.1111/medu.14296 · Cited by 117 · see citing works
Night shift decreases cognitive performance of ICU physicians
Maltese, F., Adda, M., Bablon, A., Hraeich, S., Guervilly, C., Lehingue, S., Wiramus, S., Léone, M., Martin, C., Vialet, R., et al. (2015) · Intensive Care Medicine · doi:10.1007/s00134-015-4115-4 · Cited by 108 · see citing works
Harris, J. D., Staheli, G., LeClere, L. E., Andersone, D., & McCormick, F. M. (2014) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-014-3968-0 · Cited by 104 · see citing works
Sleep deprivation differentially affects subcomponents of cognitive control
Kusztor, A., Raud, L., Juel, B. E., Nilsen, A. S., Storm, J. F., & Huster, R. J. (2019) · SLEEP · doi:10.1093/sleep/zsz016 · Cited by 101 · see citing works
Hui, S.-K. A., & Grandner, M. A. (2015) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000534 · Cited by 92 · see citing works
Shift Work and the Relationship with Metabolic Syndrome in Chinese Aged Workers
Guo, Y., Rong, Y., Huang, X., Lai, H., Luo, X., Zhang, Z., Liu, Y., He, M., Wu, T., & Chen, W. (2015) · PLoS ONE · doi:10.1371/journal.pone.0120632 · Cited by 88 · see citing works
Shiftwork and Alcohol Consumption: A Systematic Review of the Literature
Richter, K., Peter, L., Rodenbeck, A., Weess, H. G., Riedel-Heller, S. G., & Hillemacher, T. (2020) · European Addiction Research · doi:10.1159/000507573 · Cited by 82 · see citing works
Petrie, K., Crawford, J., LaMontagne, A. D., Milner, A. J., Dean, J. M., Veness, B. G., Christensen, H. M., & Harvey, S. B. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033525 · Cited by 77 · see citing works
Spiotta, A. M., Fargen, K. M., Patel, S. J., Larrew, T., & Turner, R. D. (2018) · Neurosurgery · doi:10.1093/neuros/nyy112 · Cited by 70 · see citing works
Cortegiani, A., Gregoretti, C., Neto, A. S., Hemmes, S. N. T., Ball, L., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Melo, M., et al. (2019) · British Journal of Anaesthesia · doi:10.1016/j.bja.2018.10.063 · Cited by 69 · see citing works
Night shift work in resident physicians: does it affect mood states and cognitive levels?
Costa, C., Mondello, S., Micali, E., Indelicato, G., Licciardello, A. A., Vitale, E., Briguglio, G., Teodoro, M., & Fenga, C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.139 · Cited by 64 · see citing works
Self-Valuation Challenges in the Culture and Practice of Medicine and Physician Well-being
Trockel, M., Sinsky, C. A., West, C. P., Dyrbye, L. N., Tutty, M., Carlasare, L. E., Wang, H., & Shanafelt, T. D. (2021) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2020.12.032 · Cited by 65 · see citing works
Machado‐Duque, M. E., Echeverry, J., & Machado‐Alba, J. E. (2015) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2015.04.002 · Cited by 66 · see citing works
Sleep: its importance and the effects of deprivation on surgeons and other healthcare professionals
Parry, D. A., Oeppen, R. S., Amin, M. S. A., & Brennan, P. A. (2018) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.bjoms.2018.08.001 · Cited by 63 · see citing works
Patterson, P. D., Runyon, M. S., Higgins, J. S., Weaver, M. D., Teasley, E. M., Kroemer, A. J., Matthews, M. E., Curtis, B., Flickinger, K. L., Xun, X., et al. (2018) · Prehospital Emergency Care · doi:10.1080/10903127.2017.1376135 · Cited by 61 · see citing works
Sleep pattern is associated with adipokine levels and nutritional markers in resident physicians
Mota, M. C., Waterhouse, J. M., De-Souza, D. A., Rossato, L. T., Silva, C. M., Araújo, M. B. J., Tufik, S., de Mello, M. T., & Crispim, C. A. (2014) · Chronobiology International · doi:10.3109/07420528.2014.957300 · Cited by 50 · see citing works
Sex-related effects of sleep deprivation on depressive- and anxiety-like behaviors in mice
González-Castañeda, R. E., Gálvez‐Contreras, A. Y., Martínez-Quezada, C. J., Jáuregui-Huerta, F., Garcı́a‐Estrada, J., Ramos-Zúñiga, R., Luquı́n, S., & González-Pérez, Ó. (2015) · EXPERIMENTAL ANIMALS · doi:10.1538/expanim.15-0054 · Cited by 43 · see citing works
Persico, N., Maltese, F., Ferrigno, C., Bablon, A., Marmillot, C., Papazian, L., & Roch, A. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.10.005 · Cited by 43 · see citing works
Crawford, C. C., Teo, L., Lafferty, L. A., Drake, A., Bingham, J. J., Gallon, M. D., O’Connell, M. L., Chittum, H. K., Arzola, S. M., & Berry, K. (2017) · Nutrition Reviews · doi:10.1093/nutrit/nux007 · Cited by 42 · see citing works
Effect of time of birth on maternal morbidity during childbirth hospitalization in California
Lyndon, A., Lee, H. C., Gay, C., Gilbert, W. M., Gould, J. B., & Lee, K. A. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.07.018 · Cited by 41 · see citing works
Fargen, K. M., & Friedman, W. A. (2014) · World Neurosurgery · doi:10.1016/j.wneu.2014.03.030 · Cited by 41 · see citing works
Encountering Patient Suicide During Psychiatric Training: An Integrative, Systematic Review
Leaune, É., Ravella, N., Vieux, M., Poulet, E., Chauliac, N., & Terra, J. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000208 · Cited by 38 · see citing works
Shaik, L., Cheema, M. S., Subramanian, S., Kashyap, R., & Surani, S. (2022) · Medicina · doi:10.3390/medicina58121723 · Cited by 34 · see citing works
Self-citationPanjwani, U., Dudani, S., & Wadhwa, M. (2021) · International Journal of Yoga · doi:10.4103/ijoy.ijoy_110_20 · Cited by 33 · see citing works
Mahmood, J. I., Grotmol, K. S., Tesli, M., Moum, T., Andreassen, O. A., & Tyssen, R. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4599-7 · Cited by 30 · see citing works
Incorporation of a Physical Education and Nutrition Program Into Neurosurgery
Spiotta, A. M., Fargen, K. M., Denham, S. L., Fulton, M. E., Kellogg, R. T., Young, E., Patel, S. J., & Turner, R. D. (2016) · Neurosurgery · doi:10.1227/neu.0000000000001358 · Cited by 27 · see citing works
Impact of the resident duty hours on in-training examination score: A nationwide study in Japan
Nagasaki, K., Nishizaki, Y., Shinozaki, T., Kobayashi, H., Shimizu, T., Okubo, T., Yamamoto, Y., Konishi, R., & Tokuda, Y. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.2003764 · Cited by 26 · see citing works
Frau, R., Traccis, F., & Bortolato, M. (2019) · Journal of Neuroendocrinology · doi:10.1111/jne.12792 · Cited by 26 · see citing works
Changes in inpatient staffing following implementation of new residency work hours
Oshimura, J. M., Sperring, J. L., Bauer, B. D., Carroll, A. E., & Rauch, D. A. A. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2242 · Cited by 24 · see citing works
Anxiety in Residents in China: Prevalence and Risk Factors in a Multicenter Study
Bai, S., Chang, Q., Yao, D., Zhang, Y., Wu, B., & Zhao, Y. (2021) · Academic Medicine · doi:10.1097/acm.0000000000003913 · Cited by 23 · see citing works
Night Shift and Decreased Brain Activity of ICU Nurses: A Near-Infrared Spectroscopy Study
Durán‐Gómez, N., Guerrero-Martín, J., Pérez-Civantos, D., López‐Jurado, C. F., Montanero‐Fernández, J., & Cáceres, M. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182211930 · Cited by 23 · see citing works
Fargen, K. M., Spiotta, A. M., Turner, R. D., & Patel, S. J. (2016) · World Neurosurgery · doi:10.1016/j.wneu.2016.03.024 · Cited by 22 · see citing works
Mahmood, J. I., Grotmol, K. S., Tesli, M., Vaglum, P., & Tyssen, R. (2016) · European Addiction Research · doi:10.1159/000452442 · Cited by 22 · see citing works
Association of Time of Day When Endovascular Therapy for Stroke Starts and Functional Outcome
Hajdu, S. D., Kaesmacher, J., Michel, P., Sirimarco, G., Knebel, J., Bartolini, B. M., Kurmann, C. C., Puccinelli, F., Mosimann, P. J., Bonvin, C., et al. (2021) · Neurology · doi:10.1212/wnl.0000000000011449 · Cited by 22 · see citing works
Schlafstörungen bei Ärzten im Schichtdienst
Schläfer, O., Wenzel, V., & Högl, B. (2014) · Der Anaesthesist · doi:10.1007/s00101-014-2374-z · Cited by 22 · see citing works
Negative reinforcement impairs overnight memory consolidationPreprint
Stamm, A., Nguyen, N. D., Seicol, B. J., Fagan, A., Angela, O., Drumm, M., Lundt, M., Stickgold, R., & Wamsley, E. J. (2014) · Learning & Memory · doi:10.1101/lm.035196.114 · Cited by 21 · see citing works
On-Call Duty Effects on Sleep-State Physiological Stability in Male Medical Interns
Lin, Y., Ho, Y.-C., Lin, S., Yeh, Y. H., Liu, C.-Y., Kuo, T. B. J., Yang, C. C. H., & Yang, A. C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0065072 · Cited by 21 · see citing works
Petruţ, B., Berindan‐Neagoe, I., Feflea, D., Hogea, M., Paşca, S., Bujoreanu, C. E., & Bschleipfer, T. (2020) · Urologia Internationalis · doi:10.1159/000504988 · Cited by 20 · see citing works
Teo, L., Crawford, C. C., Yehuda, R., Jaghab, D., Bingham, J. J., Chittum, H. K., Gallon, M. D., O’Connell, M. L., Arzola, S. M., & Berry, K. (2017) · Nutrition Reviews · doi:10.1093/nutrit/nux008 · Cited by 19 · see citing works
Self in medicine: Determinants of physician well‐being and future directions in improving wellness
Mendelsohn, D. A. (2021) · Medical Education · doi:10.1111/medu.14671 · Cited by 20 · see citing works
Peles, E., Schreiber, S., Domany, Y., Sason, A., Tene, O., & Adelson, M. (2014) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2014.897003 · Cited by 19 · see citing works
Sleep and Fatigue Countermeasures for the Neurology Resident and Physician
Avidan, A. Y. (2013) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000427205.67811.08 · Cited by 19 · see citing works
The effect of off-hour delivery on severe maternal morbidity: a population-based cohort study
Nam, J. Y., Lee, S. G., Nam, C. M., Park, S., Jang, S., & Park, E. (2019) · European Journal of Public Health · doi:10.1093/eurpub/ckz013 · Cited by 18 · see citing works
Mak, N. T., Li, J., & Wiseman, S. M. (2019) · Cureus · doi:10.7759/cureus.4843 · Cited by 18 · see citing works
Factors That Contribute to Excessive Sleepiness in Midwives Practicing in the United States
Arbour, M. W., Tanner, T., Hensley, J., Beardsley, J., Wika, J., & GARVAN, C. W. (2019) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.12945 · Cited by 17 · see citing works
Work–Life Balance: A Different Scale for Doctors
Nievas, I. F. F., & Thaver, D. (2015) · Frontiers in Pediatrics · doi:10.3389/fped.2015.00115 · Cited by 17 · see citing works
Pathologist workload, burnout, and wellness: connecting the dots
Khatab, Z., Hanna, K., Rofaeil, A., Wang, C., Maung, R., & Yousef, G. M. (2023) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2023.2285284 · Cited by 19 · see citing works
The Association of Sleep Loss and Balance Stability in Farmers
Siu, K., Huang, C.-K., Beacom, M., Bista, S. R., & Rautiainen, R. H. (2015) · Journal of Agromedicine · doi:10.1080/1059924x.2015.1042615 · Cited by 16 · see citing works
Increased Patient Safety-Related Incidents Following the Transition into Daylight Savings Time
Kolla, B. P., Coombes, B. J., Morgenthaler, T. I., & Mansukhani, M. P. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06090-9 · Cited by 15 · see citing works
Self-citationYe, H., Ji, M., Wang, C., Wang, C., Li, Y., Chen, Y., Cheng, L., Li, Y., & Yang, J. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.848709 · Cited by 15 · see citing works
Toubasi, A. A., Khraisat, B., AbuAnzeh, R. B., & Kalbouneh, H. (2021) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174211011287 · Cited by 15 · see citing works
Resident fatigue in otolaryngology residents: a Web based survey
Nida, A. M., Googe, B. J., Lewis, A. F., & May, W. L. (2016) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2016.01.017 · Cited by 14 · see citing works
What's new in academic medicine: Can we effectively address the burnout epidemic in healthcare?
Stawicki, S. P., Tolentino, J. C., Guo, W., Ricca, R., Vazquez, D., Martins, N. B., Sweeney, J., Moalem, J., Derrick, E. L., Sholevar, F., et al. (2017) · International Journal of Academic Medicine · doi:10.4103/ijam.ijam_47_17 · Cited by 14 · see citing works
Sleep Difficulties Among COVID-19 Frontline Healthcare Workers
Cleper, R., Hertz‐Palmor, N., Mosheva, M., Hasson‐Ohayon, I., Kaplan, R., Kreiss, Y., Afek, A. B., Pessach, I. M., Gothelf, D., & Gross, R. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.838825 · Cited by 14 · see citing works
Talusan, P. G., Long, T. E., Halim, A., Guliani, L., Carroll, N. C., & Reach, J. S. (2014) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-14-00006.1 · Cited by 13 · see citing works
Peles, E., Sason, A., Tene, O., Domany, Y., Schreiber, S., & Adelson, M. (2015) · Journal of Addictive Diseases · doi:10.1080/10550887.2015.1074502 · Cited by 13 · see citing works
The impact of duty hour limits on sleep quality of resident: a cross-sectional study
Jaradat, R., Lahlouh, A., Aldabbour, B., Saadeh, A., & Mustafa, M. (2022) · Oman Medical Journal · doi:10.5001/omj.2022.78 · Cited by 11 · see citing works
Impact of shift work on dementia: a systematic review and dose-response meta-analysis
Gao, Y., Fu, X., Hu, H., Li, T., Yuan, L., Zhang, J., Wu, Y., Yang, K., Ke, Y., Li, X., et al. (2023) · Public Health · doi:10.1016/j.puhe.2023.07.029 · Cited by 12 · see citing works
Gustavsson, K., Wierzbicka, A., Matuszczyk, M., Matuszczyk, M., & Wichniak, A. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13031 · Cited by 11 · see citing works
Lee, J. Y., Lee, J., Choi, W. S., & Myong, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041854 · Cited by 11 · see citing works
The Handbook of Wellness Medicine
Snellings, J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182 · Cited by 11 · see citing works
Garber, A., Nowacki, A. S., Chaitoff, A. M., Brateanu, A., Colbert, C. Y., Bauer, S. R., Arora, Z., Mehdi, A., Lam, S. W., Spencer, A. L., et al. (2019) · Southern Medical Journal · doi:10.14423/smj.0000000000000923 · Cited by 10 · see citing works
Baggaley, A. E., Robb, L., Paterson‐Brown, S., & McGregor, R. J. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023476 · Cited by 10 · see citing works
Sleep quality and daytime sleepiness among Polish anaesthesiologists and intensivists
Krzych, Ł. J., Piekiełko, P., Baca, A., Długosz, A., Liberski, P. S., Jaworski, T., & Kasperczyk, J. (2019) · Journal of Critical Care · doi:10.1016/j.jcrc.2019.06.005 · Cited by 10 · see citing works
Cardiac Autonomic Modulation during on-Call Duty under Working Hours Restriction
Chien, J., Chen, C. O., Lin, S., Lin, S., & Lin, Y. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17031118 · Cited by 10 · see citing works
Cheval, B., Cullati, S., Pihl‐Thingvad, J., Mongin, D., von Arx, M., Chopard, P., & Courvoisier, D. S. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022172 · Cited by 10 · see citing works
Predictors of Wellness Behaviors in U.S. Army Physicians
Hsu, D. P., Hansen, S. L., Roberts, T. A., Murray, C. K., & Mysliwiec, V. (2018) · Military Medicine · doi:10.1093/milmed/usy059 · Cited by 9 · see citing works
van Elk, F., der Holst, H. M. L., Robroek, S. J., Burdorf, A., & Hengel, K. M. O. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104881 · Cited by 9 · see citing works
Wu, Y., Jiang, F., Wu, S., Liu, Y., & Tang, Y. (2021) · Journal of Occupational Medicine and Toxicology · doi:10.1186/s12995-021-00298-z · Cited by 9 · see citing works
Wellbeing as Defined by Resident Physicians: A Qualitative Study
Slama, E. M., Batarseh, L., Bryan, F. E., Roberts, A., Bokhari, F., Cunningham, S. C., & Kowdley, G. C. (2021) · The American Surgeon · doi:10.1177/00031348211065092 · Cited by 9 · see citing works
Training satisfaction and well-being among veterinary anaesthesia residents: time for action
Tayari, H., Mocci, R., Haji, O., & Dugdale, A. H. A. (2021) · Veterinary Anaesthesia and Analgesia · doi:10.1016/j.vaa.2021.06.016 · Cited by 9 · see citing works
Automatic Work-Hours Recorder for Medical Staff (Staff Hours): Mobile App Development
Chiang, T.-W., Chen, S.-Y., Pan, Y., & Lin, Y. (2019) · JMIR mhealth and uhealth · doi:10.2196/16063 · Cited by 9 · see citing works
An innovative on-call system for paediatric residency programs: The alternate night float
Moore, G. P., Talarico, S., Kempinska, A., Lawrence, S. E., & Weisz, D. E. (2015) · Paediatrics & Child Health · doi:10.1093/pch/20.2.77 · Cited by 9 · see citing works
Shnayder-Adams, M. M., Onge, J. E. S., & Caban-Martinez, A. J. (2017) · American Journal of Industrial Medicine · doi:10.1002/ajim.22743 · Cited by 8 · see citing works
Diagnóstico dual en médicos residentes: una revisión sistemática
Vargas-Cáceres, S., Mantilla, M. F., Ortega‐Hernández, G., Bruguera, E., Casas, M., Ramos‐Quiroga, J. A., & Braquehais, M. D. (2020) · Adicciones · doi:10.20882/adicciones.1253 · Cited by 9 · see citing works
Risk of insomnia and hypnotics use among emergency physicians
Liou, Y., Li, S., Ho, C.-C., & Lee, M.-W. (2020) · Industrial Health · doi:10.2486/indhealth.2020-0217 · Cited by 8 · see citing works
Insomnia—A Systematic Review and Comparison of Medical Resident’s Average Off-Call Sleep Times
Ardizzone, E., Lerchbaumer, E., Heinzel, J. C., Winter, N., Prahm, C., Kolbenschlag, J., Daigeler, A., & Lauer, H. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054180 · Cited by 8 · see citing works
Sleep, chronotype, social jetlag, and mental health in resident physicians: a cross-sectional study
Moderie, C., Paradis, C., Philippe, F. L., Geoffroy, M., Guay, E., & Paquin, V. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11288 · Cited by 7 · see citing works
Mao, Z., Zhang, J., Wang, P., & Zuo, W. (2025) · Scientific Reports · doi:10.1038/s41598-025-12265-3 · Cited by 7 · see citing works
Merrigan, J. J., Klatt, M. D., Quatman‐Yates, C. C., Emerson, A. M., Kronenberg, J., Orr, M. L., Caputo, J., Daniel, K., Summers, R., Mulugeta, Y., et al. (2024) · EXPLORE · doi:10.1016/j.explore.2024.103022 · Cited by 7 · see citing works
Singer-Chang, G., Dong, F., Seffinger, M. A., Nevins, N. A., Blumer, J., Musharbash, H., & Helf, S. (2020) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2020.069 · Cited by 7 · see citing works
Long‐term ear‐EEG monitoring of sleep – A case study during shift work
Jørgensen, S. D., Kidmose, P., Mikkelsen, K. B., Blech, M., Hemmsen, M. C., Rank, M. L., & Kjær, T. W. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13853 · Cited by 7 · see citing works
Smyth, P. S., Maximova, K., & Jirsch, J. D. (2016) · Occupational and Environmental Medicine · doi:10.1136/oemed-2015-103489 · Cited by 7 · see citing works
Brower, K. J. (2017) · Springer eBooks · doi:10.1007/978-3-319-55583-6_13 · Cited by 8 · see citing works
Clement, K., Lacroix, G., Bélanger, S., Julien, A., Piedbœuf, B., & Beltempo, M. (2018) · American Journal of Perinatology · doi:10.1055/s-0038-1627442 · Cited by 7 · see citing works
Daher, A. M., Burud, I. A. S., Subair, M., Mushahar, L., & Xin, L. J. (2024) · PLoS ONE · doi:10.1371/journal.pone.0306574 · Cited by 6 · see citing works
Kelly-Schuette, K. A., Shaker, T. M., Carroll, J., Davis, A. T., Wright, G. P., & Chung, M. H. (2020) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-20-00304.1 · Cited by 6 · see citing works
Almarzouki, A. F. (2024) · Postgraduate Medicine · doi:10.1080/00325481.2024.2347195 · Cited by 7 · see citing works
Sleep and Psychological Problems in Medical Students
Kim, D.-W., Kim, S.-G., Kim, J., Yang, Y.-H., Jung, W.-Y., & Lee, J.-S. (2013) · Sleep Medicine and Psychophysiology · doi:10.14401/kasmed.2013.20.2.69 · Cited by 6 · see citing works
Li, D., Wu, H., Chou, F. H., Hsu, S., Huang, J., Hsieh, K.-Y., Lin, G., & Wu, P.-J. (2022) · Medicine · doi:10.1097/md.0000000000031316 · Cited by 7 · see citing works
Coffyn, S., & Siengsukon, C. F. (2020) · Journal of Physical Therapy Education · doi:10.1097/jte.0000000000000135 · Cited by 6 · see citing works
Debets, M. P. M., Tummers, F. H. M. P., Silkens, M., Huizinga, C. R. H., Lombarts, K. M. J. M. H., & van der Bogt, K. E. A. (2023) · Human Resources for Health · doi:10.1186/s12960-023-00855-z · Cited by 5 · see citing works
- Authors
- Mansukhani, M. P., Kolla, B. P., Surani, S., Varon, J., & Ramar, K.
- Affiliations
- Mayo Clinic (US)
- Texas A&M University (US)
- Corresponding author
- Surani, Salim
- Venue
- Postgraduate Medicine
- Publisher
- Informa UK Limited
- Published
- 2012-07
- Volume
- 124
- Issue
- 4
- Pages
- 241-249
- ISSN
- 0032-5481 (ISSN-L)
- 1941-9260
- OpenAlex
- W1971025355
- Semantic Scholar
- ec9f4036875ab6faa51051cdca07c340cf16076e
- Cited by
- 227
- References
- 73
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 14 · 2023: 15 · 2022: 11 · 2021: 20 · 2020: 74 · 2019: 14 · 2018: 10 · 2017: 12 · 2016: 9 · 2015: 15 · 2014: 13 · 2013: 4
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Postgraduate Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- sleep deprivation, medical residents, shift work, residency training, patient safety, medical errors, sleep quality, resident well-being, Accreditation Council for Graduate Medical Education, patient outcomes
- MeSH terms
- Accreditation, Clinical Competence, Cognition, Fatigue, Humans, Internship and Residency, Quality of Life, Sleep Deprivation, United States, Work Schedule Tolerance, Workload, Medical Errors, Sleep Disorders, Circadian Rhythm
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review