Medical Resident/Physician Performance

Around-the-clock patient care has traditionally been satisfied by heroic physician trainee work hours. Justifications for these burdens are rooted in arguments related to education, professional identity, and economics. Accumulated evidence regarding sleep restriction and, to a lesser extent, other aspects of sleep/wake homeostasis, led to the introduction of duty hour regulations by the Accreditation Council for Graduate Medical Education (ACGME). This article will highlight studies that examine the impacts of sleep deprivation, circadian misalignment, and sleep inertia, discuss the impacts of regulations on myriad aspects of medical care, summarize current ACGME regulations, and suggest areas for further investigation.