Emergency Medicine Residents' Shiftwork Tolerance and Preference

Abstract. Objectives: To determine the shift lengths currently worked by emergency medicine (EM) residents and their shift length preferences, and to determine factors associated with EM residents' subjective tolerance of shiftwork. Methods: A survey was sent to EM‐2 through EM‐4 allopathic EM residents in May 1996. This questionnaire assessed the residents' shift length worked, shift length preferences, night shift schedules, and self‐reported ability to overcome drowsiness, sleep flexibility, and morningness‐eveningness tendencies. When providing shift length preferences, the residents were asked to assume a constant total number of hours scheduled per month. Results: Seventy‐eight programs participated, and 62% of 1,554 eligible residents returned usable surveys. Current shift lengths worked were 8 hours (12%), 10 hours (13%), 12 hours (37%), combinations of 8‐hour, 10‐hour, or 12‐hour (34%) shifts, and other combinations (4%). Seventy‐three percent of the respondents indicated that they preferred to work 8‐hour or 10‐hour shifts, and only 21% preferred a 12‐hour shift. Shifwork tolerance was recorded as: not well at all (2%), not very well (14%), fairly well (70%), and very well (14%). The EM residents' eveningness preference, ability to overcome drowsiness, sleep flexibility, younger age, and having no children at home were all associated with greater shiftwork tolerance. Conclusions: Emergency medicine residents generally tolerate shiftwork well and prefer 8‐hour or 10‐hour shift lengths compared with 12‐hour shift lengths. Emergency medicine residencies with 12‐hour shifts should consider changing residents' shifts to shorter shifts.