The Performance of Junior Hospital Doctors Following Reduced Sleep and Long Hours of Work

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Abstract
Thirty junior hospital doctors were studied for one month each during 1974, A 3 min version of the Baddeley test of grammatical reasoning was given eight times during the month. It was regarded as a routine; no special emphasis was placed upon performing well. A sleep debt of 3 h or greater reliably reduced the efficiency of the first group of doctors on this test, The fall in efficiency was still reliable when corrected for the times of day of the tests. Working 18 h or longer during the last 24 h also reduced efficiency, but this could have been due to the associated loss of sleep which the long hours of work entailed. The second group of doctors always performed a 3 min laboratory forms test after each test of grammatical reasoning. Before the laboratory forms test their errors on the previous test were checked with them, and they had the sheets showing the normal ranges. On this more challenging test a sleep debt of 3 h or greater the previous night made the doctors reliably more variable in their rate of work. However a reliable deterioration in efficiency occurred only with the largest cumulative sleep debt of 8 h. The increase in variability without a change in efficiency suggests that although the doctors were tired, they were able to compensate for it during the 3 min lest. The successful compensation carried over to the test of grammatical reasoning, although it was always performed first.

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