The Junior Doctor Syndrome

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Abstract
The present organization of working hours in hospital is deleterious to the health and well-being of junior doctors. The main effects are sleep deprivation and emotional disturbance. The stresses created counter optimum patient care by undermining patient-doctor communication, hampering professional performance and diminishing motivation. It is common sense to seek a better arrangement of working hours. The use of scientifically validated concepts of circadian rhythms provide a method to do this. The reduction in the number of continuous hours worked is of prime importance, in addition to a decrease in the total number of hours on duty. The present move towards legislation will facilitate the application of these principles. We think that the proposed changes will create a situation where junior doctors have the potential to thrive rather than merely survive. This provides benefits to patients, as well as to the complete health care team, including administrators. My experience (GB) as a junior house officer was curtailed by physical illness. This was an externalization of an inner conflict between the rigorous demands of residency training and my individual needs both as a doctor and as a person. My attempts at reconciliation brought to light a number of issues which affect most junior doctors and which we discuss in this paper. We examine some of the shortcomings of the present medical system, their effects on the lives of junior doctors and the consequences on patient care. We maintain that these drawbacks need not be there, and suggest ways in which we feel the situation can be improved.

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