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Academic Medicine:
doi: 10.1097/ACM.0b013e3181eabd06
Gender Issues

A Gender-Based Analysis of Work Patterns, Fatigue, and Work/Life Balance Among Physicians in Postgraduate Training

Gander, Philippa PhD; Briar, Celia PhD; Garden, Alexander MB, ChB, PhD; Purnell, Heather MSc (Hons); Woodward, Alistair MBBS, PhD

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Abstract

Purpose: To document fatigue in New Zealand junior doctors in hospital-based clinical training positions and identify work patterns associated with work/life balance difficulties. This workforce has had a duty limitation of 72 hours/week since 1985. The authors chose a gender-based analytical approach because of the increasing proportion of female medical graduates.

Method: The authors mailed a confidential questionnaire to all 2,154 eligible junior doctors in 2003. The 1,412 respondents were working ≥40 hours/week (complete questionnaires from 1,366: response rate: 63%; 49% women). For each participant, the authors calculated a multidimensional fatigue risk score based on sleep and work patterns.

Results: Women were more likely to report never/rarely getting enough sleep (P < .05), never/rarely waking refreshed (P < .001), and excessive sleepiness (P < .05) and were less likely to live with children up to 12 years old (P < .001). Fatigue risk scores differed by specialty but not by gender.

Fatigue risk scores in the highest tertile were an independent risk factor for reporting problems in social life (odds ratio: 3.83; 95% CI: 2.79–5.28), home life (3.37; 2.43–4.67), personal relationships (2.12; 1.57–2.86), and other commitments (3.06; 2.23–4.19).

Qualitative analyses indicated a common desire among men and women for better work/life balance and for part-time work, particularly in relation to parenthood.

Conclusions: Limitation of duty hours alone is insufficient to manage fatigue risk and difficulties in maintaining work/life balance. These findings have implications for schedule design, professional training, and workforce planning.

© 2010 Association of American Medical Colleges

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