Skip to Main Content

For Residents

Resident wellness matters.

Sleep Deprivation

While you may be aware that you are indeed fatigued or feeling tired, your ability to accurately assess or predict the impact on increasingly complex tasks diminishes with greater levels of extreme tiredness. Further, as fatigue becomes a chronic pattern during your residency training, your ability to assess the degree of sleep-related impairment diminishes, and many incorrectly come to the conclusion that they have acclimated or ‘adapted’ to a deprived sleep state.

Fatigue Mitigation Strategies

Sample Individual Fatigue Mitigation Strategies

  • Ensure adequate recovery time prior to each shift
  • Attend and be engaged during fatigue risk management education and training sessions
  • Judicious use of caffeine
  • Work break/work break with no pager/phone
  • Quiet rest
  • Napping/sleep
  • Increased physical activity/light exercise
  • Ensure adequate hydration and nutrition
  • Task rotation
  • Double-checking calculations and instructions
  • Defer non-urgent cases
  • Limit overtime hours
  • Avoid mundane tasks during periods of higher fatigue risk
  • When possible avoid highly complex tasks during periods of higher fatigue risk
  • Work in pairs or teams
  • Declaration of fatigue risk to team
  • Employ self-assessment checklists for signs and symptoms of fatigue
  • When necessary, stand down

Sample Team-based Fatigue Mitigation Strategies

  • Communicate fatigue risk declaration to team
  • Communicate/document fatigue status in ‘fatigue diary’ or logbook
  • Communicate fatigue status on daily team notice board
  • Work in pairs or teams
  • Reallocate tasks
  • Increase team cross-checking
  • Increase supervision
  • Use of video conferencing/telemedicine
  • Base shift schedules on sleep science
  • Seek second opinion on critical clinical decisions
  • Ensure fatigued individual avoids acting as primary operator in procedural work
  • Scheduling less complex or less safety-critical tasks at times of highest fatigue risk, when possible
  • Ensure fatigued individual has priority access to on-call room/napping facility where available
  • Access to taxi vouchers or transportation for safe commute
  • All clinicians, educators, and learners take responsibility for identifying and reporting unsafe conditions, in accordance with professional standards and hospital policy, without fear of reprisal
  • All clinicians, educators, and learners take responsibility for maintaining optimal personal health and well-being outside of work, including maintaining physical fitness, nutrition, and sleep

To download the Fatigue Mitigation Strategies, click here

Who Should Conduct the Fatigue Risk Assessment?

To identify the unique risks for each local context, a Fatigue Risk Assessment should be conducted by a group of people who are most familiar with the local working environment, including, but not limited to:

  • Clinical educators and supervisors
  • Learners
  • Faculty physicians and supervisors
  • Hospital employees
  • Program Directors
  • Decanal team, including PGME
  • The FRM Local Working Group or Officer (LWG)
  • Risk management experts
  • Other key stakeholders

For more information on the group involved in conducting a Fatigue Risk Assessment, please see Governance, Responsibility & Accountability

If you believe you are at risk of suffering from excess fatigue in the workplace, talk to your immediate supervisor.