A gender-based analysis of work patterns, fatigue, and work/life balance among physicians in postgraduate training

Acad Med. 2010 Sep;85(9):1526-36. doi: 10.1097/ACM.0b013e3181eabd06.


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 > or = 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Burnout, Professional / epidemiology
  • Burnout, Professional / prevention & control
  • Chi-Square Distribution
  • Fatigue / epidemiology*
  • Female
  • Humans
  • Internship and Residency*
  • Job Satisfaction
  • Logistic Models
  • Male
  • New Zealand / epidemiology
  • Occupational Health*
  • Parenting
  • Physicians / psychology*
  • Physicians, Women / psychology
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Sleep Deprivation / epidemiology
  • Surveys and Questionnaires
  • Work Schedule Tolerance
  • Workload*