Does More Sleep Make for Better Doctors?

I have to agree with Dr. Pauline Chen in her concerns over limiting residency hours. Ophthalmology took over "my life" during my residency. It was as exhilirating as it was tiring...
Then I went and spent 8 years overseas, where I worked even harder than during my residency...
As Malcolm Gladwell points out in his most recent book, "The Outliers,"one needs 10,000 hours to be world class in any skill. I got that in my residency and overseas experience I feel...

This week a national panel of health care experts released a report affirming the current mandate that limits the workweek for medical residents to 80 hours and offering additional recommendations to decrease fatigue for doctors-in-training.
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Residency training, the three to seven or more years following medical school, has historically been the most intense period of a doctor’s professional life. In teaching hospitals and large academic medical centers across the country, freshly minted doctors balance learning myriad clinical skills with serving on the clinical front line. Residents are often the first doctors to see a patient in the admission process and in hospital emergencies. And up until relatively recently, they shouldered these responsibilities while working 110 hours a week or more.

I finished my general surgery training in 1998, five years before the national accrediting organization for residency programs set a limit of 80 hours per workweek for residents across the country. I worked on average 110 to 120 hours per week and had my share of being on call every other night. Like many of my peers, I know about fatigue so overpowering that the odor from your pores smells not like nervousness or exertion but exhaustion. I have experienced the teeth-chattering chill of the early morning, which never leaves despite two layers of clothing, a sweatshirt and a doctor’s coat. I remember that falling asleep at 5 a.m. for an hour before rounds does more harm than good. And I can tell you that a quick but well-timed morning shower after being up all night is the physiological equivalent of a two-hour nap.

This is not the kind of wisdom or experience I think anyone should ever have.

But I can also say that I, like many of my peers, had unparalleled experiences and freedom in residency because our time with patients was not restricted. And a part of me, I have to admit, feels badly for the young doctors and future patients who may not have a chance for the same because of the way we choose to address the problem of resident fatigue.