Driving Safety Among Surgical Residents in the Era of Duty Hour Restrictions
*Danielle R Heller, *Mollie R. Freedman-Weiss, *Alexander S. Chiu, Raymond A. Jean, Peter S. Yoo
Yale University School of Medicine, New Haven, CT
OBJECTIVE: Fatigued driving is a known contributor to adverse motor vehicle events (AMVEs), defined as crashes and near misses. Surgical trainees work long and irregular hours, even within duty hour constraints. We assessed the impact of fatigue on driving safety and perspectives on a funded ride program among surgical residents at our institution. DESIGN: Electronic, anonymized survey. Chi-Square testing determined categorical differences. SETTING: University-based General Surgery residency with 4 distinct urban clinical sites. PARTICIPANTS: 61 of 75 General Surgery residents (81%), PGY 1-5. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: AMVEs during work-related driving; Frequency of fatigue and falling asleep while driving; Use of hired rides and interest in funded rides as a potential solution. RESULTS: Ninety-seven percent reported that fatigue compromises their safety while driving to or from work. Eighty-three percent reported falling nearly or completely asleep, and 22% reported AMVEs during work-related driving. Junior residents (PGY 1-2) were more likely than seniors (PGY 3-5) to drive fatigued on a daily-to-weekly basis (69% vs 47%, p=0.02) and twice as likely to fall asleep on a weekly-to-monthly basis (67% vs 33%, p=0.02). Despite this, only 3% of residents have hired a ride service when fatigued; 88%, however, would use a free ride service if provided. CONCLUSIONS: Work-related fatigue impairs the driving safety of nearly all residents, contributing to an unacceptably high rate of AMVEs. Juniors are disproportionately affected. Despite ample data correlating fatigue with AMVEs, and near universal self-reporting of fatigued driving among residents, few residents hire ride services. Eliminating the cost barrier by funding free ride programs may protect surgical trainees and other drivers. Studies of AMVE rates after implementing such programs are indicated.
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