In step with the 14th annual National Resident Awareness Week, we are working across the province to let the public know about the important role resident doctors play in our healthcare system.

There are over 1,200 resident doctors working across British Columbia. While the majority are in Greater Vancouver, there are residents from Penticton to Peace Liard. Residents are doctors who, having already completed medical school, are undergoing specialty training in areas such as family medicine, surgery, and internal medicine. We work in clinics and hospitals as the first point of contact for patients, and we are often the doctors who provide overnight patient care.

Residency training lasts 2-6 years, depending on our chosen specialty. While our work hours vary greatly from month to month, we typically work 40-100 hours per week, with on-call shifts lasting 24-30 hours.

Our work hours have been the subject of significant controversy in recent years. Many people wonder whether a doctor in training (or any doctor for that matter) working 24 hours continuously is able to provide safe and effective care for patients, and whether our working conditions have a detrimental effect on our well-being.

The drawbacks of working such hours are clear: research has shown long work hours are associated with burnout, and residents who work longer hours are more likely to be in car accidents. Sleep deprivation also negatively affects our work: it reduces our ability to solve problem, and interferes with our ability to empathize with our patients and their families. Sleep deprivation increases our risk of depression and other psychiatric disorders, and tragically, in the past year colleagues in both Canada and the U.S. took their lives.

On the other hand, residents also need the experience that comes with working long hours. Working in a hospital overnight provides important exposure to a variety of patient problems. Being on call also challenges us to develop and exercise our clinical judgment independent of our supervisors, who review our cases after we have initially seen them. The extra hours also help ensure B.C.’s major hospitals run effectively, as residents make it possible to provide cost-effective care to the staggering number of patients served every day and night.

Resident duty hours are not standardized and vary by province. The U.S. and Quebec have limited the number of hours a resident can work in a day to 16 hours. But the results of dozens of studies suggest that for surgical residents, limiting work hours doesn’t translate into a clear improvement in wellness or burnout, and our education suffers from less time spent with senior doctors and in the operating room.

Most important, research suggests a tired doctor is not necessarily an unsafe doctor. While we don’t have enough studies to conclusively determine what the relationship is between longer hours and patient safety, the bulk of the evidence suggests it is a complicated relationship. It’s not clear what is better for patient care: being cared for by a tired doctor who knows everything about your case, or being cared for by several doctors and risking errors as information is transferred from one person to another.

Duty hours are a topic of great interest to Resident Doctors of B.C., whose purpose is to support residents throughout their training. This includes supporting and promoting resident professional and personal well-being, and as such work hours will continue to be a matter of careful deliberation from year to year.