In a study of 170 junior house officers who were followed up from their fourth year in medical school mean levels of stress were higher than in other reported occupational groups, and the estimated prevalence of emotional disturbance was 50%, with 28% of the subjects showing evidence of depression. Nearly a fifth of the subjects reported occasional or frequent bouts of heavy drinking, a quarter took drugs for physical illness, and a few took drugs for recreation. Those who were emotionally distressed at the initial study and the follow up were more empathetic and more self critical than those who had low levels of stress on both occasions. Overwork was the most stressful aspect of their jobs, though the number of hours worked was not related to stress levels, unlike diet and sleep. The more stressed they were the more unfavourably they viewed aspects of their jobs. The incidence of distress is unacceptably high in junior house officers, and both they and the hospitals need to deal with the causes of the distress.

Emotional distress in junior house officers.

https://escholarship.org/content/qt8xh0s7nf/qt8xh0s7nf.pdf?t=oyg19p

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

Reduced sleep time is commonplace for many interns and residents. Recent studies, however, suggest that sleep loss and fatigue result in significant neurobehavioral impairments in healthy young adults. We reviewed studies addressing the effects of sleep loss on cognition, performance, and health in surgical and nonsurgical residents. We describe the effectiveness of countermeasures for sleepiness, including recent work-hour restrictions. A more complete understanding of the issues of sleep loss during residency training can inform innovative strategies to minimize the effects of sleepiness and fatigue on patient care and resident safety.

https://jamanetwork.com/journals/jama/articlepdf/195255/jrf10027.pdf

Sleep Loss and Fatigue in Residency Training: A Reappraisal

/pdf/fentanyl-fentanyl-analogs-and-novel-synthetic-opioids-a-22rmyz701i.pdf

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review - eScholarship

The authors propose several simple and inexpensive ways to reduce errors in teaching hospitals. Their suggestions include computerized procedures to sign out patients when residents go off duty, standardized placement and composition of medical charts and equipment, and the replacement of “see one, do one, teach one” with a rational system for training residents to perform procedures.

Residents' suggestions for reducing errors in teaching hospitals.

A study was conducted by the authors to compare cognitive functioning in acutely and chronically sleep-deprived house officers. A multivariate analysis of variance revealed significant deficits in primary mental tasks involving basic rote memory, language, and numeric skills as well as in tasks requiring high-order cognitive functioning and traditional intellective abilities. These deficits existed only for the acutely sleep-deprived group. The finding of deficits in individuals who reported five hours or less of sleep in a 24-hour period suggests that the minimum standard of four hours that has been considered by some to be adequate for satisfactory performance may be insufficient for more complex cognitive functioning.

Sleep and nutritional deprivation and performance of house officers.

Fentanyl citrate abuse among health care professionals.

/pdf/racial-variations-on-the-macandrew-alcoholism-scale-of-the-521szply6b.pdf

David J. Kruzich

Papers

Sleep and nutritional deprivation and performance of house officers.

Fentanyl citrate abuse among health care professionals.

Racial variations on the MacAndrew alcoholism scale of the MMPI

An evaluation and education program for driving while intoxicated offenders

Hematological concomitants of alcoholism: Development and validation of a clinical screening technique