Shift work · Resident physician
Resident physician sleep guide
ACGME caps at 80 hours/week, max 24-hour clinical shifts + 4 hours transition. Reality often differs.
Primary risks
- Medical error rate ~36% higher during shifts > 24 hours
- Needle-stick injuries cluster in the 5th–6th hour of clinical handoff
Strategies that work
- Protect the post-call sleep — no errands, no social events.
- Use the 4-hour transition window: 90 minutes of horizontal time, even if you can’t sleep, restores cognitive function.
- Avoid driving home post-call if you feel any drift; ride-share is cheaper than the alternative.
Nap protocol
A 30–60 minute strategic nap on a 24-hour shift, around 02:00, measurably improves attention into the morning.