Comparison of sleep, fatigue and burnout in Post-Graduate Year 1 (PGY1) residents and faculty members – A prospective cohort study

Aim: We aimed to combine self-report measures with physiological measures (using a wrist actigraph) to compare and quantify the difference in activity levels, sleep, fatigue and professional quality of life between residents and faculty. Methods: All year 1 post-graduate (PGY1) residents and faculty were invited to participate. Participants were required to wear a wrist actigraph for four months, and complete two validated surveys (i.e. Epworth Sleepiness Scale(ESS) and the Professional Quality of Life(ProQoL)) once each at the start and again at the end of the study. Results: Forty-nine PGY1 residents and eleven faculty participated. Residents logged less sleep in a working day than faculty, with median (range) of 356 (114-630) minutes versus 393 (162-704) minutes (p=0.001). Residents had decreased sleep latency, with a shorter median time to fall asleep (6 versus 7 minutes) (p=0.001). Residents walked more, with median (range) daily steps of 10207.5 (280-26638) versus 8155 (481-31236) (p=0.001). At study start and end, residents (61.5%, 69.2%) and faculty (30%, 44.4%) both reported ESS>10, suggestive of excessive daytime sleepiness (p>0.05). Residents reported higher burnout scores compared to faculty; 34.9% versus 0% (p=0.024) and 23.1% versus 0% (p=0.304), and lower compassion satisfaction scores; 25.6 vs 0% (p=0.095), 37% versus 0% (p=0.039), for both time points. Conclusion: Although faculty sleep more than PGY1 residents, they are similarly at risk of fatigue. However, faculty experience lower burnout and higher compassion satisfaction scores. Whilst lack of sleep and fatigue can contribute to burnout, faculty likely possess protective mechanisms, which residents have yet to acquire.