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Hours, sleep, teamwork, and stress

BMJ 1998; 317 doi: (Published 14 November 1998) Cite this as: BMJ 1998;317:1335

Sleep and teamwork matter as much as hours in reducing doctors' stress

  1. Jenny Firth-Cozens, Director (,
  2. Fiona Moss, Associate dean of postgraduate medicine
  1. Centre for Clinical Psychology Research, University of Northumbria at Newcastle, Newcastle upon Tyne NE1 8ST
  2. North Thames, Thames Postgraduate Medical and Dental Education, London WC1 N3J

    For every complex problem there is a simple solution … and it's wrong H L Mencken    

    Many studies show that the quality of patient care can be severely affected by the stress levels of clinical staff, particularly doctors.1 We know too that doctors suffer high levels of stress and depression,2 more so than other workers.3 Strategies aimed at resolving the working difficulties of British doctors in training have been concerned primarily with the long, often excessive, hours worked. Following tough central directives and hard work by local task forces, many doctors now work fewer hours than five years ago. Has this reduced stress levels—or is there more to be done?

    Hours of work are easy to measure and as a strategy of stress reduction reducing them has an attractive logic. However, very little evidence confirms a relation between the number of hours worked and the level of stress or depression experienced.1 Moreover, other factors cause junior doctors greater stress than hours alone—for example, difficult relationships with senior doctors.4 Not surprisingly therefore recent studies show stress levels to be …

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