Surviving Tactics of Medical Interns Countering Long Working Hours: A Systematic Review

Abstract

Back-ground: The stressful working environment and prolonged working hours of medical interns; leads to lack of concentration, distress and higher level of fatigue leading to self-perceived medical error. Objective: This review was done to find out various coping tactics used by medical residents of diverse specialties, to overcome the effect of long working hours. Method: This literature search has been done on the protocols of PRISMA-P; (preferred reported items for systematic review and meta-analysis protocol). A comprehensive literature search has been done to understand the impact of extended duty time, on doctors in training, and finally the counter measures used by them. Data was collected from published research articles, on three databases (PubMed, ERIC and Psycinfo) and one academic search engine, google scholar. All full text English articles published in peer reviewed journals were included. Studies having Qualsyst score of ≥ 0.6 were included in literature review. Results: Four main themes have emerged; including, problem-based coping, maladaptive coping, coping at personal level and work-related coping skills. Studies showed that physician used coping mechanism including acceptance, mindfulness, spirituality, taking breaks from work, socializing, provocative & leisure activities. Physicians manage their stress at individual level by strategic planning for future, meditation, exercise, gratitude and healthy relationships with friends and family, rarely, mental health care is required. Moreover, self-sacrifices and re-balancing personal priorities were basic coping at workplace. Conclusion: A collaborated program of cognitive behavioral, mindfulness and coping skills should be adopted, implemented, and studied for residents at post-graduate level.