Nigerian Surgical Trainees' Work Schedule: It is Time for a Change!

Abstract

Background: Unregulated work schedules have deleterious effects on trainees' productivity and patients' safety. For these reasons, duty hours have been capped in many developed countries. Such regulations, however, appear to be lacking in many parts of Africa, and the effects of unregulated work hours in this part of the world have only been scantily documented. This study evaluated the work schedule of Nigerian surgical trainees, and its impact on their wellbeing, as well as assessed the perception of trainees towards capped duty hours.

Methods: A cross-sectional survey of 650 Nigerian Resident Doctors in surgical specialties was conducted in November 2020. Enquiries were made about their work schedules using a purpose-designed questionnaire, developed using Google Forms^®. The data were analysed using the IBM SPSS version 23.

Results: The mean weekly work hours of surgical residents was 122.72 ± 34.17 h. Majority (228, 40.4%) of the residents had cumulative call hours of ≥ 72 h per week. One-half (283, 50.1%) of them worked continuously for up to 48-72 h during calls, with mean daily sleep hours of 3.53 ± 1.42 h during calls. The majority (558, 98.8%) of respondents had post-call clinical responsibilities. Seventy-five percent of the respondents reported hazards from prolonged work hours, and an overwhelming majority (530, 93.8%) desire official limits on work hours.

Conclusion: Prolonged, unregulated work schedules appear to be the norm among Nigerian surgical trainees. This trend calls for urgent measures, to avoid potentially catastrophic consequences on both physicians and patients.