The effect of a surgeon's leave on operative outcomes

The fatigued surgeon has become an object of public concern. This concern has driven great changes in working practice, both in Europe and North America. The effects of acute sleep deprivation and the acutely fatigued state it produces have been studied to a degree. The effects of the inevitable chronic fatigue that a busy clinical practice produces have not yet been addressed. A break from clinical service might enhance performance by providing a much-needed rest. On the other hand, there is reasonable concern that a break from operating might adversely affect performance, by erosion of technical skill. To evaluate the effect of a break from clinical work, we looked at the impact of seven days or more of annual or study leave on the performance of cardiac surgeons.