Sleep deprivation¹ is an issue that affects practising physicians and not only medical residents, and we need to establish standards for maximum work and minimum uninterrupted sleep to ensure patient safety, states an editorial in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj110402.pdf. A recent study indicated that lack of sleep can result in higher rates of surgical² complications（并发症） if a surgeon had less than six hours of sleep the preceding（在前的） night. Doctors practising post-call may not be at optimal³ levels as fatigue⁴ can effect mental acuity⁵.

"The problem may only be getting worse," write CMAJ editors Drs. Noni MacDonald, Paul Hébert, Ken⁶ Flegel and Matthew Stanbrook. "Medical care today is more complex than in decades past….Increasing complexity⁷ of care at the bedside or in the operating theatre places unprecedented⁸ cognitive⁹ and physical demands on doctors who oversee¹⁰ and deliver care in these environments."

However, there are barriers to limiting physicians' work hours, including increased costs and the need to increase the number of doctors and residents in the system. As well, ensuring that physicians comply with restrictions¹¹ on work hours may be a challenge.

"We doctors ourselves are part of this problem," write the authors. "We need to shift our professional culture. Long periods on call should not be accepted as routine or a source of pride."

They suggest that "licensing¹², accreditation¹³（委派，信赖） , insurance and government institutions need to establish minimum best practice standards for maximum work and minimum uninterrupted sleep hours."