Article Text

Download PDFPDF

The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support
  1. M Brown1,
  2. P Tucker1,
  3. F Rapport2,
  4. H Hutchings2,
  5. A Dahlgren3,
  6. G Davies4,
  7. P Ebden4
  1. 1Department of Psychology, Swansea University, Swansea, UK
  2. 2School of Medicine, Swansea University, Swansea, UK
  3. 3Department of Shipping and Marine Technology, Chalmers University, Gothenburg, Sweden
  4. 4Singleton Hospital, Swansea, UK
  1. Correspondence to Philip Tucker, Department of Psychology, Swansea University, Swansea SA2 8PP, UK; p.t.tucker{at}


Background The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms.

Method Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being.

Results Four main themes were identified. Under “Doctors shift rotas”, doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. “Education and training” focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. “Work/life balance” reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. “Social support structures” focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules.

Conclusions The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.

  • Shift patterns
  • junior doctors
  • fatigue
  • patient care
  • safety
  • qualitative research

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

View Full Text

Statistics from


  • Funding The study was funded by a grant from the Wales Office of Research and Development for Health and Social Care, part of the Wales Assembly Government (reference: ReF06/2/ 220). All researchers involved in this study were independent of the funding organisation. The funding organisation had no involvement in the conduct or reporting of this research.

  • Competing interests None.

  • Ethics approval The study was granted ethical approval by Multi-Centre Research Ethics Committee for Wales (MREC) on 8 March 2007 (reference: 07/MREC09/18).

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.