Enabling and encouraging sleep deprivation among medical students

Abstract

We begin this editorial with a brief acknowledgement. Joanna Margaret Bates died January 18, 2020 after a long and prosperous career in family medicine and medical education with the University of British Columbia. She was a giant in her area, and few people in Canadian medical education were not touched by her scholarship. She will be truly missed. I had been up very early to catch a flight to the US at 7:00 AM. The magazine in the seat pocket drew me in search for an easy Sudoku or crossword. I completed a couple of puzzles then uncharacteristically flipped through the rest of the pages. I was jolted awake by an article about sleep (and the lack, of which I have all too much personal experience). Sleep is a personal and professional interest of mine in the context of medical student wellbeing and burnout. We know that poor sleep is common among medical students, but its prevalence is also higher than in non-medical students and the general population. Non-medical students and the general population are also sleep deprived which puts medical students in a class by themselves. If sleep quality and quantity are distributed among medical students along a somewhat normal curve, then about 15% of that population of medical students is at least one standard deviation worse than the mean. Since medical students are more sleep deprived than the general population, and 15% of them are much worse off, we should be alarmed. Considerable evidence indicates that good quality sleep is important for cognitive and psychomotor performance and physical and mental health. Poor sleep has been implicated in burnout 1,2 and a host of other ill effects. 3 We need sleep, good sleep, and lots of it. 4 Not only are medical students more sleep deprived than the rest of us, 1,3 those of us involved in medical education are complicit in an unspoken, unconscious conspiracy to cover up, minimize, and even boast about poor sleep habits and sleep deprivation. The World Health Organization has compared shift work, a prime driver of sleep deprivation, to first degree carcinogens like cigarette smoking. 4 How ironic, then, that those charged with improving the health of the population themselves have dysfunctional habits 1,5 and attitudes about this most important health and hygiene practice. If I could put the health benefits of sleep into a bottle, I would make billions. We seem to ignore both the immense