Perils of the Fatigued and Sleep Deprived Doctor


Perils of the Fatigued and Sleep Deprived Doctor

We would like to express our deepest condolences over the recent passing of Dr Nurul Huda Ahmad, a paediatrician in training who was involved in a motor-vehicle accident (MVA) on 9th May 2017 in Kuala Terengganu.

Her accident is the latest involving a medical officer who was driving home post-call, after completing nearly 33 hours of duty. Prior to this, we lost another of our colleague, Dr Afifah Mohd Ghazi in a similar nature of accident. It is high time for actions to be taken to prevent the loss of more innocent lives.

In relation to MVAs, we recognise that there are many contributing factors namely vehicle issues, poor road conditions and distraction among others. However, we cannot exclude the fact that fatigue or sleep deprivation is a recognisable and preventable factor in MVAs.

In 2015, the Islamic Medical Association of Malaysia (IMAM) and Pertubuhan Amal Perubatan Ibnu Sina Malaysia (PAPISMA) published a survey among healthcare professionals about post-call MVAs. The survey which obtained 440 respondents over a space of 18 hours revealed that more than half of the accidents (54.8%) occurred after working for 25-36 hours. In addition, 64.8% of the respondents admitted to suffering from psychological trauma following the accident.

Despite its limitations, the survey highlighted the need for further investigations into the correlation between MVAs and the preceding hours of duty.

The effect of healthcare workers’ fatigue and motor vehicle accidents have been similarly studied elsewhere (CP West et al 2012, Arnedt JT et al 2005, Barger LK et al 2005).

After serving the compulsory 24 hours on-call duties, most medical doctors would have to continue their duties for a further 4-10 hours. The stress of working combined with sleep-deprivation definitely invites exhaustion and fatigue. Sleep deprivation is one of the recognised factors for MVAs and is comparable to the state of intoxication induced by alcohol (Kowalenko al 2000, Barger LK et al 2005, CP Landrigan et al 2008)

In order to prevent the loss of another innocent life within the medical fraternity, we hereby urge the Ministry of Health and the respective stakeholders to:

1) set up a dedicated task-force involving multiple stakeholders from the Ministry of Health, Ministry of Transport, universities and medical NGOs to investigate the incidents of MVAs among healthcare workers and it’s correlation with their working hours;

2) establish a “Safe Working Hours” law or act to safeguard our healthcare workers and the public at large;

3) instill awareness in the form of campaigns and active engagements with healthcare workers on safety measures in the event of tiredness and sleep deprivation;

4) provide alternative transport facilities or shuttle services from the hospitals to certain designated drop off points;

5) provide compulsory “post-call off” or “day-off” for night-shift healthcare workers or on-call doctors.

With the consolidation of efforts from all parties, we can together ensure the well-being and welfare of our health care professionals and prevent another human tragedy.

Issued by:

Dr Jeffrey Abu Hassan, President of Islamic Medical Association of Malaysia (IMAM)

Dr Chew Chee Ming, President of Malaysian Medical Association (MMA)

Dato’ Dr Suhaini Kadiman, President of Pertubuhan Amal Perubatan Ibnu Sina Malaysia (PAPISMA)

Dr N.Thiyagar, President of Malaysian Paediatric Association (MPA)

Dr Muhamad Hazizi Bin Muhamad Hasani, President of Malaysian Integrated Medical Professionals Association (MIMPA)

Dr Muhammad Hakim Nordin, President of Malaysian Doctors Club (MDC)

Dr Abdul Halim bin Shibghatullah, YDP of IkramHealth of IKRAM

Dr Ahmad Firdaus Bin Mohd Haris, President of Medical Mythbusters Malaysia

Dr Zul Azlin Razali, President of Green Crescent Malaysia

Khairul Hafidz Alkhair bin Khairul Amin, Chairman of Medical Twitter Malaysia (MedTweetMY)


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