In a small study published Monday in the Annals of Internal Medicine, researchers found that not getting enough sleep hurts the ability of fat cells to respond to insulin efficiently. So sleep isn't only about restoration (real "rest") but also abut cellular function and the processing and utilization of glucose.
We just don't get enough sleep in training. There is no time to actually get restorative sleep when you work 80-100 hours per week. The hospital acknowledges that burnout among nurses is directly correlated with working more than 40 hours per week and monitors that closely. While I thought it was all about quality time with significant others, nutrition, and quality of life, turns out it's also about good sleep.
Fact is, any system of training that includes the hazing phenomenon of decreased sleep and lower quality of life only produces tired clinicians with a propensity to glucose intolerance. It hasn't worked so far to produce great physicians and more importantly may be the prime cause for physicians leaving the profession in record numbers with many remaining very unhappy.
To what extent it is about sleep, quality of life, and other restorative processes is largely unstudied, but I know now that all the fatigue I see around me isn't good for the person, let alone patient care. It's really time to stop the madness that is post graduate medical education in this country. Who knows; With some real effort to reform the system, maybe we'll actually improve the system.
Nah. I hallucinated there for a moment.
Let us not look back in anger or forward in fear, but around in awareness. 
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