LAUSR

Inadequate sleep negatively affects decision-making. The extent to which it may affect medical residents' performance on the In-Training Examination (ITE) is unclear. Research from Weeks et al., 2021 showed that each hour of sleep a medical resident received prior to the ITE, increased their odds of scoring over 70% on the exam by 25%. A typical resident sleeps six hours a night, which is less than the recommended seven to nine hours a night. Associations between COVID-19 and sleep disorders are more prevalent among healthcare workers. We aim to correlate pediatric ­residents' habits and COVID-19 status with their 2022 ITE scores. A cross-sectional, 10-question, electronic, and anonymous survey was sent to the pediatric residents (N=74) in our program. Fisher’s exact test was used to assess the correlation between ITE score less than 70% and rotation at the time of the exam, COVID-19 status, caffeinated beverages, and exercise. Linear regression model was used to analyze the impact of these variables on ITE scores. All statistical tests were two-sided, and p< 0.05 was considered statistically significant. Our methods were limited by a small sample size and recall bias. A total of 37(50%) residents completed the survey and were included in the analysis. Of those residents, 27(73%) sleep 6-7 hours/night, 9(24.3%) use melatonin regularly, and 23(62.2%) drink caffeine daily. Residents diagnosed with COVID-19 before the 2022 ITE scored significantly lower on the ITE. (-12.1, 95% CI[-23.9, -0.27], p=0.045. There was not any significant association between ITE score less than 70% and rotation (p=0.79), caffeinated beverages (p=0.41), and exercise (p=0.99). ITE scores of pediatric residents in our program were not significantly influenced by exercise, caffeine consumption, or rotation at the time of the exam. Interestingly, residents who tested positive for COVID-19 before the 2022 ITE displayed significantly lower scores. This finding is in line with a limited number of prior studies pointing to possible long-term cognitive consequences associated with this infection. To better understand this association, we suggest a larger study incorporating sleep hours the night before the exam and COVID status.