Junior doctors are being put at increased risk of road traffic accidents because of exhaustion.
Long hours increase doctors risk of traffic accidents
A survey of 1,619 junior doctors by the Royal College of Physicians found that one in six had a road traffic accident when commuting in 2004-05.
Returning from a night shift was found to be most risky, although half of accidents happened on the way to work.
The College warned that working patterns were to blame with doctors doing too many night shifts in a row.
The annual survey of specialist medical registrars found that 264 of the doctors questioned had a road traffic accident - 134 when driving to work and 130 when returning from work.
Although more of the doctors who crashed on their way home had been working a day shift rather than a night shift, the overall risk of crashing was far higher for those who had worked through the night.
Doctors only work about one night in 10, but 56 of the doctors who reported an accident on the way home were returning from a night shift and 74 from a day shift.
The introduction of the European Working Time Directive in 2004 means that doctors no longer work more than an average of 56 hours in a week.
But the RCP said despite attempts to reduce working hours, poorly designed rotas left almost half of doctors working seven 13-hour shifts in a row, resulting in a 91-hour week.
It recommends hospitals switch to a nine-hour shift pattern rather than 13 hours, with fewer shifts in succession.
Professor Ian Gilmore, President of the RCP, said: "Patient and doctor safety is being compromised by current junior doctor rotas, but the good news is that we have workable evidence-based solutions to offer acute hospitals around the country."
Professor Roy Pounder, the RCP lead on the European Working Time Directive said rotas which included seven 13-hour shifts were "clearly not sensible".
"Evidence from around the world shows that night shifts are the most dangerous for having accidents. Your first shift is the safest and every consecutive shift after that increases your risk - seven shifts in a row is the worst thing you can do for accidents."
The Department of Health has already issued advice stating that rotas with seven consecutive night shifts should be avoided.
But Professor Pounder said this advice had not been actioned.
Dr Andrew Rowland, vice-chairman of the BMA Junior Doctors Committee, said: "These figures are very worrying. Not every NHS Trust has done everything it could to safeguard the safety of its medical staff.
He said many hospitals had removed junior doctors' rest rooms.
Dr Roger Duckitt, a specialist registrar in acute medicine in Worthing, Sussex was knocked off his motorbike on the way home from a night shift by a car pulling out from parked traffic.
"I'd like to think there's nothing I could have done but you do wonder if you would have been a bit more sharp and braked quicker."
"When you get in your car you start to unwind and it's a combination of tiredness and thinking about what's happened in the night. I was lucky but I have heard about a doctor who died in a crash on the way home from work."