Workload and schedule optimization has been the subject of numerous studies in surgery, emergency medicine, and resident education literature.No studies have been done to evaluate the role of fatigue and cognitive efficacy in the neophyte laborist specialty, though increasing patient safety is an underlying assumption of this model of care. Using a validated actigraphy based wristband, ReadiBand, and its proprietary analysis algorithm, SAFTE (sleep, activity, fatigue, and task effectiveness), we attempted to quantify cognitive efficacy of laborists during three types of shifts, patterns of efficacy through different rotations of the schedule, and the impact consecutive night shifts on fatigue.After a targeted fatigue avoidance education session, data were collected again. Patterns of improved efficacy and sleep efficiency emerged, which may have implications for designing ideal laborist scheduling and workflow.