A Race Against the Grain to Residency Reform

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A medical resident’s life is defined by numbers. 80-hour weeks. 28-hour shifts. Little to no sleep. This relentless schedule lasts for three to seven years, depending on their specialty, meaning young doctors spend the majority of their 20s and early 30s in a constant state of exhaustion. A single resident can see up to 20 patients per shift, making critical medical decisions while running on fumes. With nearly half of medical residents experiencing burnout, many are questioning whether this outdated system is truly preparing physicians… or just breaking them.

For decades, the grueling nature of medical residency programs has been seen as a rite of passage—an unrelenting trial by fire that tests aspiring physicians’ endurance, commitment, and ability to handle the pressures of the medical field. But in recent years, growing concerns about resident well-being, patient safety, and overall effectiveness have fueled calls for urgent reform.

Medical residency programs are designed to provide hands-on training in a hospital or clinical setting, preparing physicians for the realities of patient care. However, for many, residency becomes an exercise in survival rather than learning. Long shifts, sleep deprivation, and intense pressure to perform at all times create an environment where burnout is inevitable.

“While eliminating residency programs entirely might not be realistic, reforming them is absolutely necessary. The current structure demands grueling hours and relentless stress, creating a system that breeds burnout instead of fostering well-rounded, effective physicians. Not to mention, they’re unnecessarily competitive. We’re asking young doctors to sacrifice their physical and mental health to prove their commitment, but at what cost?” asks Sarah M. Worthy, CEO of DoorSpace.

The argument for reform is straightforward: overworked doctors are not better doctors. 

We wouldn’t allow a truck driver to be on the road for 28 hours straight, but we expect a resident to make life-or-death decisions after working that long? This program structure encourages a culture of exhaustion and turmoil and disguises it as resilience. In reality, the long-standing belief that suffering through brutal working conditions is necessary to produce capable doctors is not enduring; it’s dangerous.

Excessive work hours do not translate to better training or stronger medical skills. Instead, they create an environment where doctors are too exhausted to absorb new information, make clear-headed decisions, or even retain their passion for medicine. Many residents find themselves running on autopilot, moving from patient to patient in a haze of exhaustion, rather than engaging deeply in their training. 

“With program caps in place, the competitive nature of these programs adds a weight of stress. This year, over 50,000 potential physicians applied for residency, yet only approximately 41,000 landed a spot; closing the door on thousands of needed future doctors. We need a system that balances rigor with humanity, one that focuses on practical skills, emotional resilience, and long-term sustainability,” adds Worthy.

Residency doesn’t just affect doctors during their training years; it has long-term consequences on career satisfaction and longevity in the field. Burnout is a leading cause of early exits from the medical profession, with many young doctors choosing to leave medicine altogether due to the intense demands of their training. Given the physician shortages already facing the U.S. healthcare system, creating a more sustainable residency model isn’t just about protecting young doctors—it’s about ensuring that hospitals and clinics have enough trained professionals to care for future patients.

Worthy shares: “Dr. Nakita Mortimer was a resident physician at Montefiore Medical Center who killed herself in May of 2023. She was brutalized by the residency program and her colleagues felt that unduly pressure well past her death. Residency should be about growth, mentorship, and preparing physicians to deliver the best care possible.” 

Residency programs exist to train the next generation of physicians, but the current system does more harm than good. Forcing young doctors to endure exhaustion and burnout doesn’t make them better—it makes them more likely to leave medicine or, worse, make dangerous mistakes. Reforming medical training isn’t about making it easy; it’s about making it effective, humane, and sustainable. As more voices call for change, the medical community must finally acknowledge that overwork isn’t a badge of honor—it’s a liability.