Residency Blog Posts

I've cried in bathrooms for a lot of reasons throughout residency: acute-on-chronic stress, feelings of inadequacy, the relentlessness of morbidity, and just plain exhaustion. What got me this time was this: no matter how much you give of yourself to residency, it will never be enough. We are all highly replaceable, and systems and institutions won’t ever love us back.

Huge news out of the American Medical Association this week: resident physician burnout is down to 28.6%! Of course, not long ago, the AMA was reporting that 50% of residents were experiencing burnout, but now thanks to this new AMA-exclusive survey and data analysis, the burnout rate has been cut in half in just 2 years!

The Pitt is far and away the most accurate depiction of residency I've seen on TV. But there's a moment in Season 2 where the Internet’s reaction — and what the show itself seems to say —doesn’t line up with what I’ve seen in my 6 PGYs. 

I find myself lingering at her tombstone. I must go. More patients to see. But walking away feels disrespectful. What if I get too busy again to come back? I want her to know I remember.

What happens when a residency program closes and is replaced by an army of NPs and PAs? We found out in 2019. The neurosurgery residency program at the University of New Mexico lost its accreditation, leading to a staffing scramble. Replacing 7 residents at $70k per year required hiring 23 NPs and PAs at an average of $115k per year.

One day, a medical student asks me what it’s like to be a resident. I tell them it’s an incredible opportunity to learn at an accelerated pace. They ask if it’s hard. I tell them no, it’s actually very fair. After all, I am not an employee. I am a Learner. A 28-year-old Learner with a doctoral degree, six figures of debt, a full patient load, and just enough authority to be accountable but not enough to matter. It’s just like medical school, except better. They seem reassured.

The conversation around The Match has been artificially flattened into a false binary. That we can either keep the system as is, or dismantle it entirely. But that’s not how labor markets work. It’s also not how reform happens. Meaningful change to the current system will likely take years, but this is the time that we should be organizing and advocating for better alternatives. Let’s consider some of them.

The Match almost guarantees that programs will not be incentivized to continually improve and raise the standard of training. If there is no risk of missing out on new residents, or very low risk of current residents leaving, then there are no pressures to improve or even maintain a certain level of training. 

If you do not secure a position during the early Scramble, the process is not over. Openings continue to appear throughout the year. I obtained my general surgery position outside the match on July 14th and started residency a month later. I was able to make up for this time and still graduate with my medical school cohort by limiting the vacation I took throughout 5 years of residency; anything is possible! 

A good mentor helps you navigate the tension between ambition and realism, offering guidance that challenges you without defining you. Seek coaches, not cheerleaders, and you’ll not only grow as a physician, but learn how to mentor others with the same honesty and care.

Will medicine ever be willing to admit that calling resident labor ‘training’ only makes it easier to underpay, overwork and restrict the people doing it? Probably not on its own. But with enough people demanding change, there may be a blueprint for how the power imbalance can shift back towards the residents themselves.

Welcome to Multi-D, where I interview colleagues in different specialties. We’ll explore common specialty misconceptions, and ask–what do you wish other specialties knew about yours?Today we’re joined by Maheetha Bharadwaj, who specializes in urology!

Residency was never designed with lactating physicians in mind–nor should it be. We're certainly the minority. As medical education and training evolve, it's time to make breastfeeding "okay" for residents. 

Beneath the victory lap in some of these “I proved them wrong” videos lies a deeper nuance worth unpacking: first, the trap of building your choices around “proving them wrong,” and second, the role of a good mentor: someone who tells it like it is and gives balanced guidance, even when the odds are steep.

Even though I won’t be an attending until my late 30s, I don’t consider myself “behind” by any measure. Focusing on what I value, rather than chasing what’s conventional, has made this journey deeply rewarding.

Because somewhere between the exhaustion and the uncertainty, there’s still that quiet spark — the one that made me want to do this in the first place.

Welcome to Multi-D Specialty Board, where I interview colleagues in different specialties. We’ll explore common specialty misconceptions, and ask - what do you wish other specialties knew about yours?

When I applied to Family Medicine, the hardest part was narrowing down over 700 programs.‍ For dermatology, the hardest part was the math: a match rate under 50%, and even lower for prior-year graduates.

Ever since I started sharing my journey switching residencies, the number one question I receive is: “How did you tell your program director? And how did they react?” 

When my patients left with new diagnoses, I sometimes felt like I had drained the joy out of their visit. That’s when I started questioning whether I could do this work for the rest of my career.

How did I make this decision feel less overwhelming? By breaking down these daunting, existential questions (Am I wasting years of my life away? What happens if I don’t match?) into concrete yes/no questions. 

High-achieving women are familiar with facing challenges, and pursue them without hesitation. However, the reality is that dating should be the opposite of this. There is no challenge that needs to be pursued - no nosebleed that we must stop.

Acne carries a huge psychosocial burden and is linked to higher rates of depression and anxiety, so offhand comments can be damaging and can deter talented medical students from applying to dermatology. This was almost the case for me.

If a resident is having a rough time, the classic advice is to ‘keep your head down and wait it out.’ But is that all that a resident can do? Does that advice help when dealing with complicated interpersonal issues either relating to attendings in the department, consulting services, or staff and nurses? Having an understanding of people’s motivations and the way in which they are viewed by an organization at large can help someone at the resident level navigate this complicated world and better position themselves to come out relatively unscathed on the other side.

This is the part of the story most people don’t talk about. Electroconvulsive therapy (ECT) still carries a brutal stigma, even though it can be lifesaving. This is one of the most honest accounts you’ll ever read: not just about ECT, but about the fear of losing your mind, your work, and your place in the world. And what happens when you start to come back.

We talk about mental health in medicine, but too often reduce it to faceless data points. Pediatric intensivist Juliana Romano, MD, reminds us that behind every statistic is a name, and behind each one is a story. A story about what it means to speak up or stay silent. To reach for help or disappear. To choose to live. This is hers.

Weighing the pros and cons of refinancing student loans during training, offering guidance on when it makes financial sense.

A resident reflects on the mental health crisis in medicine - exploring stigma, burnout, and how to build a culture that supports physician well-being.

An OB/GYN resident shares the emotional and professional challenges of balancing medicine and motherhood - and how each role deepens the other.