Why Medical Residency Programs Are Facing Growing Pressure to Change

As thousands of incoming medical students prepare to enter the profession, many are already expressing anxiety not about exams or patient care—but about residency. The path to becoming a licensed physician has long been regarded as one of the most grueling professional journeys, and for good reason. Data from multiple studies show that nearly 43% of young doctors in residency programs screen positive for depression, a statistic that’s raising alarms about the sustainability of the system.

Medical residency, the years-long training that follows medical school, was designed to turn theoretical knowledge into hands-on practice. But in reality, it has become synonymous with long hours, sleep deprivation, relentless stress, and a work culture that can be isolating at best and traumatizing at worst. For many, residency has become the defining barrier between future healthcare workers and a long, healthy career in medicine.

“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 healthcare technology company DoorSpace.

Worthy’s perspective is one that’s increasingly shared by both students and professionals across the healthcare field. The expectation to work 80-hour weeks—or longer—without adequate sleep or recovery time has led to a troubling norm: residents not only struggle with mental health but also fear speaking up about it. Many worry that admitting burnout or asking for help could affect their evaluations or chances of advancement.

This fear has real consequences. Numerous studies have found that exhausted residents are more likely to make medical errors, suffer from anxiety or depression, and ultimately leave the profession altogether. At a time when the United States is already grappling with physician shortages, this is a risk the healthcare system cannot afford to take.

What makes the current residency structure even more controversial is how little it has changed since its creation over a century ago. Despite advancements in technology, data-driven care, and patient-centered treatment models, the residency format remains rigid and hierarchical. Critics argue that this outdated model doesn’t align with modern understandings of work-life balance, mental health, or even optimal learning environments.

At the heart of the issue is a cultural expectation that stress and overwork are a rite of passage. Many attending physicians and program directors who endured the same hardships in their own training are resistant to change, perpetuating a cycle of institutionalized burnout.

Yet, pressure to reform is mounting—not just from within the field but also from patients and policy advocates. Reform proposals range from reducing shift lengths and capping weekly hours to incorporating more mental health support, mentorship programs, and even tech tools to track and address signs of burnout early.

Some programs are starting to pilot more humane approaches. A handful of teaching hospitals have begun offering flex-time options, mental health days, and peer support groups. While these efforts are still in their infancy, early feedback suggests they could improve both trainee wellbeing and patient safety.

Sarah M. Worthy and others advocating for change believe that reforming residency isn’t just about protecting young doctors—it’s about ensuring the future of healthcare itself. A profession that eats its young, she argues, won’t be sustainable in the long term.

“This isn’t just a workforce issue—it’s a public health issue,” Worthy has said in interviews. “We can’t afford to keep losing promising physicians to systems that break them before they even get started.”

As the next generation of medical students begins their journey, many are hopeful that change is finally on the horizon. But until reform becomes more widespread and systemic, the warning signs remain clear: without urgent action, the medical field risks burning out the very people it needs most.