The lifestyle of a medical resident is something that has been a topic of fierce debate for many years. The American medical system is widely known to rely heavily on a large workforce, with medical residents having to shoulder a significant portion of the responsibility at the expense of their well-being. This brings into question the ethics of medical residents participating in this system and the implications of altering their lifestyle. In this piece, I will explore the debate between critics and proponents of the status quo.

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     First, the lifestyle of a medical resident can be defined by understanding their role. Medical residents are newly graduated physicians undergoing specialized training after medical school. This typically entails long hours, back-to-back shifts, and the authority to diagnose, prescribe, and treat patients. Ross University School of Medicine states that the resident life is “challenging, with high expectations, long hours, and often too-little sleep.”1 It is not uncommon for medical residents to work consecutive day and night shifts as part of their rigorous schedules.

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     Working such long hours for a job that requires so much constant decision-making, critical thinking, and hand-on work brings into question the quality of life associated with working this job. This brings us to the critics’ side of the debate, who argue that medical residents deserve better working conditions. One consequence of the arduous lifestyle is depression among medical residents. In one study, researchers found a pooled prevalence of 28.8% for depression or depressive symptoms in medical residents,2 and for medical residents planning to start families, it gets worse. Dr. Emma Bye and her colleagues at the University of Nebraska sought to understand how parental postpartum depression manifests among medical residents. Their study shows that 42% of female residents reported experiencing symptoms of postpartum depression, compared to 11% of females in the general population.3 This result is unfortunately unsurprising given the lack of priority given to medical residents’ mental health and personal lives. In addition to discussing the impact of a resident’s lifestyle on their health, we must also acknowledge medical errors as a potential consequence. 

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     Next, we can discuss the arguments made by proponents of the status quo. We will do so by examining the current medical system and the environment. In the present, medical jobs are hypercompetitive, and many applicants will take on unpaid work to gain relevant experience and to strengthen their credentials. This holds true for undergraduate, medical, and other education levels below residency. Alweis et al. state that hospitals focusing on creating an educational community have medical students who “expand the capacity of the current healthcare workforce of a system by providing coverage during healthcare emergencies, staffing of services in difficult-to-recruit specialties, and decreasing provider burnout”.6 The article discusses provider burnout and turnover specifically in the context of higher-level healthcare providers. 

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     Residents are required to take on consecutive day and night shifts to maximize patient care. Since the hospital doesn’t simply shut down at the end of a shift, and certain patients require more care and/or documentation during a resident’s shift, resident hours become unrestrained in order to prevent negligence. In fact, medical errors are typically made more often by attending physicians than by residents.4 Medical errors made by physicians can be categorized based on the severity of the consequences. Medical residents who made at least one harmful medical error had significantly higher initial depression scores than those who did not (p = 0.03),5  calling into question how depression among medical residents affects their performance. It is also important to note the ratio of resident physicians to an attending physician in a medical setting. Since attendings generally hold to the hours they have planned, they can hand off patient care to the resident team working and patient care is not compromised. This also holds true for nurses and other medical providers in that facility. Thus, higher-level providers are able to stick to more humane schedules due to the comfort of being able to hand-off patient care to medical residents. 

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     In order to remediate the issue of intense residency schedules, work hours must be prioritized as a critical factor in healthcare facility scheduling, not merely treated as an administrative afterthought. Patient hand-off responsibilities could be more equitably distributed among residents, nurses, and attending physicians, creating a truly collaborative care model that both reduces individual workload and improves continuity of care. For example, some hospitals such as the University of Texas MD Anderson Cancer Center have successfully implemented team-based hand-off systems where residents, nurses, and attendings participate in joint rounds and share documentation duties.7 Furthermore, concrete measures to support resident mental health should be instituted, such as guaranteed access to counseling services, protected time off for medical appointments, and clear protocols for maternity leave and personal emergencies. The current system, which often forces residents to choose between their wellbeing and their training, is neither sustainable nor conducive to developing competent, resilient physicians.

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     Ultimately, this ongoing debate between prioritizing the fluidity of patient care in a hospital and resident quality of life is a multifaceted issue that requires navigating challenges such as preventing patient negligence and/or abandonment, resident mental health and postpartum depression, and burnout. It questions the possibility of “balance” in not only the resident lifestyle, but also in hospital labor distributions. These issues present possible structural changes to hospital systems such as the I-PASS system or allowing medical residents to have more emergency time off as well as other provided mental health initiatives by their hospitals. These changes will necessitate a fundamental shift in the medical system to move towards a more ideal future.