Commentary by Johanna Shapiro, PhD, and Joel Shallit, MD
Katherine is a third-year medical student on her internal medicine rotation at an academic medical center that serves as a busy tertiary-care hospital for its region. The residents she works with are swamped with work; when they are not actively admitting and caring for patients, they are inundated with paperwork, submitting online orders, and completing health record notes. Katherine knows that the residents are kind and generous people who have been selected twice—for medical school and then for residency—on the basis of test scores, academic performance, and character recommendations. She cannot help but note, however, their frustration with patients who demand so much of their time, their irritation with nurses who page them about questions the residents think have obvious answers, and their eagerness to “turf” patients to another service or practice center to lighten their case loads. She can understand the origins of these behaviors while feeling that the residents are in danger of burning out and becoming more cynical than would be healthy for a long-term career.