The Ravelled Sleeve of Care

Residency training is in crisis. There have been calls for change in both the lay press and the professional literature. Some prestigious residency programs have failed to fill their slots in the matching process. Legislation affecting residency programs has been proposed in several states. Increasingly active house staff unions are demanding changes. In this article we review the literature describing the stresses experienced by residents in training, the toll these stresses may take on residents, and the suggestions that have been made for reducing these stresses. (JAMA1989;261:889-893)