These are unnecessarily taboo topics within most residency programs. When residents are unable to fulfill their clinical duties—whether due to illness, parental leave, or other health reasons—the burden almost always falls on the remaining residents. Programs often try to rearrange schedules to minimize disruption when the leave is planned, but when that’s not possible, the expectation is that other residents will absorb the extra work—without additional pay and on top of their existing workload.

Residents are typically exempt from Fair Labor Standards Act (FLSA) overtimes rules because we are classified as “learners/trainees” rather than traditional employees. This creates an environment ripe for exploitation, particularly, when it comes to staffing coverage gaps. As with many aspects of residency training, there is little room for negotiation. Residents are expected to nod, smile, and shoulder the extra responsibility. Asking for additional compensation is frowned upon and uncomfortable. Ironically, the same attendings who endured this during their own training often perpetuate this system. The phrase “robbing Paul to pay Peter” aptly describes the situation. Touting paid medical or parental leave while relying on overworked residents to cover the gap at the expense of their own much-needed time off feels disingenuous at best.

Fellow residents and fellows- I would love to hear your thoughts on how we, as the next generation of attendings, can better support our future trainees.

Yours truly,
Shivani