In the following article, published in NEJM Catalyst, Rich Joseph discusses the trend of “MD drop out” due to the institutional norms and medical training environment, which instigate physician burnout. Because patient care is top priority, there is an unspoken tendency to consider changes to the work environment and training process as less important — even when these changes would clearly benefit patient care. The author recommends that all residents have representatives who have real negotiating power with hospital leadership to protect their own well-being and to champion patient safety. Furthermore, physicians need to be not only patient advocates, but also social activists, and should therefore be offered formal training in effective communication and leadership of multidisciplinary teams.