This New England Journal of Medicine Catalyst article details effects of increasing consecutive work hours that residents can work. Residents are already inundated with an impossible cognitive load — more data, endless communications, and increasing systemic pressures — that diminishes the rewards of practicing medicine and often detracts from true patient care. Studies show sleep deprivation causes progressive decline in attention to detail, compromises performance, poses serious and preventable hazards, and increases medical errors. The article postulates that increased hand offs between residents and longer work-hours are not mutually exclusive and emphasizes that it underscores how antiquated residency education is. There is a need for revitalizing graduate medical education, paving the way for trainees to engage in formal leadership training, coalition building, and advocacy to improve the health of the populations we serve.