Many new doctors can't reliably afford food

Clinical takeaway: Consider financial strain as a hidden contributor to trainee wellness. First-year residents may face unexpected food insecurity despite physician salaries, suggesting a need for targeted support during the transition into residency.

Food insecurity has been linked to poorer physical and mental health; earlier research among residents and fellows also found associations with burnout and social isolation. Relocation expenses and the wait for a first paycheck can leave incoming interns financially stretched.

In a cross-sectional survey of 164 resident physicians and clinical fellows at the Yale New Haven Health System, 30.5% met USDA criteria for food insecurity. Half of respondents reported high food security, while 14.0% had low food security and 16.5% had very low food security.

The burden was concentrated among interns. Nearly 45% of PGY-1 trainees reported food insecurity, compared with 23% of trainees in later years, making first-year residents about twice as likely to be affected. The pattern persisted across multiple analyses and appeared driven largely by financial pressures during the transition from medical school into residency. Most PGY-1 respondents completed the survey within the first 4 months of internship, meaning their recall period captured relocation expenses, licensing costs, gaps between student aid and a first paycheck, and the start of loan repayment obligations.

Money, not time, emerged as the key barrier. Three-quarters of trainees who cited lack of money reported food insecurity, compared with just 4% of those who did not. Common experiences included being unable to afford balanced meals (45%), worrying food would run out before more money was available (31%), and skipping or reducing meals because of financial constraints (30%). Food insecurity did not differ significantly by specialty.

The authors concluded that food insecurity appears to be "an underrecognized issue in graduate medical education" and said financial supports targeted to the PGY-1 transition warrant further study.

In an accompanying editorial, Julie L. Oyler and Amber Bird argued that the key message is not the exact prevalence estimate but the repeated finding that food insecurity clusters in the earliest stage of residency. They wrote, "The question is no longer whether food insecurity exists in medical training. The more useful question is what medical schools, residency programs, and sponsoring institutions will do about it."

Source: Mahan E, et al. (2026 Oct 26) JAMA Netw Open. Food Insecurity Among Resident Physicians and Clinical Fellows at a Large Academic Medical Center