As a resident physician, eating a full meal during a long shift can feel like a rare luxury—and finding the time or energy to make that meal healthy can seem downright impossible.

According to the 2024 AMA National Resident Comparison Report, which includes responses from more than 3,600 residents nationwide, about one-third of residents skipped a meal on three or more days in a single week. Nearly half reported eating at least one poorly balanced meal on three or more days during that same period. 

Exclusive to the AMA, these findings, which represent data from all organizations that surveyed residents with the AMA’s Organizational Biopsy® in 2024, reinforce a common reality in graduate medical education: basic acts of self-care can often fall by the wayside under the pressure of residency.

Given the rigorous demands of residency training, is it possible for residents to eat regularly—and reasonably well? A resident physician and graduate medical education (GME) faculty member offered a few tactics that residents can use to take small steps toward better nutrition. 

Institutional culture plays a key role in shaping resident wellness—and when residents speak up, programs often listen.

At Inova Fairfax Hospital in Virginia, residents raised concerns about the food available to them. Their feedback sparked a multiyear quality improvement initiative resulting in a revamped hospital cafeteria menu featuring balanced options aligned with American Heart Association guidelines.

Shirley Kalwaney, MD, Inova’s director of GME and a longtime advocate for nutrition education, helped guide the effort.

“If you want to change the menu available to you, step one is speaking to someone about it,” she said. “It doesn’t have to be your program director—it could be a faculty member, a chief resident or members of your resident wellness committee.”

Inova Fairfax Hospital is a subscribing institution to the AMA GME Competency Education Program, which delivers education to help institutions more easily meet Accreditation Council for Graduate Medical Education (ACGME) common program requirements. Program subscribers have access to award-winning online education designed for residents on the go. It’s easy to use and saves time with simple tracking and reporting tools for administrators. Learn more.

A second-year internal medicine resident in Athens, Georgia, Oladipo Odeyinka, MD, said that communal meals can help ensure that residents are eating well, even during the most disruptive rotations. 

During 12-hour overnight shifts, “most of us eat dinner before we come in and then have a snack at the resident lounge or cafeteria around 2 a.m.,” said Dr. Odeyinka, an AMA member. “But then when we wrap up around 7, we try to congregate. Go downstairs to the cafeteria and get a good breakfast before going home to sleep.” 

This shared routine helps residents anchor their nutrition even during nocturnal rotations.

The AMA Thriving in Residency series has guidance and resources on navigating the fast-paced demands of training, maintaining health and well-being, handling medical student-loan debt, and other essential tips about succeeding in graduate medical training.

Bringing your meals can help ensure that you take a meal break—eliminating the time commitment of a trip to the cafeteria or nearby restaurant—and that you eat well. 

Residents “are not going to have the time to cook every day,” Dr. Kalwaney said. “On your time off ... that’s the time to do meal prep. When you hit the grocery store, buy for several meals and cook in batches to make leftovers last.”

“Preparing meals at home rather than eating out is always healthier. You avoid the high consumption of added sugar, salt and saturated fat that increase risk of chronic diseases.”

As far as what to buy for meal prep, Dr. Kalwaney advised residents to eat whole foods when possible and stock up on shelf-stable, budget-friendly items such as canned beans (low-sodium) and frozen fruits and vegetables.

Decision fatigue is real. If healthier choices are prepped or within reach, you’re far more likely to choose them—even when you're exhausted. 

Stocking fruit, nuts or vegetables can help maintain steady energy and avoid the crash that comes with high-sugar snacks.

“If you have a bunch of stuff that you can easily eat that’s healthy, you’re going to eat that,” Dr. Kalwaney said. 

Accessibility is key, Dr. Kalwaney said. That could mean keeping fruit in your locker, freezing healthy meals and bringing them with you to work or storing trail mix in your white-coat pocket.

This is also true away from the hospital. 

“A healthy food environment at home is vital,” Dr. Kalwaney said. “if you kept ultra processed foods, like chips and soda, in plain sight, you will consume those items first—especially when time restricted and/or sleep deprived. 

Dr. Odeyinka’s program has a stocked fridge in the residency lounge. He advocated with the program to avoid high-sugar options such as soda and cookies in favor of fruit and water.

A long residency shift demands energy, and fueling your body is essential for functioning at your best. That fuel won’t always come in the perfect form.

During stretches of intense shifts, you’re bound to make the occasional less-than-ideal food choice. The key is not to aim for perfection, but consistency. Even a quick or unhealthy option is better than skipping a meal altogether given your responsibilities as a physician.

“Even if you have to have a slice of pizza, that’s much better than nothing,” said Dr. Odeyinka. “Once in a while you can indulge, but then next time, I’d try to go to the salad bar.”