By Cassie Shortsleeve

First, there were frequent and repeated personal insults. Then there was a stretch where her program’s entire second-year class was fired or held back, pushing calls from every fifth night to every third, with no relief. There was the chief who screamed at a junior resident in a crowded elevator that he was “f--king ugly” and should face the corner. The resident obeyed.

By her fourth year of residency, Frances Mei Hardin, MD, said, “All love for the work of a surgeon was beaten out of me.”

One day, during a neck dissection, an attending physician began berating her for lack of experience, accusing her of not studying and openly mocking her responses. After 20 minutes of what she calls “the pimping and bullying song and dance that’s very common in the operating room,” Hardin excused herself from the 8-hour surgery. “Something died within me that day,” she said.

Crying in the bathroom, Hardin called a close friend and co-resident, who wasn’t surprised. This type of situation had happened to her, too — multiple times. Her advice was that Hardin should collect herself and go back in. Hardin didn’t.

In the aftermath, Hardin developed complex posttraumatic stress disorder and was suicidal. “In the culture of surgical training, it is not admissible to admit these types of things,” she said. “When it happens to any one of us, it feels catastrophic, it feels personal, it feels like a moral failure — and it’s none of those things.”

Last year, Hardin left her job as a surgeon after completing residency and practicing privately in the rural South. She’s one of the projected 86,000 physicians who will leave medicine by 2036.

Physicians across specialties, practice settings, and career stages are walking away from healthcare.

The Breaking Point: Identity

Discussion around the physician exodus is not new, but data suggest the figures aren’t slowing. A 2025 study tracking more than 700,000 physicians found that the share leaving clinical practice climbed from 3.5% to 4.9% between 2013 and 2019. And that was before the pandemic.

The high rates of physician burnout may be contributing to that trend. A March 2026 study found that burned-out physicians are nearly 1.5 times more likely to leave clinical practice.

Every doctor who leaves medicine has a different story — “burnout” is a catch-all term — but talk to enough of them, and you’ll hear similar themes. Lack of inclusiveness is a common issue.

Board-certified otolaryngologist Anthony Chin-Quee, MD, who left in 2019, said that even early in training, medicine felt restrictive. There were only two paths: academic or private practice.

But for Chin-Quee, the constraints were more personal. “I’m Black, and that’s a big deal, especially when you’re in medicine. When you get into surgery, and then subspecialized surgery, there really aren’t a lot of us. That is very isolating,” he said. Chin-Quee sensed he was being “held to a different standard as far as what mistakes were acceptable.”

His personality also seemed outside the mold of the “buttoned-up” surgeon. “I like to have fun, I like to joke around, I like to sing, and I like to have fun with my patients,” he said. These traits made him an outsider.

The attitudes Chin-Quee encountered had direct consequences. When an attending learned he’d been reading the novel, The Hunger Games, word spread through back channels that he “wasn’t taking surgery seriously.” His bosses’ attitudes toward him changed, which he attributed to the rumors.

It seemed that Chin-Quee would have to hide who he was to survive in medicine. At his lowest, he was depressed, internalizing his struggles in ways that darkened things further. “You associate yourself with your performance, and when you don’t perform, then you feel like you’re not worth it.”

Chin-Quee quit surgery in Los Angeles in 2019 without another job lined up.

The Breaking Point: ‘Death by 1000 Cuts’

Mel Thacker, MD, thought she’d stay at the female, three-partner practice she helped lead in Massachusetts until she retired. “I wanted to become a doctor when I was 13, and I achieved my dream. But it’s not a fairy tale,” she said.

Although Thacker had near-full autonomy — something many doctors strive for — moral injury crept in through financial incentives she couldn’t unsee. As a sinus surgeon, she knew that a procedure done in her office would net $15,000, while the identical one at a surgery center would reimburse just $3000. “So I will subconsciously encourage them to do the office procedure. It made me feel disgusting,” she said.

Thacker watched colleagues exploit this gap further. She saw physicians “making millions, hiring famous singers to come to their birthday parties, driving Lamborghinis on this money that they’re making by unethically doing procedures on people.”

She also watched the system exploit physicians: A colleague had $40,000 clawed back by an insurance company after years of caring for a dying cancer patient. Thacker herself was jumping through hoops to prescribe cheap, readily available medications.

The shame and self-disgust she felt eventually became physical and she started having panic attacks in the operating room. In early 2021, she took time off, found a psychiatrist, and discovered coaching as a new career path. She left her practice in 2024.

She and many other physicians describe leaving medicine not as a single moment but as “death by 1000 cuts.” They point to administrative hurdles that they feel have a stranglehold on the healthcare industry.

In an essay, endocrinologist and menopause and thyroid specialist, Corina Fratila, MD, described practicing medicine as being “a glorified data-entry monkey in a Kafkaesque insurance labyrinth, legally obligated to spend more time clicking boxes in Epic than making eye contact with another human.”

Fratila, who recently stepped away from conventional medical practice, excoriated the health insurance system of preauthorization in another essay. “A huge societal flaw has been perversely turned into emotionally manipulating the people with the biggest hearts into giving away their resources for free,” she wrote. “No wonder patients detest our healthcare system, and doctors are leaving medicine in droves.”

What Would It Take to Stay?

Just as physicians leave for different reasons, their visions of a better system vary. But the picture of an ideal healthcare system often involves reworking it from the bottom up. They imagine a system that’s more inclusive, less bureaucratic, and centers the patient-physician relationship.

Many agree that training must be the starting point. Chin-Quee called for making some of the informal, unwritten norms, the “hidden curriculum” of medical culture more explicit in medical school, “so that people are going in clear-eyed.”

Hardin said that, at times, even she had to actively fight the urge to “treat trainees the way she was treated.” She argues that culture change is the prerequisite for progress in all areas, and it must start early. As well as enduring personal attacks in training, “you have to grapple with all those times that you watched someone get abused,” she said.

Hardin points to the Accreditation Council for Graduate Medical Education’s 80-hour workweek limit as an example of why policy without culture change fails. Some programs, she said, simply instruct residents not to log more than 80 hours, even when they work more. “We can put policies in place all day, but they don’t work if they are not being enacted at each institutional and departmental level.”

Chin-Quee also questions the idea of medicine as “a calling,” which frames physicians as morally superior with no room to be full human beings.

“What medicine needs to focus on is not ‘How can I take this person and make them the doctor I want to see?’” he said. “It’s ‘How can this person become the doctor they want to be and expand what I think being a doctor can be? How can we embrace the diversity of backgrounds and cultures and perspectives and recognize that that makes physicians better?’”

Chin-Quee said friends who are considering leaving medicine often call him “to ask permission, if it’s okay to leave.” (He usually tells them yes.) And most of the conversations are about identity. His priority now is a profession that is “joyfully aligned with who I am,” and he encourages friends and colleagues to find the place where they are “waking up excited.”

For Thacker, the fix is more structural. “The patient-physician relationship has to be the beating heart of healthcare,” she said. “I can go into an operating room, and it’s a black box. I’m fully trusted with somebody’s life. But once I’m out, I have to prove every single thing that I’ve done with the exact language [that insurance companies need].” While not always practical, she points to direct care models as a potential path forward.

In her essay, Fratila wrote, “Every day feels like a hostage negotiation between your soul and your malpractice insurance…. This system isn’t broken. It is working exactly as designed. For profit. Not for people.”

What Comes Next

Physicians who leave take different roads out of healthcare. Shortly after leaving his job as a surgeon, Chin-Quee landed a job in the writers’ room at Grey’s Anatomy and later The Resident. He now consults for a start-up building an AI-powered coach for physicians and medical students. He also wrote a book, I Can’t Save You: A Memoir, published in 2023.

Thacker coaches surgeons full-time and hosts the podcast Surgeons with Purpose. She also does locums work 1 week a month, which she describes as “straightforward and joyful in a way her practice never was.”

Hardin published her own memoir, Surgeon on the Edge, this year and co-founded The Hippocratic Collective, a physician-led media company, alongside Thacker. Hardin has hope that the next generation of physicians will find greater balance. She believes the exodus from medicine is accelerating, in part, because a younger generation of doctors has higher standards for how they will (and will not) be treated. This new attitude may be enough to force medicine to change.

The stakes of continuing with the status quo are too high, many physicians feel. “When you have a workforce that is not working at their best, their product suffers,” said Chin-Quee. “And in this case, the product is everyone’s health.”

The experts cited in this article had no relevant disclosures.