RT Journal A1 GIARDINO AP, GIARDINO ER T1 REsident stress JF American Journal of Diseases of Children JO American Journal of Diseases of Children YR 1989 FD October 1 VO 143 IS 10 SP 1129 OP 1130 DO 10.1001/archpedi.1989.02150220017002 UL http://dx.doi.org/10.1001/archpedi.1989.02150220017002 AB Sir.—Hoekelman1 recently identified factors that lead to stress during residency training. He claimed that causes of stress go beyond long work hours and the severely ill population for whom residents care, and stated that the stress to which residents are exposed is accentuated by the uncertainty of their futures once training is completed.Hoekelman suggested many changes that residency programs can adopt to reduce the stressors that are inherent in the present system. However, significant changes in residency training will not be implemented until members of the medical faculty begin to understand the transformations that have begun to take place in the provision of health care. These have occurred as a result of the corporate restructuring of health care systems. Since the rise of what Relman2 terms the medical-industrial complex, hospitals are often managed by business executives rather than the traditional physician administrator who once managed residency training and