Binge drinking in residency: A risk worth breaking

By Anastasia Climan, RDN, CD-N | Fact-checked by Barbara Bekiesz

Published July 31, 2023

Key Takeaways

Drinking comes with the territory of medical training, but residents may be particularly vulnerable to heavy alcohol use or abuse due to stress and burnout during training.
Half of medical residents report binge drinking in the past year, according to research.
Surviving residency and life as a physician means finding healthy ways to balance work and play.

Binge drinking is deeply ingrained in college culture and often spills over into the next phases of life. Medical residency is no exception. In some surveys, half of medical residents say they binge drank over the past year, and 18% report binging at least once a month.^[]

Heavy alcohol use or abuse can have serious health implications for residents, and dangerous consequences for patients. Yet many residents who binge drink may be reluctant to look inward and address the issue.

Defining binge drinking

According to the CDC, binge drinking is the most common pattern of excessive alcohol use in the US. It is commonly defined as consuming four or more alcoholic drinks for females, or five or more alcoholic drinks for males, in a short period of time—causing a rapid and substantial spike in blood alcohol concentration.

People who binge drink are not necessarily dependent on alcohol, but the practice is harmful and carries a higher risk of alcohol use disorder.^[]

Addressing the underlying burnout

Burnout often sets the stage for alcohol abuse among physicians, and up to 45% report at least one symptom of burnout during residency training. In certain specialties like neurology, burnout rates soar as high as 70 percent.^[]

"Heavy alcohol use and binge drinking are, unfortunately, very common during medical training due to a ‘work hard, play hard’ mentality"

— Anita Chandrasekaran, MD, MPH

"A lot of trainees haven’t developed good coping strategies and are burned out, relying on alcohol as self-treatment for mental health issues. "

— Anita Chandrasekaran, MD, MPH, rheumatologist

"I think more wellness resources for medical students and residents are necessary, as well as protected time for trainees to engage in positive coping strategies, such as exercise,” she adds.

The work of a resident is mentally, emotionally, and physically taxing. And while you can’t necessarily change the system you work in, you can look for ways to set boundaries against burnout—and alternative ways to spend your time.

Alternatives to alcohol

Finding healthy and effective coping strategies is essential for playing the long game as a physician.

In addition to established stress-reduction techniques like meditation and yoga, finding a fun and engaging physical activity can get your mind off work and lower your dependency on alcohol for entertainment or comfort.

When was the last time you went rock climbing, roller skating, or exercising at a trampoline park? How about going dancing, swimming, or riding your bike? You may associate these activities with childhood, but there’s no reason kids should have all the fun. In fact, it’s possible that more fun is exactly what you need to channel those alcohol cravings into a more rewarding pastime.

The key is to set aside some time to find a healthy alternative that doesn't involve drinking and prioritize it.

When alcohol use crosses the line

Even if you’re a resident who doesn’t drink heavily, chances are, you know other residents who do.

The health implications of alcohol abuse are significant and too critical to ignore.^[] Alcohol raises the risk of infections, injuries, violence, and traffic accidents. In the case of medical residents, heavy drinking can lead to hampered performance, potentially leading to deadly medical mistakes.

Still, while heavy drinking is detrimental to disease prevention (and to a professional career in medicine), controversy over the potential benefits of moderate intake leaves some clinicians navigating along blurred lines.

If you are concerned about your own drinking habits, test yourself by planning for an alcohol-free period, whether it’s a week, a month, or 3 months. If you come to find this commitment is too hard to keep, you might need help to stop drinking.

Individual counseling, support groups, or 12-step groups, can give you the tools you need to be successful and gain control over the amount of space alcohol occupies in your life. By taking the initiative, you’ll set a positive example to other residents or med students who want to drink less.

If you are concerned about other residents' drinking, particularly if you believe it could affect patient care, it's important to intervene immediately. Consider bringing it to the attention of an attending physician or supervisor.

It may be difficult to know for certain if another person is abusing alcohol, but some telltale signs include being chronically late to appointments, unknown whereabouts, the smell of alcohol, disheveled appearance, irritability or erratic behavior, increased patient complaints, poor charting, decreased quality of care or productivity, or careless medical decisions, among other signs.

What this means for you

Alcohol may seem like a normal way to cope with stress, but you and your co-residents deserve healthier options. Balancing hard work with enjoyable exercise is a good alternative to drinking. And sometimes professional help makes sense if you struggle to make changes on your own.