Welcome to Nashville, Welcome to Jackson—Reimagining Residency Orientation

he transition between medical school and residency is associated with a decline in learner empathy, 1,2 increased burnout, 3,4 high rates of loneliness, 5 and threats to professional identity formation. 6,7Furthermore, an elevated focus in premedical education on cultural competency, social determinants of health, and communityfocused care may go unmatched once medical students become new residents, and clinical concerns take priority over nonclinical topics. 8But neither learning nor clinical training takes place in a vacuum, divorced from cultural context-learning is a profoundly social process.The COVID-19 pandemic accentuated social inequities, 9 physician 10 and patient loneliness, and isolation, 11 which contributed to burnout at levels not seen perhaps for generations.With great change (learning environment, geography, phase of learning) comes great responsibility, for present and future learners alike.To practice well, physicians must also live well, with dedicated time, space, and attention to social and historical context: even on day one.These societal and system level adaptations call for a redesign of residency orientation, a tradition universal in graduate medical education (GME).