Food Insecurity Among Resident Physicians and Clinical Fellows at a Large Academic Medical Center

Importance: Food insecurity is associated with adverse health and affects approximately 1 in 5 US medical students. A recent multi-institutional study found food insecurity in 14% of graduate medical education trainees using a 2-item screen; prevalence by the 10-item US Department of Agriculture Adult Food Security Survey Module remains poorly characterized. Objective: To estimate reported food insecurity prevalence among resident physicians and clinical fellows and identify affected subgroups and barriers. Design, Setting, and Participants: In this cross-sectional, anonymous electronic survey at the Yale New Haven Health System, all physicians in accredited postgraduate training were eligible (approximately 600). The survey was fielded August 7, 2023, to May 19, 2026, and responses arrived through November 2025 (121 of 165 [73%] in 2023). Exposures: Year of training (including postgraduate year 1 [PGY-1] status) and self-reported barriers to obtaining food. Main Outcomes and Measures: Food insecurity, a score of 3 or higher on the 10-item US Department of Agriculture module; prevalences and associations reported with 95% CIs. Results: Of approximately 600 eligible trainees, 165 (28%) participated; 164 had complete food security data (53 PGY-1, 34 PGY-2, 23 PGY-3, 32 PGY-4, 22 other, including fellows). Overall, 50 of 164 respondents (30.5%; 95% CI, 24.0%-37.9%) met criteria for food insecurity. PGY-1 prevalence (24 of 53 [45.3%]) was approximately twice that of later years (26 of 111 [23.4%]; odds ratio [OR], 2.71; 95% CI, 1.35-5.43; P = .004). Lack of money was associated with food insecurity (45 of 60 [75.0%] vs 4 of 100 [4.0%]; OR, 72.00; 95% CI, 22.61-229.30; P < .001), whereas lack of time was not (OR, 1.24; 95% CI, 0.61-2.49; P = .55). PGY-1 trainees more often endorsed lack of money (27 of 52 [51.9%] vs 33 or 108 [30.6%]; OR, 2.45; 95% CI, 1.24-4.85; P = .009). Prevalence by specialty ranged from 5 of 26 (19.2%) to 5 of 10 (50.0%) (P = .24). Conclusions and Relevance: In this cross-sectional study of 164 resident physicians and clinical fellows, approximately one-third of respondents reported food insecurity, with the highest burden among PGY-1 trainees, whose recall window spanned the transition from medical school into residency, and an association with lack of money. Financial supports targeted to that transition warrant prospective evaluation.