Burnout is an urgent problem for individual physicians, patients, healthcare systems, and residency programs. Preventing and responding to burnout in psychiatry residents is clearly essential to healthcare organizations, patient care, and physician well-being and should be a core value of all graduate medical education (GME) programs. Residency program leadership can find great utility in understanding the organizational factors that contribute to burnout and attempting to ameliorate them. A focus on promoting resident well-being, quality education, and professional fulfillment is likely to be the most durable and rewarding approach to preventing burnout. This chapter includes common scenarios illustrating how burnout and other distress might present in psychiatry residents and residency programs. Possible responses by the residency program director are then described and include immediate interventions and suggestions for integrating the lessons learned to prevent future burnout.