This review addresses the way in which sleep physiology influences the medical profession and health care delivery. The training process for the medical professional has undergone dramatic changes over the past century. In recent times, however, the complexity and level of care delivered has out-stripped a trainee's ability to forego sleep and is compromising both physician and patient safety and thereby threatens the foundation of the profession. Recently, significant strides have been made in our understanding of sleep loss and consequences to physicians-in-training. Nevertheless, the implementation of changes fostered by such findings faces numerous conceptual and practical obstacles. This review updates the reader on recent evidence for changing the way medical professionals are trained, and opines on how solutions generated from such research should be embraced. Additionally, the deficiencies in our current understanding of sleep and medical training are identified so that future research can be undertaken in such areas. Acknowledging the defects in our current system of training physicians and enacting further changes is sorely needed to improve patient safety and the well-being of physicians-in-training.