As part of the continuing effort to study perceived attitudes, stresses, and coping mechanisms of pediatric interns in a hospital-based training program, this paper focuses in depth on how attitudes toward patients and toward the internship experience become more negative in the course of the internship year. Sources of stress and changes in coping mechanisms are documented. There were no significant effects of gender or marital status on interns' attitudes. Gender and marital status were not correlated with performance during the year, and attitudes were not consistently correlated with performance. Discussion of the significance of these findings in pediatric training and suggestions for redirection of pediatric training programs are made.