OBJECTIVE: This study examined psychiatry resident burnout in emergency departments and its association with residents' posttraining plans to care for Medicaid patients and others publicly insured. METHODS: Between November and December 2013, psychiatry residents in North Carolina were recruited for a cross-sectional, Internet-based survey concerning emergency department experiences, attitudes about their roles, feelings of burnout, and posttraining intentions to treat Medicaid patients. The completion rate was 51% (N=91). RESULTS: In bivariate analyses (N=82 with an emergency psychiatry rotation), burnout was positively associated with frequent exhaustion (p<.001) and perceived suboptimal supervision by the attending physician (p<.01). Compared with other residents, residents planning to accept Medicaid after training had significantly lower burnout scores (p<.05). Experiencing assault in the emergency department indicated decreased likelihood of treating publicly insured patients after training (Medicaid, odds ratio=.09, p<.05). CONCLUSIONS: Adverse experiences with patient care in the emergency department during psychiatry residency appear to be linked to professional burnout and threaten to shape long-term plans regarding care for publicly insured patients.