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When Residents Let Conscience Be Their Guide: Professional Development and Educational Opportunity. Residency is a time of professional identity formation. During this time, residents may first be exposed to conflicts between professional duties and personal beliefs which may lead to a request for a conscience-based exemption. Faculty, whether the supervising attending or the program director, have an important role in the professional and ethical development of residents by acknowledging and supporting residents as they encounter these potential conflicts. In this paper, we highlight three areas of unique issues that arise within the context of residency training programs when a resident makes a request to be excused from clinical duties based on personal conscience: namely, the maintenance of educational standards, the burdens that may be placed on colleagues, and the responsibility for faculty to foster the professional development of ethically sensitive pediatricians.