Kimberly Paynter / WHY
Dr. Leah Rethy was pregnant during her first year of internal medicine residency at the University of Pennsylvania Hospital in Philadelphia. She gave birth in her second year. She worked through her 40th week of pregnancy so she could save time and spend more time with her newborn baby.
Now she’s back to work and needs babysitting. Lots of childcare. Resident physicians often work long and irregular hours, sometimes up to 80 hours per week. And childcare is one of the main issues motivating Rethy to push for a union at his hospital.
In February, most residents of two major hospitals in Penn Medicine decided to form a union, and the National Labor Relations Board will elect them in early May. They join a wave of other residents unionize in programs across the country, most recently at Montefiore Hospital in New York, George Washington University in Washington, D.C.And Mass of General Brigham in Boston.
If successful, these residents would join the Interns and Residents Committee, the medical residents’ union. According to union figures, the number of campaigns has increased from two in 2021 to eight in 2022, an unprecedented increase.
The challenges of child care
Rethy says her problem with childcare is not unusual – residency follows undergraduate education, and generally four years from medical school, so he straddles childbearing years for most people.
“I know a lot of people who have been late having children,” she says. “And I’ve also heard a number of stories of people who put off having children and ultimately have real challenges getting pregnant due to their age and various factors.”
Kimberly Paynter / WHY
Rethy laments the waiting lists for daycare affiliated with Penn Medicine and says finding her own daycare is too expensive.
“The cost of childcare…in a month is about half my total salary, and the cost of a nanny is basically my entire salary,” says Rethy.
She says that experience led her to believe that unionization is the best way for residents to demand better working conditions and higher pay, which would lead to better patient care.
A workforce that cannot leave
Sunyata Altenor is the director of communications for the Committee for Interns and Residents, or CIR, as the union is known. She says residents who want to unionize understand that the program is supposed to be hard work, with long hours. But they want to be treated fairly for their efforts, in a workplace they can’t simply choose to leave, because it’s part of their training.
“It’s easy to exploit doctors at this stage of their careers,” Altenor says. “They’ll only be there for a few years. You’re kind of expected to go through this tough, hazing culture and then on the other end become a attending physician.”
Prominently, Stanford Medicine did not include residents in their COVID-19 vaccination plans in 2020, leading to protests, and later, a successful organizing campaign.
Dr. Chantal Tapé, a third-year family medicine resident at Penn Medicine, said residents expect challenging work and long shifts, but they also wish they could be healthy and financially stable. so that they can focus on patient care.
She said it is “frustrating as a prenatal care provider” to see colleagues struggle during pregnancy to get to prenatal care appointments and early parenthood to pay for childcare. Her colleagues cannot follow the advice she recommends to her patients.
Parking, mice and cockroaches too
Residents of Penn Medicine cite numerous issues for their decision to form a union, such as: the upcoming loss of parking benefits that would result in an additional $200 monthly cost to residents; and dirty call roomswhich are rooms where residents stay and rest if they have to work at night.
Residents say some current call rooms have mice and cockroaches.
Dr. Madison Sharp, a third-year OB-GYN resident, recalls not even having a call room to sleep in during a 24-hour shift.
“So I tried sleeping in a dialysis chair that didn’t lay flat in a conference room on my side,” she said. “Two years later, residents on that same rotation still don’t have a place to sleep for a few hours on a 24-hour call shift…keep in mind that Penn just opened a billion dollar hospital but neglected to create a physical space for us.”
Resident at Penn Medicine
In a prepared statement, Penn Medicine says it values residents and is “proud of how we have sought to continually improve the lives and well-being of residents.” The statement maintains that it offers benefits and salary increases to provide competitive working conditions. Beginning July 1, resident salaries will start at just over $69,000 per year, according to Penn Medicine. They also say that “trainees” should bring their concerns to administrators through an existing advisory board.
“I was the chairman of this board last year, and I can tell you firsthand that the House staff board is extremely limited in what we could accomplish,” Sharp said. “It was incredibly frustrating to stand up for residents and fellows and not be heard or have our concerns brushed aside or dismissed.”
Residents of the University of Vermont Medical Center voted to form a union last year. Following the successful union vote for residents, support staff, including maintenance workers and technicians also unionize.
The Jersey City Medical Center residents’ union has already advocated for a better work environment in the years since it organized, said fourth-year orthopedic surgery resident Dr. Andrea Attenasio. For example, she said they had recently succeeded in getting the hospital to provide food for residents who worked after hours; provide sheets for the rooms where residents stay if they work at night; and to stop tying resident salary increases to overall hospital performance, a major concern with rising inflation and rising costs of living.
Attenasio said the bargaining power and strength in numbers that comes from being a member of a union makes a difference for residents:.
“It’s an automatic support system and it allows you to go to your hospital administration in a united front.”