Most of the 1,200 residents and fellows at Montefiore Medical Center on Wednesday said that they were seeking to join a chapter of the Service Employees International Union, and asked The Bronx teaching hospital, one of the borough’s biggest employers, for immediate recognition of their bargaining unit at a news conference on Tuesday.
The medical professionals are joining the SEIU’s Committee of Interns and Residents (CIR), the largest and oldest union for housestaff — the industry’s term for medical interns, residents and fellows not yet on staff. Housestaff typically work long hours participating in patient care under the direction of an attending physician, at a fraction of the pay.
One of the largest employers in New York City, Montefiore is a powerhouse nonprofit medical provider in The Bronx that has four hospitals in the borough along with numerous primary care sites and health clinics. Administrators recently rattled physicians after announcing plans to consolidate three of its Bronx health centers beginning last month.
It also has one of the top ten most popular residency programs of the 561 in New York State, according to data from the American Medical Association. CIR spokesperson Sunyata Altenor told THE CITY via email that approximately 7,000 New York City medical residents are part of a CIR union.
Dr. Libby Wetterer, a third-year resident in family medicine, said that issues to be addressed include reducing patient-to-staff ratios, improving parental leave, and better supporting people who are sick or go on extended leave. The union can be a voice with other unions and community groups to ensure Montefiore “really has The Bronx community at heart.”
The union announcement follows a rally last week calling for better wages and better staffing at the medical center, led by nurses with the New York State Nurses Association (NYSNA) who are also supporting the CIR residents in their unionization drive. Gothamist reported last week that two custodians who worked for Montefiore during the pandemic are filing a class action lawsuit, alleging they were denied overtime pay.
Dr. Nakita Mortimer, in her first year of anesthesiology training, described residency as a “balancing act of two truths.”
“One truth is the honor it is to care for the members of The Bronx community and New York at large. It’s a privilege to learn from and collaborate with other Monte housestaff in this very fulfilling work,” Mortimer told THE CITY. “The other truth is that with its current conditions, this very work is often unnecessarily challenging to our wellness as individual people.”
About 70 percent of the 1,200 doctors completing their residencies have signed on to the union, according to Mortimer, one of the union’s organizers.
Montefiore residents began organizing around the working conditions during COVID, and their union effort to organize began about a year ago, according to Altenor. The young doctors seek changes to jobs that presently entail 60- to 80-hour work weeks for annual pay of between $60,000 and 80,000.
These issues are not exclusive to Montefiore housestaff. Nationally, the effects of the long, arduous hours can take a toll on the mental health and safety of housestaff, which the pandemic laid especially bare.
“The fact that the medical profession has one of the highest rates of burnout, and suicide, compared to other professions, speaks to the urgent need for change,” said Mortimer.
A spokesperson for the medical center did not answer a direct question about whether it would recognize the union, instead sending a written statement. “Our success and our reputation are grounded in the world-class training we provide and the compassionate care we extend not just to our patients, but to our residents and all who make the selfless commitment to provide care here,” it reads in part.
Filling the Gaps
Shortly before the pandemic started, CIR union members at the Institute of Family Health in Harlem successfully negotiated a three-year contract that reduced the 80-hour-per-week cap to 70 hours, and increased salary by 9% over the course of the contract, spokesperson Omara Gerardo-Valdez told THE CITY. When that contract ends in June, members seek a 17% raise over the following three years, Gerardo-Valdez said.
A spokesperson for Montefiore pointed to labor shortages as a national issue and said they “are working to fill vacancies and exploring new recruitment strategies.” They did not elaborate on those strategies.
Mortimer, the first-year anesthesiology resident, presently makes $60,000 and owes about $300,000 in medical student loan debt. She noted that some housestaff have had to transport patients within the hospital, a job that physicians normally don’t do and that takes time away from other patients.
“The problem is that that falls on us, right? We end up having to fill in the gaps when we could be spending our time just caring for other patients and doing the job we’re supposed to do,” said Mortimer. She recalled one instance when she had to transport a patient who needed an MRI from the intensive care unit to the radiology department.
Clare Wynne, a pediatrics physician who began her residency in July 2020, said she makes a base salary of $70,000 with no available overtime while working up to 80 hours a week over the span of a month. She can work more than 80 hours one week if she works fewer hours in another week that month, per guidelines set by the Accredited Council of Graduate Medical Education, a national body governing post-graduate medical education.
Over the past year, Wynne said she’d regularly average around 70 hours a week.
“A lot of us see the union as a way to advance and expand healthcare access in The Bronx,” she said.
“The thing about residents is that we can do the work of an attending [physician] but we are paid like a third as much,” said Wetterer. “We’re like cheap labor, basically.”