Medical residents in New York’s public hospital system are demanding pay parity with their peers getting medical training at similar hospitals as they negotiate a new contract agreement.

Also among their demands in talks with Mayor Eric Adams’ labor representatives are improving management of on-call shifts and adding funding for new equipment, measures they say are essential to sustaining the city’s health care system. 

New York City Health + Hospitals’ 2,300 residents — doctors-in-training who are recent medical school graduates — have been working without a contract since their most recent one expired in December 2021.

Their last raise came in March 2020, just as medical professionals found themselves on the front lines of the fight against COVID.

The residents, who are members of the Committee of Interns and Residents–SEIU, make up about half of all physicians in New York’s public hospital system, according to estimates from the union.

Many of the doctors bargaining with the city now cut their teeth treating COVID patients at a time when New York was the global center of the virus – often at the expense of their mental health and their emotional and physical well-being.

Dina Jaber, a fourth-year internal medicine chief resident at Kings County Hospital, began her residency at the onset of the pandemic, serving a community that at the time was one of the city’s most vulnerable. She said it only strengthened her resolve to continue working in the public sector — and to fight for her patients on behalf of her union.

“We work together for a common cause, which is our patients,” she said. “So we use our voice from the conditions we’ve worked under so we can be focused, energized and passionate in our care.”

Added Jaber: “Being able to come into work and maybe be that person who’s putting a smile on their face and really doing my best for them, just makes it so that I’m fulfilling what it is that I came here to do.”

Union Surge

On Tuesday, residents at eight public hospitals, including Bellevue in Manhattan, Jacobi in The Bronx and Kings County in Brooklyn, will rally to call attention to the contract talks.

Among the residents’ demands are raises that will put them on par with their peers at other city safety-net hospitals. The current average starting salary for H+H residents in their first year is $66,469, according to the union.

They also want H+H management to increase the number of doctors on call at any given time, in order to avoid punishingly long shifts, and for the city to increase its contributions to the union’s patient care trust fund, which is used to buy hospital equipment and other resources. 

The union’s current salary proposal would deliver a 20.75% boost over five years retroactive to late 2021 along with a one-time $3,500 bonus; the city’s most recent offer is a 16.21% salary increase over that same period, with a $3,000 bonus. The two sides had their most recent bargaining session in November. The union is also proposing the city increase its contribution to the patient care fund by 0.04% per resident, to be used towards new equipment, research and community engagement projects.

Some hospitals are so starved for resources that doctors have resorted to creative ways to share equipment. One Kings County Hospital resident testifying anonymously before a September 2021 City Council hearing said medical staff there had created a WhatsApp group titled “Where is the ultrasound?,” to track the whereabouts of the lone imaging tool that services three entire floors of the hospital’s internal medicine wards. (That hospital, thanks in part to the union’s trust fund, was able to purchase a new ultrasound, Dr. Jaber said.)

Because the city historically bargains with larger unions first, the residents’ union has had to wait behind several prominent public-sector unions for its turn at the bargaining table. Residents, like all public-sector workers in New York, cannot go on strike.

(Doctors at Elmhurst Hospital, part of the Health + Hospitals system, were able to strike last year because their residency program is operated by Mount Sinai’s Icahn School of Medicine.)

In a statement, H+H spokesperson Christopher Miller said the agency is “grateful for our residents who play a critical role in patient care every day.”

“As negotiations are ongoing, we look forward to continued discussions with the Committee on Interns and Residents,” he added. “Our goal is to strengthen our partnership and arrive at an agreement that benefits everyone.”

The union is basing its salary proposal on the salaries of residents in the city’s other safety-net hospitals, including Brookdale University Hospital Medical Center and Elmhurst Hospital. Under the city’s current offer, H+H residents in their first year of residency would earn an average $5,000 less annually than their peers at those facilities, a gap that widens to $10,000 by their third year. 

The contract talks are an opportunity for the doctors to capitalize on a surge in health care labor organizing in New York and beyond, as health professionals reel from the effects of the pandemic and corporatization of the nation’s health care system. 

More than 1,200 medical residents unionized at Montefiore Medical Center in The Bronx in 2022, and unionized doctors at Mount Sinai facilities in Harlem and the West side achieved pay parity with their non-union colleagues last year after threatening to walk out on the job. Residents at H+H’s Elmhurst Hospital in Queens, once dubbed the “epicenter of the epicenter” of the pandemic, won higher salaries and other benefits after striking for the first time in a generation last May. Nurses at Montefiore and Mount Sinai also won staffing agreements after waging a three-day strike last winter.

Nationally, health care workers accounted for 20% of all workers involved in work stoppages in 2022, despite representing less than 10% of all U.S. employment, according to data from the most recent annual report from the Cornell University School of Industrial and Labor Relations.

“I think with this new generation, everyone’s realizing that just because in the past people just put their head down and did the work, that maybe we can be the ones to make the change, to say ‘This isn’t how things should be,’” said Jaber.

“We all care about our patients — we didn’t go into medicine for anything else.”