'Overworked and underpaid': University at Buffalo resident doctors and fellows launch union campaign

But all across the country, resident physicians are starting to organize in an effort to improve their working conditions and boost patient care.

That movement has now come to Buffalo.

Resident doctors and fellows at the University at Buffalo, who staff hospitals across Western New York, filed a petition on Wednesday with the National Labor Relations Board to unionize with the Union of American Physicians & Dentists, which has more than 5,000 members. About 810 interns, residents and fellows are employed by University Medical Resident Services P.C., according to the filing, which came during the same week as the sixth annual "Thank a Resident/Fellow Week" at UB and its affiliated hospitals.

Dr. Stuart A. Bussey, president of the Union of American Physicians and Dentists, said the campaign boils down to "too much work, not enough pay, not enough voice," likening medical residencies to "almost like a hazing procedure" for their difficult working conditions and low wages.

"In unity, we aim to amplify our voices to improve salaries and advocate for safer working conditions," the UB residents, fellows and interns wrote at ubhousestaff.org, a website dedicated to the organizing effort. 

In a statement, the UB Jacobs School of Medicine and Biomedical Sciences said it is aware of the organization efforts of its residents, fellows and interns, noting it is the latest in a growing number of graduate medical education unionization efforts taking place nationally.

"We are highly appreciative of the talents and work of our trainees and have worked diligently with them on recent salary increases, including fiercely advocating for them to receive the state's health care worker bonus," the Jacobs School said. "We look forward to continuing to work with our trainees to ensure they have a first-class learning environment and are compensated fairly and competitively."

Doctors in residency and fellowship programs have been unionizing all over the country, particularly since the Covid-19 pandemic that has stressed the health care system, and its employees, like never before.

This month, in fact, residents and fellow physicians – often referred to in the industry as house staff – at Loma Linda University Health in California filed a petition to unionize with the Union of American Physicians and Dentists. So, too, did resident physicians and fellows at University of Pennsylvania Health System, seeking to organize with the Committee of Interns and Residents.

'Overworked and underpaid'

The unionization effort among UB residents and fellows began about a year ago, when they received their contract and salaries for the upcoming academic year, which began in July.

The UB residents said they are paid significantly less than colleagues in similar cost-of-living cities, such as Rochester, Syracuse and Albany. The pay discrepancy is detailed on the UB house staff website.

According to information on the UB Office of Graduate Medical Education's website, the salary schedule for medical residents, as of Jan. 1, ranges from $57,492 for postgraduate year one to $65,067 for postgraduate year seven. 

By comparison, at the University of Rochester, that same postgraduate range for the 2023-24 year is $63,870 to $79,084, according to the university's website. The range at Albany Medical College, meanwhile, is $67,917 for postgraduate year one and $71,758 for postgraduate year seven.

Looking nationally, first-year residents – sometimes called interns in the industry – made an average of just under $60,000 in 2021, according to data from the Association of American Medical Colleges.

In its statement, the Jacobs School said the salaries posted online do not reflect the various benefit packages offered at the different upstate institutions. UB noted that its residents and fellows do not have payroll deductions for cost-sharing. Further, the school said, health benefits for residents and fellows are paid in full by UB.

"When accounting for the differences in benefits, the UB compensation package is much closer to our colleagues across the state," the Jacobs School said.

In addition, UB said that its residents and fellows received a 3% pay raise on Jan. 1 and will get another 3% raise on July 1, which were sequential pay raises negotiated in lieu of the previously negotiated 2% overall raise. 

On its website, UB's Office of Graduate Medical Education notes that UB-affiliated hospitals "support all aspects of resident education including, but not limited to, resident salary report."

Those hospitals include Buffalo General Medical Center; Oishei Children's Hospital; Millard Fillmore Suburban Hospital; the Buffalo VA Medical Center; Erie County Medical Center; Roswell Park Comprehensive Cancer Center; and Catholic Health's hospitals. 

And in New York, residents can work up to 80 hours per week.

"We have continuously been overworked and underpaid by our UB affiliated hospitals," the residents, fellows and interns wrote on the website.

While a postgraduate year one salary at UB of $57,492 would be more than $27 an hour based on a 40-hour work week, that essentially drops to $13.82 an hour if the resident works 80 hours in a week. (The minimum wage in upstate New York is $14.20 an hour.)

What that often means, the residents said, is a six-days-a-week schedule, with some residents rising at 5 a.m. to go to work and not getting home until 10 p.m. And during the Covid-19 pandemic, residents and fellows said they didn't get any hazard pay, despite working on the frontlines. 

In its statement, the Jacobs School said that in national and internal surveys, its UB residents and fellows "do not identify worrisome concerns about working conditions such as patient safety issues or lack of personal protective equipment."

'A seat at the table'

A medical residency is essentially post-graduate training for newly minted physicians who have completed medical school.

Often, first-year residents spend time rotating through different specialties, allowing doctors to find the role they want to pursue during their residency and career. Given that, the length of a medical residency often depends on the area a doctor looks to specialize in. 

During their residency, doctors provide direct care to patients under the supervision and mentorship of more experienced physicians.

And once doctors complete residency and fellowships, their wages increase substantially.

"The Jacobs School of Medicine and Biomedical Sciences at UB is committed to optimizing the training of our residents and fellows," UB said in its statement. "At all times, the graduate medical education programs at UB strive to optimize the outcomes for our patients, their families and our communities, at the same time optimizing the clinical learning environment for the benefit of our residents and fellows."

On their website, the UB interns, residents and fellows note that while they "understand medical training is not supposed to be easy and that there is a culture in paying your dues," they want a seat at the table so they can have a say in their working conditions and how it ultimately affects patient care.

"We need a say in our working conditions," the website reads, "and we need to demand a seat at the table so that we can provide a safe working environment for ourselves and for the safety of our patients."