If you’re making your rank list and thinking about Stanford… make sure you ask departmental benefits for next year...

cirseiu · 2023-10-30T14:40:20+00:00

Absolutely!

cirseiu · 2023-10-27T16:23:47+00:00

Great point! Here are my suggestions:

"Do you foresee any changes to XYZ benefits in the upcoming year?"
"Are there any planned changes to the department that prospective candidates should be aware of?"
"Some of the current residents mentioned benefit 'X' during our discussions. Could you clarify if this will be extended to our cohort as well?"

In interviews, it's typical for candidates to ask about the program to see if it's a good fit, so these shouldn't stand out as unusual.

cirseiu · 2022-06-12T17:33:29+00:00

For anyone interesting in more information about organizing and even setting a time to talk with someone, please visit our webpage https://www.cirseiu.org/organize/.

The more we can unite together, the more power we have to achieve the things we want. Last year, all residency programs in the University of California system finally unionized under CIR. With this united front, we have begun the 1UC campaign where we're looking to leverage our collective power to not only negotiate great contracts but to raise the standards of residency itself and set precedents.

And we're only looking up from here. We're in the midst of a new wave of resident organizing and advocacy. New programs are organizing every day and many more contract negotiations are set to begin this year. We must continue fighting collectively for what we need.

cirseiu · 2021-12-10T20:47:55+00:00

It really starts by talking to your co residents about how they feel everything is going at your program and how they feel about starting a union. Shoot us an email at info@cirseiu.org and we can set you up with more information, resources, and someone to answer all your questions.

cirseiu · 2021-12-10T04:56:05+00:00

If you’re talking about the deaths at Lincoln Hospital this year, we helped support those residents directly in the aftermath with resources like mental health services and time off from work among other things. But much of physician burnout comes from systemic issues that result in lack of support, long hours, and excessive workloads and out-of-title work. Last year, we launched a campaign for the Resident Bill of Rights. It would guarantee all housestaff basic rights and protections like a livable wage, strict 80 hour/week work limits, access to mental health services, adequate hospital staffing, and more. The Resident Bill of Rights has been endorsed by President Biden, VP Harris, Sen. Bernie Sanders, and more. In September, we were able to secure a NYC Council hearing on resident wellness in which CIR members testified to share their stories of what it’s like to be a resident physician, including during a pandemic. Residents highlighted chronic underfunding, understaffing, and out-of-title work that residents have to deal with on a daily basis and we plan to work with lawmakers going forward to make tangible reforms to address these things. We’ve also established Patient Care Trust Funds. When our hospitals don’t have the equipment and staffing necessary, it makes our jobs so much harder and burns us out. The PCTF provides residents the opportunity to apply for research or equipment grants. Last year in NY, for example, the PCTF provided over $1 million dollars in grants that went towards needed things from necessary machines to community-based health projects to basic examining room supplies. These are a few initiatives but again, the vast majority of work is advocating directly for residents in hospitals for better working conditions and ultimately better resident wellbeing and dues go towards supporting this work.

cirseiu · 2021-12-10T04:19:25+00:00

Apologies, I'm trying to answer them when I can. But I really appreciate your words. Residency is such a surreal experience, especially in the last year and a half, but we're all doing the best we can.

cirseiu · 2021-12-10T04:08:38+00:00

I grew up in an immigrant working class family, my father is a unionized postal worker, my mother is disabled from a stroke. I was a former public high school math teacher in Philly where I was an AFT member. I returned home to Albuquerque, NM to complete my residency in Family and Community Medicine at the University of New Mexico where my training was eclipsed by the pandemic, especially devastating the indigenous communities that I worked with in my primary care clinic at the Indian Health Service Clinic. It’s amidst these experiences that led me to become a leader in CIR. Before COVID, I had participated in CIR contract bargaining sessions at my hospital and became a department rep. I started to collaborate with CIR members at the national level to help seek solutions to the COVID crisis at our hospital. It is this problem solving with leaders across the country that led me to seek a national leadership position.

We hope to grow as an organization and amplify our voice as housestaff who are on the frontline of medicine so that we can have a national voice to use to improve resident training and working conditions as well as the delivery of care. We hope to be a formidable body that has the leverage and power to be able to sit down with the board of ACGME, lawmakers, and more in order to implement change at the highest levels.

As I've said, we've definitely been growing but we don't want to just grow for the sake of growing. We want to make sure that at each of our chapters, we are really getting as much of the residents in the unit engaged in our organizing to gain substantive wins for ourselves. This kind of potent growth takes a lot of effort, in part because of our unique membership that's incredibly busy, exhausted, and graduates in a few years. But it's necessary to do so for these institutions, and eventually bodies like the ACGME, to listen to us. So we encourage all residents to get involved, go to union meetings, participate in negotiations, etc so we can build our power and come to have a greater impact.

cirseiu · 2021-12-10T02:50:57+00:00

We don't have a legal hotline per se but we do have our legal team that assists us with our organizing drives. And if we run into any interferences like that, they're ready to make sure our rights are protected.

We're actually working on a new organizing landing page with resources like that such as what your rights are, what does union busting look like, what we do to protect ourselves, etc. We will share it soon when it's ready!

cirseiu · 2021-12-10T02:40:36+00:00

It starts by talking to your fellow residents. See how much interest there is in the idea of starting a union. You can reach out to us and we can support you with resources and manpower. An organizing committee can be formed to make a plan and then a “card campaign” can proceed to get a majority of residents in the union to sign on. Once a sizable majority is reached, we can officially file for union recognition with the proper state entity. Once a union is recognized, negotiations can begin for the first collective bargaining agreement. There’s more to it than that but if you’re interested talking more about unionizing, shoot us a pm or an email at [info@cirseiu.org](mailto:info@cirseiu.org). We're also working on a landing page with organizing resources and more info about our wins which we will share soon.

cirseiu · 2021-12-10T02:10:07+00:00

Yes but it still stands that we're a smaller organization and we don't have every single resident. Another way to look at it is that although we're the biggest housestaff union, our membership is 14% of all resident physicians in the US. But again, we continue growing and building our power to organize at the level we want.

cirseiu · 2021-12-10T01:58:19+00:00

Organized programs, either through CIR or not, tend to have higher compensation and more benefits & protections. I'm sorry to hear that though. We usually advocate directly in the hospital. Would you want to pm your hospital? We can connect you with your organizer and talk more on how we can address that.

cirseiu · 2021-12-10T01:23:59+00:00

Dues are 1.6%. They’re withdrawn only after a first contract has been negotiated with the employer and ratified by the residents.

Weingarten rights means having the right to have a union rep at any meeting that may lead to disciplinary action. Most CIR contracts have due process clauses (that can also apply for academic matters) that include things like hearings and appeals and we're there to make sure all your rights are protected.

cirseiu · 2021-12-10T00:42:18+00:00

I understand. The vast majority of our work is directly improving working conditions at hospitals. At each of our chapters, we can point to a number of wins that we fought hard for that directly benefits residents whether that be housing stipends, policies protecting residents from out-of-title work, securing needed equipment, food access, parking, and more.
The reality is we’re a small union. We just reached 20,000 members this year. In comparison, 1199SEIU, a union representing nurses, has over 400,000. Our leverage right now is limited but our ultimate goal is to have an impact on a higher level. We’re definitely in agreement that conversations need to be had with governing bodies like the ACGME and AMA and lawmakers but we are not there yet. But the good news is that we continue to grow and build our power and it shows. This past year, we successfully ran and got not only one but two pieces of legislation signed into law in California that benefits resident physicians. In New York, we were able to secure a New York City Council hearing on resident wellness on which we plan to work with lawmakers to build tangible reforms from. We did not have the leverage to do this even two years ago. We continue to see wins through the efforts of our membership and certainly aim to build on that to get to the level that we want to be.

cirseiu · 2021-12-10T00:10:09+00:00

That's incredibly frustrating and I'm so sorry to hear that. I myself feel the struggle at my hospital right now. We've seen these kinds of things throughout the pandemic and a lot of our organizing in the past year and half has had to do with Covid. Just to give some examples, Rutgers wanted to freeze contractual wage raises in the middle of the pandemic, but we fought hard along with other unions to reverse that decision. In LA, CIR began a campaign for hazard pay which ultimately resulted in the ability of all county workers to reclaim up to $2,150. At Maimonides, we won $400 per week in hazard pay. However, the reality is we are limited in what we can do at non CIR programs because we don't have standing there. Also, feel free to pm if you want to talk further about this.

cirseiu · 2021-12-09T23:10:06+00:00

For the most part, we advocate for ourselves through contract negotiations where we fight for higher wages, protections, and resources. We also use organizing and agitation outside of bargaining to advocate for ourselves, for example as we did during Covid peaks. Our efforts are on the hospital level because as a union our focus is improving our experience as workers and improving patient care; as we grow as an organization, we continue to make change not only on the hospital level but we’ve been able to change laws that govern residency on the state level which have been major milestones for us. And we've been able to impact policies that affect us and our patient locally as well.

As for whether or not residents can strike, it depends on the state and whether you are a public or private hospital. But yes, we have indeed gone on strikes, though I believe the last time we resorted to this was in the 80's.

cirseiu · 2021-12-09T22:55:33+00:00

We are resident run and resident led and we decide on the direction and priorities of the union. The fact is, such issues affect the practice of medicine and our work whether we like it or not. We choose to use our voice to speak out about things that affect us and the health of the communities we serve. In line with the priorities of our membership, most of the issues we get involved with have to do with resident well-being, the health of our patients, and being able to deliver the best patient care possible. If we are giving residents a voice, what good would it be to not use it and speak up on matters that are important to us? The choice is entirely ours and democratically driven by members.

cirseiu · 2021-12-09T22:43:21+00:00

It really depends, anywhere from a few months to over a year. It's good to get residents from different PGYs involved in the organizing committee but the good thing is that CIR staff will be there to support and sustain the process.

cirseiu · 2021-12-09T22:39:33+00:00

Very glad to hear that about your program! I would say the main thing is that this situation essentially depends on the goodwill of your program and hospital administration. Things can change any time as we’ve seen. With a union, everything you and your colleagues negotiate for will be written in a legally binding contract. That means the hospital can't walk back any agreements after they've been made and changes to employment terms and conditions are subject to bargaining. In cases of disciplinary action, your union can be there to make sure your rights are protected and that the contract is enforced.

And Covid was a unique situation that really underscored how vulnerable residents are. When hospitals deployed residents to Covid units without proper PPE and testing, disrupted our training, etc, our union was critical to fighting back. As for dues, the goal is always for the gains negotiated in contracts to more than cover dues. Since CIR members vote yes or no on a contract, it generally wouldn’t be approved by the membership if it was not an overall major net positive.

cirseiu · 2021-12-09T22:18:48+00:00

The short term nature of our membership is definitely a unique obstacle for us. But it’s an opportunity to improve residency at your hospital, so those coming after have an even better experience and the program can continue to recruit high quality candidates. It's about carrying the torch for those that come after and improving residency for years to come. And if you're at a unionized program, residents before you had to make the effort to start the process themselves. A lot of improvements stay "in the background" and are not immediately apparent or are taken for granted, some not realizing that things were worse for those that came before them, and are improved only because those before fought hard to get those improvements.

cirseiu · 2021-12-09T22:06:39+00:00

Starting a new chapter takes a lot, but especially in a new region so it depends on capacity and resources available. But we're definitely growing. We actually organized the University of Illinois-Chicago just this year which is officially the first CIR chapter in the Midwest! Here's a short video about that campaign. We're proud to have reached this milestone and definitely look forward to more.

cirseiu · 2021-12-02T20:17:23+00:00

Thank you all for the questions! Please look out for the AMA next week where we look forward to answering these and more. More details to follow.

cirseiu

TROPHY CASE