Why we’re unionizing – from your fellow housestaff

Debunking misleading statements and focusing in on why we need to harness our collective voice for real change.

Dear Residents and Fellows of Stanford Health Care,

As your GME Council housestaff representatives (GMEC reps), we wanted to clarify some important points raised in recent communications between the GME office and the housestaff and their program leadership. We want to address each of your thoughtful and valid questions and concerns (we have asked all of these ourselves at some point).

  1. Does the union represent a 3rd party interest?

Our union is led by housestaff (not some nebulous third party) – meaning your fellow housestaff are your union representatives, and we as housestaff negotiate the contract. Every resident and fellow deserves a voice – and we invite representatives from every department to join us at the table when we sit down to negotiate. CIR (Committee of Interns and Residents) is a national resident union movement. Just like CIR itself is led by residents, each CIR chapter is housestaff led and run, with support from union staff who will help us negotiate and enforce our contract. What CIR gets us is legal, media, and organizing infrastructure that allows a union to outlast residents who take on additional responsibilities to advocate for their peers and eventually graduate.

  1. Will unionization result in the loss of program-specific benefits?

As the residents and fellows of Stanford, we elect representatives from amongst ourselves to bargain on our behalf. We would not vote to accept a contract that guts departmental benefits, a concern that has been raised by program leadership across departments over the past few days. In fact, we intend to negotiate for a ‘maintenance of benefits’ clause which both preserves current departmental benefits and raises the standard across all departments. A rising tide lifts all ships. The only reason why departmental benefits would be removed is at the discretion of the hospital, GME, and/or departmental leadership. In fact, expressed and implied threats to remove those benefits are illegal in a unionization campaign, and we would love to know if this is what you have been told. Currently, there is nothing protecting the program-specific benefits that many of us enjoy; as many housestaff can attest, these benefits can fluctuate significantly when leadership changes hands or when the hospital is under duress.

  1. Can’t we achieve the same goals via established channels, such as GMEC?

The GMEC has been the historical avenue for housestaff advocacy at Stanford. As three of your current GMEC representatives, we have tried our best to advocate for improved conditions for housestaff through existing channels. We went into this year with the intention of making the partnership between GMEC and Stanford GME as productive as possible. However, we have repeatedly found ourselves burdened down by several layers of committees and working groups without tangible progress, and the lack of an effective voice. For example, after the Housestaff Leadership Council was established last year following the vaccination protests, we were asked to remove the word “Leadership” from our title as they did not think housestaff should be involved in “real” decisions. All five of your elected GMEC reps are in agreement – we cannot successfully advocate for housestaff through existing channels alone. Harnessing our collective voice – like after the vaccine debacle – is the only way to get a true seat at the table.

Ultimately, we have learned that there is a limit to what GME alone can address; as non-unionized employees, there is no legal obligation for the hospital to bargain with us. Over the past two years, Stanford leadership has shown that they do not have the bandwidth to advocate for the residents and fellows that provide the backbone for our clinical services. Despite this, we are still fully committed to making the housestaff experience better; we simply no longer feel that it will be possible to achieve the kind of dynamic, humanistic change that is necessary to improve our working conditions and educational experience without reimagining what housestaff power in representation looks like.

As residents and fellows, we know the depth of our value, contributions and sacrifices. And we are the ones who shoulder the consequences of unfulfilled promises and delays from hospital leadership in addressing critical needs and issues in an ever-expanding healthcare enterprise. In light of this, we have collectively come to the conclusion that we as housestaff must advocate for ourselves – and for each other.

It is time to take our seat at the table.

In solidarity – Jessie, Grant, and Lawrence

PS. These blasts have been going to spam, and we are not allowed to use Stanford email listservs (dampening housestaff voices yet again). Please forward widely and add stanfordhousestaffunion@gmail.com to your contact list 🙏

PPS. Stay tuned for a point-by-point breakdown of the “FAQ” from Stanford. Spoiler: there’s a ton of misleading and a bit of borderline illegal stuff in there.

Learn more

Get Involved

Town Hall Sign Up – 3/9, 7 PM

Debunking misleading claims

(email sent to housestaff 3/3/2022)