What are we bargaining for?

A union means that we are empowered to use our collective voice to effect necessary change in our workplace. Housestaff are traditionally very vulnerable employees – we sign our contract through the Match before even finding out where we will work; we live in fear of retaliation as we cannot easily change workplaces; and we are only here for a few years meaning that the employer can simply wait us out in order to avoid change. The 500P expansion, the vaccine rollout, the COVID surges, and more have all shown us that there is a pattern of the hospital neglecting and exploiting its housestaff employees. Forming our union will ensure we are at the bargaining table, rather than forgotten.

We are organizing not only for a new economic contract – so that every potential housestaff and their families can live here – but also for a new social contract – so that we’re not treated as cheap labor anymore. We need:

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Better working environments

When we are cheap labor, our working conditions are not a priority to the hospital – meaning we get overlooked for vaccines, we sleep in hallway stretchers because there’s not enough call rooms, and we’re expected to shoulder the increased census from a new hospital without additional support.

Better patient care

It’s not safe or fair to patients that their on-call physician is overworked – and therefore underslept and emotionally exhausted – and has to finish up four other consults before they can even be seen. It’s not fair or safe for us either.


The GME Wellness survey revealed residents are experiencing more burnout now than during the rise of COVID. We have to take care of our patients, ourselves, and our families, and often we’re not given the time or resources to do all three. We can’t fix burnout by telling people to be more resilient. We need to fix the root institutional issues.

And a seat at the table

We can’t get any of this done unless we stand together and demand it from the hospital. A union gives us sustainable leverage and bargaining power – without this, the hospital will just keep ignoring us until we tire out or graduate.

We’ve started negotiations! Here are a few common themes we’ve heard from you:

(and as a reminder – our current benefits are the bargaining floor. Before our union there was nothing stopping the hospital from taking away our benefits – but now we can protect them with one, and intend to do so for all departments with maintenance of benefits clauses).

Current situation Potential wins
Parental leave

5 days paid. Stanford makes you combine sick leave, disability leave, and vacation to get 100% of your salary for any additional weeks.  If you do not qualify for CA state disability/paid family leave (new employee) or have gotten sick or already taken vacation – you cannot use that for salary support for additional parental leave.

UCSF just won 8 weeks paid parental leave in their 2023 contract; UC Davis and U Michigan have 6 weeks.

The American Academy of Pediatrics advocates for 12 weeks of parental leave. Stanford should be on the leading edge and meet the guidelines of the doctors that it trains. (Certain specialty board requirements may limit how much someone can actually take, but this is changing in many fields.)

Retirement benefits
After years of receiving no retirement benefits, in 2021 (as a response to the collective action around the vaccine), we were given a 2% basic contribution + 2% matching contribution. Every other SHC employee gets 5% basic + at least 5% matching. Benefits on par with other SHC employees – 5% basic + 5% match.
On call coverage for duty hour violations/sick leave

Currently there is only punitive feedback for accurately reporting duty hours (being chided that it will catch the attention of the ACGME, or being sent home knowing that someone else is taking on your extra work for no pay). Similarly, residents often experience undeserved guilt for taking a sick day, knowing someone will be called off jeopardy or given extra work.

Additionally, the hospital has historically forbidden paid on-call coverage, and even now does not have consistent policies supporting it, citing ‘a slippery slope’ as a reason to not allow departments to pay their residents.

On call coverage compensation for covering a sick or over-hours colleague’s call.


Example (NYC H+H): Residents working an additional on-call shift receive $418 for a weeknight and $558 for a weekend or holiday shift. They receive $210 for a short call. The hospital contributes $379,474 annually to pay for these additional shifts.

We have historically received a ~3% cost of living raise each year. Inflation this past year was 7.9%. This raise is not guaranteed anywhere in our contract and the institution could easily stop offering it.

Guaranteed year-to-year raises in our contract.


UCSD got a 6% raise in the first year of their contract, and UC Davis negotiated a 12% wage increase over the first 2 years.

CIR is fighting for a starting resident salary of $104,000/year in California.

Increased housing stipends
We receive $7,200/year (pre-tax) in housing stipends. Our PGY 1-4 salaries still place us in the “low income” bracket for Santa Clara County. UCLA’s union negotiated a $12,000/year housing stipend, and UCSF’s union negotiated $13,200/year.
Increased meal stipends
We receive $10 on our paychecks for each 12 hour inpatient shift logged at SHC on MedHub (outpatient shifts do not count). Now that they have started taxing this, the equivalent is $6.50 for a 12 hour shift, which barely covers a small bowl of soup from the cafeteria.

UCLA negotiated $3000/year for meals, with a $25/day UberEats credit for sites without a meal benefit.

UCSF has a $300/month meal stipend.

Parking permits cost $35-$116/month to park a 10-15 minute walk from the hospital. Parking in the 500P garage costs $12/day ($300/month).

SHC currently will not even give free handicapped parking to residents with physical disabilities (they have no legal obligation as the garages are privately owned by Stanford).

UCSF’s union successfully fought back against attempts to take away their free weekend/evening parking.

Call rooms
There’s not enough call rooms in the hospital and we all know it. Despite residents advocating for more call rooms when 500P was being built, these rooms never made it into the final design. Additionally, the 300P call room blocks are not elevator accessible and therefore inaccessible to our colleagues with physical disabilities.  Designate enough accessible call rooms so that housestaff never have to sleep on stretchers and in our cars.
Fatigue mitigation
If you’re too tired to drive, you need a safe way to get home (especially since you might not even have a call room to sleep in). Currently we can use the SHC Uber account to go home from 300P/500P – but not from any of the other sites we work at. Additionally, frequent usage of the Uber service is often questioned by the GME – let us be the ones to decide if we can drive safely. Provide app-based rideshare options to/from ALL Stanford training sites (including VA, Valley) so that we never have to worry about falling asleep at the wheel and risking our lives/the lives of others.
Orientation pay
Currently orientation days are unpaid, despite interns having to move to the area weeks before receiving their first paycheck. Pay housestaff for days spent on orientation. It’s pretty simple.
Housestaff wellness
Stanford has the nation’s first “Chief Wellness Officer”, but we don’t see these efforts extending to housestaff. Funds promised to the GMEC representatives for housestaff wellness events have never materialized. We can negotiate funds to hold social events and wellness activities for a chance to interact with each other outside of the hospital/consults/admits, to improve camaraderie and overall morale (Alpine Inn??).

UCLA negotiated a $50k/year housestaff wellness fund, and their union advises the GME on its use.

(see more wins highlighted here)
(read our tweetorial about it here)

We want broad representation from all departments when we negotiate! We want your input on these topics. Want to bargain on a topic not listed here? Let us know!