Several work environment issues have made their way to the HOA in the past couple of months as the University is unable to fill job vacancies of advanced practice providers (APP’s).  Recently, the UH ICU had a Thoracic surgery resident function as a Physician’s Assistant (PA) on the night shift. They were specifically told to act as first contact for the ICU and not to leave this new post. This is a job previously performed by a PA with the assistance of the resident.  Did affected residents receive additional compensation because of the change in assignments, additional work?  No.  However, the collective bargaining agreement (CBA) allows for additional compensation to be paid.  

In Family Medicine a resident was activated from the Jeopardy Pool to cover for the vacation of a PA, which is not the purpose of having a Jeopardy Pool.  As you know, the pool is supposed to be used to cover for your peers, not to cover for staffing shortages.  Did affected residents receive additional compensation because of the change in schedule, assignments, additional work? Again no.  Even though the HOA continually and repeatedly, points out the CBA allows for additional compensation to be given.  

In another example of additional work being assigned to house officers, a grievance was ultimately filed on behalf of Heme/Onc fellows which was denied, as is routine for Labor Relations, and yet, a PA was ultimately hired. The PA covers a large majority of the additional calls previously handled by APP’s when the Ambulatory Diagnostic and Treatment Unit (ADTU) was open.  Did affected residents receive additional compensation because of all the additional work?  I’m sure you know the answer to that question… no.

Most recently, the HOA was told that Pediatric residents are not allowed to mitigate their fatigue while on duty and are not allowed a call room working in the intensive care unit.  This is against the foundational guidance provided by the Accreditation Council of Graduate Medical Education (ACGME) who is the organization that provides accreditation for over 100 training programs at Michigan Medicine.

Currently, our Psychiatry residents are not given access to mental health care outside Michigan Medicine.  They only have access to the providers they work with – their own Faculty.  This is something else the ACGME requires, and yet, our institution ignores it. Graduate Medical Education refuses to contract with a provider outside the health system to see to the mental health care needs of our Psychiatry residents. The House Officer Mental Health program is 100 percent staffed with attendings who our Psychiatry residents work with and are evaluated by as trainees.  

These are all issues Graduate Medical Education should be addressing and seeking a corrective action for.  Because of the burnout and fatigue experienced by our residents and fellows, the HOA must bargain over job descriptions and other work environment issues that it never had to discuss during past negotiations.  Unfortunately, times have significantly changed and the ACGME Institutional Requirements aren’t really requirements at all in the eyes of the administration. This is not okay. 

The HOA will need the support of the entire membership when it comes to bargaining a new agreement.  We worry the current Agreement could expire without a successor in its place, resembling the current state of our nursing union. We hope a year from now we are not in the same situation. However, the issues above do not portend a favorable outlook.

Support each other and support the HOA - we will always fight and support YOU.