Boston’s wave of medical unionization has added about 800 new doctors in training to its ranks.
Residents, fellows, and interns at Beth Israel Deaconess Medical Center went public Friday with their intention to join the Committee of Interns and Residents, a local of Service Employees International Union, citing long hours, insufficient pay, and other unsustainable working conditions.
The announcement came about two weeks after the doctors in training at Beth Israel, a Harvard Medical School teaching affiliate, filed a petition with the National Labor Relations Board to seek union representation. The next step is for the residents, fellows, and interns to vote on unionization, with ballots scheduled to be counted on Jan. 21.
“We’re trying to do the right thing for our patients, and we’re coming up against a system that’s really not working for them, and it’s also not working for us,” said Christopher Joshi, a first-year internal medicine resident at Beth Israel. “It’s really hard to take care of patients when we feel like we can’t afford to live in a very expensive city, when we don’t have food and time to sleep.”
In a statement, a spokesperson for Beth Israel Lahey Health, the hospital’s parent company, said the health system would await the results of the union election.
“BIDMC respects and supports the right of our trainees to make an informed decision about union representation, and we will proceed with the election process in accordance with all NLRB procedures. However, we believe that working directly with trainees to support their unique role at BIDMC is the best path forward,” the statement said.
The Beth Israel residents, fellows, and interns are far from alone in their union push. Residents and fellows employed by Care New England and Brown University Health in Rhode Island announced they were organizing in November, and residents and fellows at Mass General Brigham voted to join CIR/SEIU last year, though they have yet to secure a contract. CIR/SEIU also represents residents and fellows at Boston Medical Center, the UMass Chan Medical School, and Cambridge Health Alliance.
Aside from residents and fellows, hundreds of providers at Mass General Brigham, Cambridge Health Alliance, and Salem Hospital have also organized this year, coming at a time when many physicians see corporate medicine as hampering their ability to care for patients.
One of the key grievances of the doctors in training, Joshi said, is a lack of salary transparency. In the 2024-2025 academic year, Beth Israel residents and fellows, depending on what postgraduate year they’re in, earn salaries between $76,680 and $108,000, plus a stipend between $7,500 and $10,000. But these cohorts don’t know how much they will earn throughout the rest of their multiyear programs, he said, since pay scales are determined on an annual basis.
While Joshi said he was prepared for the 80-hour workweeks common in residency, he wants the hospital to provide financial stability in turn — especially since he has about $100,000 in student loans to pay off.
“It is obviously challenging to be a resident, and we all understand that, and we all sign up for that. I think what we don’t sign up for is not knowing if we’ll be able to afford our apartment next year,” Joshi said.
The BIDMC spokesperson said the hospital “is among the most competitive programs for salary and benefits for residents,” including providing 12 weeks of paid medical leave.
“While we do have the flexibility to adjust the scale based on market conditions, we are transparent about annual compensation,” the spokesperson said.
Beth Israel Deaconess Medical Center, a nonprofit hospital, is on sounder financially footing than many of its peers. From October 2022 through September 2023, BIDMC’s total revenue outpaced its expenses by about $160 million, giving it a total margin of 5.9 percent, according to state data. By contrast, the median total margin across all of Massachusetts’ academic medical centers was just 1.5 percent.
Beth Israel is also planning to build a new, $1.68 billion, 300-bed cancer hospital in partnership with the Dana-Farber Cancer Institute.
However, Beth Israel Lahey Health has not been without its challenges. The system, which operates 14 hospitals in Massachusetts and New Hampshire, said in September that it was cutting an unspecified number of positions, citing ballooning costs and insufficient reimbursements.
Dana Gerber can be reached at dana.gerber@globe.com. Follow her @danagerber6.