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Medical Residents Deserve Representation in this Comunity

There was a cross post about a medical resident suicide that was locked due to off topic comments, but it being locked really irked me. I am a long time reader in this sub and have one of the most upvoted post in the subs history. I feel like the mods locking out discussion from that thread invalidates my inclusion in this subreddit. Now on to why we deserve to be a part of this movement: ​ Medical residents are one of the most abused working classes in the USA. I will preface this with the fact that medical residents generally make 50-60k a year, so most of us are not starving (although 50-60k in VHCOL and HCOL cities is borderline poverty level). ​ To understand the abuse you have to understand the dynamic of our job. We can be an independently practicing doctor unless we complete residency. In order…


There was a cross post about a medical resident suicide that was locked due to off topic comments, but it being locked really irked me. I am a long time reader in this sub and have one of the most upvoted post in the subs history. I feel like the mods locking out discussion from that thread invalidates my inclusion in this subreddit. Now on to why we deserve to be a part of this movement:

Medical residents are one of the most abused working classes in the USA. I will preface this with the fact that medical residents generally make 50-60k a year, so most of us are not starving (although 50-60k in VHCOL and HCOL cities is borderline poverty level).

To understand the abuse you have to understand the dynamic of our job. We can be an independently practicing doctor unless we complete residency. In order to gain a spot in residency, you have to compete in The Match TM. The Match is an algorithm that matches us into our residency program. You apply to however many spots (generally 50+), you have to pay for the application and a $$ per spot (so applying to more spots is more expensive), interview at a handful (usually around 10), and then you rank them in order of your preference and a computer decides your fate. If you do not match then you can “scramble” into an empty spot, but it is probably not in your specialty of choice. So if you want to be a dermatologist or neurosurgeon and you don't match, you can either taken an open family medicine or internal medicine or pediatric spot and “be happy” you can have a future job or you can try again the next year with a huge black mark on your permanent record saying you didn't match.

Because we are matched into our spot, we can not negotiate salary, benefits, work hours, etc.. We are subject to the rules of the program we go to. The match is binding. Sounds like it violates anti-trust laws doesn't it? A captive labor force with no negotiating power. You would be correct. Paul Jung, MD sued based on this in Jung vs AAMC and the outcome was a rider being added to bill making it exempt from anti-trust laws. Kinda fucked up.

But don't worry, it gets worse. Remember when I said you can't practice without completing residency? Programs know that and know you are a captive workforce. You NEED them to be able to pay off your student loans and work as a doctor, but there are 100 people who would love to have your spot. They have all the power in the relationship. They abused their workforce so much that we had to pass rules that govern residencies that we can't work more than 80 hours a week (averaged out mind you, not a hard cap) and can't work more than 28 hours in a row. Some malignant programs ask you to lie about hours and threaten retribution if you don't. People who work at the higher end of the hour spectrum (surgeons, ICU) are making less than the federal minimum wage.

The student loans I mentioned above that also help keep us captive. There are varying reports as to how much we collectively owe. In 2015 the average was 246k. Since then it has ballooned more, especially with more for profit schools opening. There have been other reports that up to 17% of students do not have federal student loan debt, so that average can be much worse than it appears.

The icing on the cake? Medicare gives each program about 125k a year per person to cover the education of residents AND they can bill for our services. It is really hard to find statistics on how much we bill for, but I've seen numbers as high as 1 million a year in billing per resident in the higher billing specialties such as neurosurgery. So hospitals use government subsidy to pay us and then profit off of our labor without giving us a cent of it.

I know doctors make a lot after residency, but the culture of you will make a lot later so put up with the abuse now is ruining the profession. Burnout is at an all time high during a pandemic, in a field that already has one of the highest suicide rates.

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