The Committee of Interns and Residents (CIR), a national residency union with more than 17,000 members, has proposed a "Resident Bill of Rights" to help hospital interns, residents, and fellows "feel more empowered."

Amelia Breyre, MD, a fourth-year emergency medicine resident at the Alameda Health System in Oakland, California, and a regional vice president for CIR, told Medscape Medical News that the goal is to get residents to sign the bill and for program directors, hospital administrators, the Accreditation Council for Graduate Medical Education, and potentially legislatures to take notice.

"No matter where you are a resident, there should be standards that (reflect) a humane way of treating residents. We're a very disenfranchised work force.… My honest hope is that it inspires residents to advocate for themselves, to feel more empowered to do so," she said.

The proposal, which has been in development for months, according to Breyre, outlines nine key points:

A living wage that allows us to support our families and pay off our educational debts. That wage must be appropriate to location. Also included should be family health insurance at no cost to the resident with choice about the coverage provided, subsidized housing, and a child care stipend for those with dependents. The right to provide the best care possible for our patients and act in the best interests of the communities where we live and work. Included in this request is a larger effort to increase diversity in residency programs and faculty appointments, and strict enforcement of limits on nonphysician work so residents can spend more time with their patients. No more than 80 work hours per week, not as an average and including nonclinical tasks. Time off for being sick and seeking healthcare, including paid parental leave, without pressure to leave it unused. Recognition as full-time workers and a right to unionize. Organizers say this would allow the ability to "use our collective voices to advocate to employers and lawmakers for our patients and ourselves as workers, not as learners." Transparency, standardization, and due process from the institutions and employers that make key decisions about our careers and futures. Specifically, they call for "transparent standards and unbiased decision-making in graduate medical education; a fair system for resolving grievances, without retaliation or bias; and the ability to hold employers accountable." Access to mental health services without scrutiny or stigmatization. Equal access to learning and career development. Included in this request are education and book stipends, access to hospital committee leadership roles, reimbursement for board certifications and educational conferences, and time off for job interviews and conferences (outside of continuing medical education days or vacation days). Adequate hospital staffing and support. This would include maintaining backup call schedules for every residency program.

"We're trying to get the word out through our grassroots network," Breyre said.

The requests are designed to help further the CIR mission listed on its website: "We unite and empower resident physicians to have a stronger voice within their hospitals. With a growing, nationwide union of residents and fellows, we garner more negotiating power and support for our patients, and our communities. We use our collective voice to advocate for cost-effective, high quality health care for all."

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