The University of California, San Francisco’s Department of Medicine says its residency program “aims to holistically support all residents” in part by seeking to “promote justice and diversity.”
It’s located in the most expensive city in the U.S. where the Department of Housing and Urban Development says a family of four earning $139,400 a year qualifies as “low income.” An annual salary of $97,600 now puts a single adult in the “low income” category as well.
Residents and fellows at UCSF, physicians who’ve completed medical school but work as trainees to learn specialties, earn from around $78,000 to $85,000 a year.
On top of paying the highest housing prices in the country, many of them are saddled with another monetary burden. The financial technology company Credible says eight out of 10 medical school graduates borrow to earn their degree, taking on an average of $251,600 in student loan debt.
Many residents also have families to support according to “Emily,” a UCSF fellow who asked Discrepancy Report not to reveal her real name.
“We work usually around 80 hours a week,” she explained. “There is no way that the hospital could run without us. We’re kind of the first people called and involved in care. … When most people come to the hospital and they think of who their doctor is, they probably think of a trainee without realizing it.”
Historically, employees have paid for parking during daytime hours, and for years Emily and her colleagues have gotten a break in the form of free parking on nights and weekends.
But on June 30 residents and fellows received an email from administrators with some unwelcome news: as of Sept. 1, the free parking policy will end.
“Those with night/weekend duty pay $39/month to park on campus,” Kristen Bole, a UCSF spokesperson, said in an email explaining the new policy. “Any employee or trainee can get a monthly 24-hour parking permit for $302/month, which is roughly $15/day. Occasional UCSF parkers pay a $24 discounted daily rate when needed. These rates include the required 25% tax on all drivers who park in the City & County of San Francisco, and all of these can be further reduced by participating in our pretax commuter program.”
“It’s what we call an unfair labor practice,” a staff representative for the Service Employees International Union’s Committee of Interns and Residents told Discrepancy Report. “It wasn’t presented as a proposal that we would bargain over. It was a change in working conditions that they attempted to impose unilaterally. When we heard about the change, we did get in touch with U.S. labor relations and they have subsequently offered us a meeting.”
The union shared testimonies from trainees on social media that described concerns about safety and financial hardship.
“I take overnight and weekend call for patients with eye emergencies,” an unnamed resident was quoted as saying on Twitter. “Not having a secure parking location will delay care for patients and also impose a risk on my personal safety. In addition, cost of living is extremely high already and paying for parking will cause additional hardship for me as a trainee.”
“Increasing the time/difficulty of commuting will make me less inclined to sign up for extra courses,” said a quote from another anonymous resident. “As such I will contribute less to my field.”
“It just feels disrespectful to take away a benefit that we’ve been given for so long when we’ve already kind of sacrificed a lot in terms of our education throughout this pandemic,” Emily explained. “A lot of us volunteered a lot of extra time to cover shifts or the ICU and rather than paying us back or showing a level of appreciation … it feels like they kind of just take more from us.”
“All frontline workers are important at UCSF, and we appreciate the contributions they make to our patients,” said Bole. “As a dense, urban environment, parking is extremely limited in San Francisco, but there is a robust public transit system. UCSF also offers free shuttle services between our campuses and public transit hubs to help reduce the need for personal cars and reduce the impact of traffic in our community. However, we understand that public transit and shuttles may not work for everyone, especially those who work night and weekend shifts, and have made on-campus parking available to all who require it.”
“When I am working nights, I’m on call, which means I am not going to the hospital unless there’s an emergency happening,” said Emily. “And I need to get to the hospital fast and sometimes at 2 a.m. it’s not even feasible for me to take public transportation at that time. It’s not safe for me to bike. The only option that I personally can see where I live and how to get there in the morning quickly and safely is to drive, which means that effectively I would have to pay for that parking.”
Emily is also concerned about diversity.
“It discourages people who come from a disadvantaged background to pursue this field. And this is one small piece of that. But it’s a bigger trend and it’s a bigger problem,” she said. “We don’t have enough Black physicians. We don’t have enough physicians who come from disadvantaged backgrounds. And there’s such a financial burden to becoming a doctor that we’re not going to fix that unless we address finding affordable ways for people to get through training without accumulating a lot of debt.”
