To the editor:
March 20 was National Match Day: the day when medical students find out where they’re going to spend the next three to seven years of training, known as residency. Most of the new MDs will be focused on their new specialties, hospitals and cities. In the months that follow, concerns will turn to more mundane worries: housing, healthcare, childcare. Few, if any, realize the hardships they will face in the coming years.
Residency, the period of training that follows medical school prior to board certification, is supposed to be difficult. It’s a time of intense training and learning, one during which doctors learn both the art and science of practicing their chosen specialty. Residents work up to 80 hours each week, across nights, weekends and holidays. For this privilege — and it is absolutely a privilege to be in training — residents are paid a national average of around $13-16 per hour (calculated by dividing median salary by 60-80 hrs./week). First-year residents at Stanford Hospital have a post-tax adjusted gross income of $43,787 ($3,650 per month). Although the median rent for a one-bedroom apartment is over $2,200 per month in Palo Alto, this is still a living wage for single residents without children.
Consider, however, what happens when a resident has a child (after all, life happens). Policy makers in California use the Self Sufficiency Standard as proxy measure for poverty. In Santa Clara County, the self-sufficiency wage for two adults and one infant is $6,352 per month. If a resident’s partner cares for the child(ren) in lieu of work, the family will come so far below this level that they may even qualify for government assistance. If both partners work, then the family requires childcare. Unfortunately, residents are at the very bottom of the priority list for on-campus childcare at Stanford; many have spent years on the wait list. If and when they are allowed in, there is no subsidy for the cost: $2,110 per month. Those that make it off the waitlist thus often take out personal loans just to pay the bills.
Stanford does have a generous health benefits package for residents, and for that we are grateful. Still, the fact is that Stanford Hospital could do more to support residents if we were a priority. The hospital is in the top five for earnings for non-profit hospitals nationwide, taking in over $1 billion in excess revenue (akin to profit) over the last four years. Stanford Hospital is also paid more than $60 million each year by Medicare for training the approximately 1,100 residents and fellows who work here. There are only 40 residents seeking childcare at Stanford right now; fully covering the cost of that childcare would be less than 0.1 percent of the annual benefits budget.
So, to the newly matched physicians: Welcome to Stanford. You are some of the best and brightest that our medical system has to offer, and your training here will be superb. Hopefully by the time you arrive, Stanford Hospital will have changed its policies to ensure that it is practical to be both a resident and a parent.
Timothy E. Sweeney M.D., Ph.D.
Resident, General Surgery
Elected Representative, Graduate Medical Education Committee
Contact Timothy Sweeney at tes17 ‘at’ stanford.edu.