To whom this may concern, 

There has been a universal outcry amongst all residents and fellows concerning the rigid and unfair changes involving the imminent decrease in food stipend amount to $12 per day. A significant number of the residents and fellows who will be adversely affected by the change have voiced concerns as detailed below. In the spirit of working together to come to a solution that works for all of us, we have come up with some potential alternatives: 

1. Please consider increasing the daily spending limit to $25 a day with a monthly cap of $360 OR
2. Please consider reinstating the $420 monthly stipend OR
3. Please consider adding the previously provided $420 monthly stipend to our salary instead, and additionally enforcing at least a 25% discount on cafeteria food OR
4. Please consider increasing the $12/day to $25/day OR
5. Allow unused funds to roll over.

Residents and fellows can easily spend more than $12 for a single meal simply by purchasing water, a yogurt, and one additional item such as a bag of potato chips or a snack. The employee cafeteria is exceedingly overpriced where a daily special (including a single food item i.e a chicken sandwich, without a side or beverage) runs around $10. As most rotations require us to be in the hospital for 8-12 hours, and occasionally have to present early and stay extra hours if warranted due to a patient's condition, $12 per day with no opportunity to roll over unused funds from day to day is unacceptable given the current prices in the cafeteria as stated above. This is especially harsh for those residents and fellows working on the ICU teams who are consistently at the hospital during multiple meal times throughout the day. With rent and gas prices drastically increasing across Miami, residents depend on the hospital that employs us to provide nourishment to fuel our bodies and mind to do our jobs of learning and providing patient-centered care. At this point, not even fresh coffee is available to us free of charge except on the weekends. If we are unable to adequately fuel and nourish ourselves, it becomes increasingly difficult for us to perform our duties at the level that we aim and are expected to perform. This abrupt change in something essential such as a proper meal without cutting into our already low salary is detrimental to our physical health, mental health, and overall morale. While other hospitals in the area enjoy benefits such as higher salaries, lower cost of food, and access to the doctors’ lounge with associated nutritional options free of charge, we at Palmetto are subject to a nearly 15% cut in our food stipend which is deeply demoralizing. We are aware that other departments receive $30/day stipends who work similar hours.

Additionally, this decrease in investment in our nutrition at work does not provide a positive impression to those seeking to join the program and will make it increasingly difficult to recruit high-quality residents in the coming years. We implore you to consider the repercussions of this decision, both immediately and long term. We would deeply appreciate it if you would consider our various options above as an alternative as this is undoubtedly a serious matter. 

Thank you.