TO: Graduate Medical Education Committee; Creighton University School of Medicine-Phoenix

Sub: Need meal stipend adjustments for resident physicians at both VHMC and SJHMC

 
We demand change to the current meal stipend proposal. This stipend proposal was made without input from those it directly affects, Creighton University residents. As it currently stands, house staff will be profoundly impacted financially and physically. Further, this change in how we feed our residents will distinguish Creighton as the worst residency program in Phoenix when considering how we support our residents on shift. 

 

Current CUSM-P proposal:

•  Total of $1600 per year for both locations together
• Residents can split the total amount based on their time at each location.
• Meal stipend calculated based on 12 hours shift.
• This equates to $133 per resident per month. Based on the number of shifts per month (varying b/w 20-28shifts in each program) each resident will get $5-6 per meal. This amount is only if the resident eats only once during the 12hours shift.

 

Average meal price at each location:

• VHMC:  Meal costs $8 plus a bottle of water. The average cost will be $10/day.

                      - For 6 months: Average cost will be $1500 (If the average number of shifts per month is 25)

• SJHMC: Meal cost $7 plus a bottle of water. The average cost will be $9/day.

                      - For 6 months: Average cost will be $1350 (If the average number of shifts per month is 25)

• This is the bare minimum meal that a resident needs. Any extra drink will cost more.

 

HLC Proposal 1: Fixed sum per day

• $15/day at both SJHMC and VHMC
• This format has been widely liked among residents and has demonstrated success overtime

HLC Proposal 2: Needs based whole sum allocation

• Annual meal credit   of $2850 divided as the resident deems fit between the two locations at the beginning of the year
• This number was drawn from above information referencing anticipated needs of residents on shift. 

 

Why meal stipend adjustment is important?

• Residency is not only a job; it encompasses the majority of a resident’s life. Time off shift is often spent studying and engaging in academic projects. Providing adequate meal stipend is necessary for any resident. Residents are already overworked and amid rising costs across the nation, many are struggling to make ends meet and support families. Keeping the restriction will negatively impact their education, physical/financial/environmental wellness, and the growth of the program.
• The meal stipend has never been sufficient at SJHMC. 70% of the residents run out of money ($1000) 3months before the academic year ends. Additionally, the cafeteria prices have almost doubled in the last 2years at VHMC, but no resident has complained about that as we can get at least one meal there at VHMC.  
• Major difference in meal stipend plan from other programs in Phoenix, AZ:

                     - Most programs offer unlimited access to the physician lounge, where they provide food besides a meal stipend. We don't have a physician lounge for residents that serve food.

                     - No other program keeps restrictions about the length of the shift to be eligible for a meal

Impact of each plan on residents/program:

• Positive impact of keeping $15/day:

                     - Less stress on residents about finances

                     - Adequate meals and drinks at work

                     - Positively re-enforce future students while choosing our program as other programs in the Phoenix area has better flexibility.

                     - Prove our programs are well balanced with wellness, mental, emotional, and physical health.

• Negative impact if keeping $1600 per year:

                    - It affects residents' wellness and eventually affects ACGME feedback

                    - Downgrades our program compared to other programs in the same city

                    - Medical students are less likely to choose our program in the future.

• During this time of year, we welcome our new interns to begin their practice of medicine. Understanding the system, learning, and dealing with finances with these restrictions on meal stipends is very challenging and will affect our education.  
• In conclusion, it would be appropriate for residents and the residency program to keep a flexible meal stipend of $15/day at each location, which is quite functional and sensible overall. If this is not feasible, we request the allotted amount to be increased to $2850 per year to accommodate resident needs.