Physician residents in New York City’s public hospital system issued a stinging indictment Friday of conditions they and their patients face in hospitals and demanded the city intervene to fix what one described as a “recipe for disaster” and what another called an “avalanche of failure.”
More than a dozen current and former residents at the city’s Health + Hospitals network testified at a City Council hearing focused on conditions at hospital residency programs, and they delved into a wide range of problems, including low pay, shifts that last more than 24 hours and racial disparities in the care patients receive.
Dr. Hannah Marshall, a third-year resident at Kings County Hospital, which serves mostly Black residents in Central Brooklyn, pointed out that not only is staff spread too thin, but that the lack of basic resources is hurting her patients’ health.
“Having to deal with that constant fight for more resources for our patients, for better and just care, leads to a moral injury that eventually compounds these feelings of burnout that we can’t do anything more,” she said, her voice cracking. “We are constantly fighting for our patients against this avalanche of failure, and it leads to this general disillusionment and compounds the burnout. It’s not just a failure of H+H. It’s a failure of the American health care system.”
The Council hearing, which was conducted remotely, was called after the Daily News broke the story about conditions at Lincoln Hospital’s residency program, where at least two residents took their lives. Colleagues in that program blamed those deaths — and a third that was not officially ruled a suicide — on the program’s harsh work conditions.
On Friday, more residents came forward to offer their insights into what’s wrong with programs like Lincoln’s — especially in light of the COVID pandemic, which put residents on the frontlines of an unprecedented public health crisis.
Many of the residency programs at the city’s public hospitals rely on foreign-born residents. Like American-born residents, many are faced with high medical school debt and the pressure that goes with knowing if they drop out of their program, it’s far from certain they’ll get into another.
Dr. Ernesto Blanco, a former resident at Coney Island Hospital, recalled how during his time there between 2017 and 2020 he was constantly made to perform jobs that weren’t his responsibility, which translated into less time serving patients.
“There wasn’t much of a choice” as to whether he could say no to those demands, he recalled.
He remembered being granted a four-day work leave because of a combination of on-the-job burnout and stress from the political situation in his native Venezuela, which left many there without electricity and him unable to contact his family for days. But the leave he was initially granted was quickly rescinded within just two days.
“The culture at Coney was not one that valued and championed residents’ physical or mental health,” he told the Council’s Hospitals Committee. “One of the reasons I feel I can speak freely today is because I no longer work at Coney Island.”
While doctors are perceived as high-earners, residents aren’t. On average, a resident in the Big Apple typically earns $63,000 a year, works between 60 and 80 hours a week and has $250,000 in debt to pay off, according to Michael Del Valle, who works at Jacobi Hospital and is a rep for the Committee of Interns and Residents, which represents doctors in residency programs.
Dr. Zadoo Bendega, a fellow at Harlem Hospital, testified Friday that she’s one among many who feel this constant and unyielding financial strain. Bendega, an American whose family lives in Nigeria, said since signing on with the residency program in Harlem, she’s struggled mightily to pay her rent.
It’s not a dilemma she envisioned she’d find herself in given that, according to her, the contract she signed with H+H provides for “housing support.”
“This was not the case at all,” she said, fighting back tears. “My hospital and H+H should have provided support to me to find an apartment when I moved here. With my income, I’m still struggling to pay the rent because it’s more than my paycheck … it’s more than half of my paycheck.”
Stephanie Guzman, an H+H spokeswoman, responded that “all claims of unhealthy, unsafe, or unfair work conditions are taken seriously and reviewed by the system.”
Residents did not appear to be buying it, though.
Dr. Pramma Elayaperumal, a former Woodhull Hospital resident, said all the stress amounts to a “recipe for disaster.”
“Residents are abused,” he said. “The strain that residents are subjected to was only exacerbated by the COVID-19 pandemic.”
Councilwoman Carlina Rivera (D-Manhattan) acknowledged efforts Health + Hospitals has undertaken to address some of the issues, like promoting wellness among residents, but she suggested much more needs to be done to deal with the structural issues at play, such as insufficient staffing.
“We do not want to lose talent, and we cannot lose another life,” she said. “I will not stop until we see some changes.”
