FAQs

Select a button below to get answers to your most frequently asked questions on a particular topic.

COVID-19 WELLBEING YOUR VOICE SALARY & BENEFITS UNION FAQs ‘ASK US’ ANSWERS ARCHIVE

COVID-19 FAQs

DELAYED GRADUATION. Can program directors delay graduation because of redeployment? Or because of being out sick with COVID? What is the role of GME if we have concerns regarding decisions made at the program level?

Program directors must assure a resident has met all requirements for graduation, including time requirements, required rotations/experiences, and procedural volume. These are requirements set forth by the ACGME and specialty boards.

A program director may delay graduation of any trainee who has not met the substantive requirements for graduation. Many specialty boards have issued relaxed guidance during the COVID-19 pandemic. These temporary specialty exemptions take into account how COVID-19 may affect your normal training in terms of time and patient/clinical volume.

Within MedStar, in order for a program director to delay graduation, s/he must demonstrate a need to do so to the satisfaction of GME and the DIO. GME and the DIO must make certain that any decision to delay graduation is consistent with ACGME requirements and any board specialty requirements. Finally, if a trainee disagrees with a decision to delay graduation, the trainee may seek a review under the House Staff Due Process policy and/or may file a complaint with the ACGME. If you believe your program director is not adhering to your respective specialty requirements, please contact GME.

EDUCATIONAL GATHERINGS. What are the criteria for deciding whether a program-related event can occur and whether it should occur in-person or virtually, and how many people can participate in an educational conference?

In general, education-related in-person gatherings outside of routine patient care activities should be minimized to the extent feasible, regardless of gathering size, in preference of alternative virtual means. Additional information can be found in our Educational Gatherings Policy.

ELECTIVE ROTATIONS. Can I pursue an elective rotation that is based at a site outside of the MedStar Health system?

Given the complexities related to the COVID-19 pandemic, we are limiting elective rotations to (1) those that comprise an existing, required component of the residency or fellowship curriculum for all trainees in the program as filed with the ACGME, (2) elective experiences that are necessary for board preparation in a given specialty or subspecialty and are not currently offered or available within the MedStar system, or (3) the opportunity to gain exposure to a fellowship domain that is not currently offered or available within the MedStar system. In this latter circumstance, priority is given to fellowship exposure at local institutions that we work closely with for other existing clinical rotations, such as Johns Hopkins, University of Maryland, George Washington, and INOVA.

FELLOWS. If fellows are redeployed to their primary specialties as full attendings (taking on full attending decision making, full liability, etc.), would compensation reflect typical fellow moonlighting pay or standard attending pay? When will fellows be credentialed as attendings?

If MedStar decides to redeploy fellows as attendings, those fellows will be compensated as attending physicians for their service as attendings.

Qualified fellows have already been credentialed through our disaster privileging process to work as attendings, but unless or until MedStar notifies you of a need to deploy you as an attending, you should not undertake any work as an attending. When the state of emergency ends, these disaster privileges will also end.

HAZARD PAY. Will we be provided hazard pay given the additional risks we are taking on with the pandemic?

MedStar does not provide hazard pay to anyone. But, MedStar does take every precaution consistent with national guidelines and best practices to reduce any risks to you and our patients associated with the pandemic.

In some situations, some associates are being paid to work extra shifts. Residents and fellows are not being asked to work above and beyond their normal duty hours.

MOONLIGHTING. Why are residents being restricted from moonlighting when it seems attending physicians are not?

As residents/fellows, there are many restrictions on moonlighting that apply to you and not to attendings. For example, the ACGME explicitly requires any moonlighting be pre-approved by the Program Director, as it requires us to monitor and limit your duty hours, and to monitor your stress, fatigue and wellbeing. Attending physicians are different from trainees because they are not subject to ACGME requirements; however, MedStar is discouraging them from moonlighting.

We are currently restricting moonlighting for all trainees because we realize that simply performing the requirements of your residency right now is more stressful than normal. In addition, we have become aware that a number of neighboring hospitals are not following the same level of safety precautions as MedStar. We are not comfortable subjecting trainees (as trainees or moonlighters) to locations where their health is placed at greater risk.

MOONLIGHTING. Can some moonlighting be allowed? For example, could we allow internal moonlighting? If we moonlight for home call exclusively, if not deployed, would that be okay as it has no risk of additional exposure?

After hearing your concerns and reevaluating the potential risk of exposure to you and your colleagues, we will begin allowing internal moonlighting for those who had previous existing approvals, assuming there is still demand for that work. However, we will continue restricting external moonlighting to assure adequate rest, safety, and duty hour management. Please work with GME and your Program Director to discuss resuming any prior approved moonlighting.

All moonlighting is subject to availability of work. There is no current demand for residents to moonlight for eVisits. If the demand returns, we will notify you of that opportunity.

PRIORITIZATION OF LEARNERS & EDUCATIONAL EXPERIENCES. What are you doing to ensure continuity of education in the setting of a pandemic response?

In order to ensure the safety of all of our associates, learners, and patients during the COVID-19 pandemics, we have established guidelines related to all Clinical Learning Environments within all MedStar Health entities, which can be found at this link: https://www.covid19.medstarapps.org/wp-content/uploads/2020/07/MedStar-Health-Prioritization-of-Learners.pdf

QUARANTINE. If a resident is placed in quarantine, do we lose vacation time? How are our medical expenses paid?

Any resident/fellow placed in quarantine (either pending testing or due to a positive COVID-19 test) is placed in paid leave status that is not vacation time. MedStar will cover the costs related to any medical care you require resulting from COVID-19. Please contact GME for any specific questions or issues.

VACATION. Can a resident roll over vacation to the next academic year? Will residents who have lost their vacation be paid or reimbursed in some way? What happens to vacation time you might have lost if you are a graduating resident/fellow? Will there be a payout? Is back-up call to be considered vacation time? For those of us working one week on/one week off, do those weeks “off” count against our vacation or 48 required clinical weeks per year?

Cancellations. If you had your vacation cancelled by your program director due to staffing requirements, then the Program Director, working with GME, will roll up to two weeks of vacation into the next academic year for you.
Travel Disruptions. Many people had spring break and other travel plans disrupted. If your planned vacation/travel was cancelled or disrupted due to COVID (i.e., travel restrictions, flights, etc.), and you still took the time off, then additional vacation will not be rolled into the next academic year.
Impact on the Upcoming Year. Program Directors are currently authorized to flex a maximum of two weeks of vacation time into the upcoming academic year. We understand that may be very disruptive to the schedule. GME will work with your programs to prioritize fair vacation allocation going into the next year.
If you are graduating at the end of this academic year and your vacation was cancelled by your program director to assure workforce continuity, you will either be allowed to take the vacation time before you graduate, or you will be paid for the time that was cancelled (up to two weeks).
What counts as vacation. If you are assigned to back-up call, you are considered working. Programs assigning residents one week on, one week off for pandemic staffing have been instructed to not count the time off as vacation. Even with a week-on/week-off schedule, in many cases specialty board and ACGME requirements are being adhered to. While on the “week off,” residents are not on vacation, but instead are expected to participate in conferences (via web), conduct any at-home assignments (including telehealth, discharge summaries, home call, etc.) and engage in scholarly activity as assigned by the program director.

EMERGENCY LOANS

My partner has been furloughed due to the COVID crisis and we’re struggling to make ends meet. Is there any financial assistance available?

MedStar Health GME has offered emergency loans to residents and fellows for several years. These loans are interest free, and must be paid back prior to graduation through payroll deduction. The amount of the emergency loans has temporarily been increased from $1,000 to $2,500.00. Please contact GME for assistance with an emergency loan.

MEDICAL COVERAGE

Will this extension include coverage for our families? Will it cover me if I’m in a different state?

We were happy to be able to provide you with this extension of benefits so you do not have to worry about health insurance for you or your family during these extraordinary times. This one-month extension is an effort to provide you with gap coverage as you transition to your next position. The terms for this extension are based on your current coverage. Whatever health plan you are currently enrolled in will be the same for your extension month – including any depended coverage. If you are outside of the MedStar network, you will need to review what your current health plan’s coverage terms are for any out-of-network care.

I don’t understand how my medical bills will be covered if I become sick with COVID. Can you confirm how my bills will be paid?

If you become sick with COVID-19, you will be covered by MedStar’s Workers Compensation benefits. Workers compensation benefits include two components: 1. Wage replacement for time you are unable to work; and 2. Medical expense reimbursement. In the event that you test positive, please reach out to GME to determine your specific situation. If you receive any bills for COVID testing that was done through Occupational Health, please bring those bills to GME so we can get them taken care of for you. In addition, if you require medical care relating to your COVID illness, please advise your provider that this is a Workers Compensation claim. They will be able to bill MedStar directly.

OUTPATIENT SETTINGS

Is there any consideration to allowing N95s for PUIs in the outpatient setting?

Symptomatic patients in the outpatient setting should be wearing a procedural mask (Source Control), and providers should be wearing surgical or procedural masks. These masks are sufficient for source control of a droplet disease. N95s are not needed in these circumstances because, in the absence of AGP, COVID is not considered an airborne transmission disease per CDC. (see also recent study supporting the safety of this guideline https://www.nature.com/articles/s41591-020-0843-2).

POLICY AND PROTOCOLS

Is there a policy on associates bringing in and wearing their own PPE?

There is adequate PPE in the hospital and providers should not need to bring their own PPE. PPE that is provided to the MedStar Health System care teams has been reviewed by occupational health, environmental safety, infection prevention, infectious disease, and the quality and safety leadership, with a focus on protecting our teams. This is the sole purpose of this process. The team works closely with supply chain leaders to ensure that only PPE which provide adequate protection is released. Because PPE from other sources may not have gone through this same comprehensive review, and because there is no way for us to ensure PPE from outside sources provides adequate protection, we have asked providers to not bring their own PPE in for use in the MedStar Health care environment.

Are there any policies in place that direct attending physicians to limit residents’ exposure?

Attending physicians have been instructed to reduce “layering” of learners for teaching purposes. Teams should be limiting the number of learners exposed to COVID patients to the minimum necessary.

RESOURCES

Is there one place that I can find current COVID information for MedStar hospitals, like occupancy numbers by hospital, etc?

All computer desktops now have the COVID NOW shortcut installed. When you click on this link, it takes you to a Starport page with current data. You will see this data on the top right of the page.

SUPPLIES AND AVAILABILITY

What is the status of PPE supplies?

We know there is a national constraint on PPE. We have been working aggressively with our supply chain since January to maintain our PPE supplies. That said, we continue to look to the future to assure we are prepared. Our supply chain leaders have been working daily to assess and expand our supply of PPE by both leveraging existing partnerships and exploring new potential sources of PPE. We are also implementing conservation strategies consistent with best practices and published literature.

SURGICAL PATIENTS

Are there specific, written guidelines on PPE protection for OR staff?

For PUI/COVID+ patients, PPE should be the same as for direct, in-room patient care with eye protection, N95, gown, gloves. For non-PUI/COVID+, a surgical mask should be worn with the exception of the proceduralist performing intubation/extubation, who should wear an N95 during the intubation/extubation. Up to date guidelines can be found at www.MedStarHealth.org/COVID19resources.

VACATION/PTO

Why do some residents get more vacation than others?

All residents receive two weeks of vacation per year. Each program director, at their discretion, can grant up to an additional two weeks away (consistent with ACGME and specialty board requirements) for illness, fellowship interviews, conferences, and other qualified reasons.

Wellbeing

WELLBEING RESOURCES

I appreciate that we have Wellbeing support at MedStar, but I’m not sure what that means exactly. How does MedStar define “wellbeing”?

Often people think of things like yoga, meditation, or organized social activities when the word “wellbeing” is used. But it is actually much more than that. At MedStar, we think about wellbeing in three inter-connected categories:

Culture of Wellness – How does it feel to be at work?
Efficiency of Practice – How difficult is it for me to do my job?
Personal Resilience – How am I, as an individual, doing mentally and physically?

All three of these components lead to your level of Professional Fulfillment and/or your level of Burnout. For those reasons, we approach each of the three components at MedStar in different ways. Most of what is covered in this FAQ today is focused on your personal resilience.

Is there one place where I can access all of the Wellbeing resources?

Absolutely. First, bookmark the MedStar Health website www.MedStarHealth.org/Wellbeing for a current listing of wellbeing benefits. Or, you can reach specific physician wellbeing resources on the academics landing page at www.MedStarHealth.org/Academics and click on “Wellbeing” on the top right menu bar.

ALTERNATE HOUSING OPTIONS

Most of my anxiety right now is about COVID exposure and my family. I am working in COVID units and have a high level of exposure. I’m tired and worried about my family. My elderly mother lives with us and she is high risk. Are there any options for me to stay somewhere temporarily so I can minimize exposure to my family?

MedStar Health is partnering with participating hotels in Maryland and the Washington, D.C., region to provide rooms for our associates and physicians who prefer to isolate themselves and/or stay in a private room following shifts to mitigate potential exposure to family, household members and/or roommates. The cost for these accommodations will be covered by MedStar Health.

This benefit covers one, single-occupancy room per associate—no guests are permitted. Associates must provide their MedStar ID badge upon check-in (and for some, a credit card) to the participating hotel. Click here to view participating hotels, booking information and cleaning/linen services (which vary by location). A listing of hotel locations and services is also attached to this FAQ, but please check the website, as it is updated regularly. Please reach out to GME for more information.

Can I also use these hotel services if I am quarantined?

Yes. Contact GME for more information.

CHILDCARE

What childcare options currently exist?

We know that childcare is a major concern for all our providers with children. Therefore, we’ve made a big push toward expanding current options and creating new childcare options.

In DC: MedStar Health has partnered with Bright Horizons (2101 L Street NW) to create unlimited, consistent, and free childcare.

In DC, MD, and VA: MedStar Health has partnered with the YMCA to provide unlimited, consistent, and free childcare. All locations are highly vetted, follow CDC safety guidelines and include meals.

We have also expanded the Care.com option for a total of 25 back-up days. As previously, the service is a shared-cost model with a copay included. Information on all the childcare options can be found on www.medstarhealth.org/wellbeing.

FINANCES

There’s a lot of stress around finances right now. What resources are available to help with that?

There are several programs currently available through MedStar Health to help you financially during these difficult times. Emergency interest-free loans up to $2,500 are available through Graduate Medical Education. We are also working with Financial Beginnings to put together a series of financial literacy seminars tailored specifically for residents and fellows.

TIME MANAGEMENT & PERSONAL ERRANDS

I seriously just don’t have time to do anything outside of work. I wish I could just have someone to help me navigate personal things that are piling up. For example, I really need a plumber and don’t even know how to find a qualified one who could come on my one day off work.

Remember we have the Physician Concierge program available to you at no cost. The Physician Concierge program provides you with confidential personalized care planning, access and navigation to well-being and convenience resources (like finding a plumber who can come to your house on a specific day and time!). Physician Concierge is available to help with work or life challenges or when you just need to talk with someone. Whether you need emotional, social, physical, financial or career-related support, the Physician Concierge program is here to help. This resource can be accessed through the MedStar Concierge Connect app. This is a free app that provides easy, one-touch access to services available to you through the Physician Concierge program. Also please remember your spouse/partner also has access to utilize this service. Download from the App Store or access these resources on the website www.MedStarHealth.org/Academics

Given our current schedules, it’s difficult to even be able to shop for food. The waits are long to get into the supermarket and especially tough to navigate with our clinical schedules.

We are working with grocery stores to create specific windows of time for healthcare provider-only access to shop. We will continue to work on this to provide more options. Also, remember the medical student volunteer group will provide grocery shopping and delivery. You can access their websites by region at either (DC) DCcovidSitters.com or (Maryland) MDCovidSitters.org

In DC: We are working with Whole Foods Market to create a specific window specifically for healthcare providers to come in and do their food shopping. You will need to present your badge when you come in. Current locations include:

Whole Foods Market Logan Circle (1140 P Street NW) 9-930PM nightly
Whole Foods Market Foggy Bottom (2201 I St NW) 8-9PM

In Baltimore: Whole Foods Market is only taking online orders with no in-person shopping.

We are also working with other regional markets to set up similar arrangements.

EMOTIONAL & MENTAL HEALTH SUPPORT

Are there any emotional support resources specific to COVID-19 that are available?

We have launched new virtual support groups in conjunction with MedStar Behavioral Health. There are specific support groups that are just for residents and fellows. You can participate either completely anonymously if you wish. Support groups are through WebEx technology.

New virtual self-care seminars teach various coping strategies such as mindfulness, meditation, breathing exercises, etc. are also available.

The Physician Concierge program has expanded their current platform to assure the concierges have current information on all COVID-related resources, including expedited access to mental health professionals.

Also, if anyone has an urgent mental health issue that requires immediate intervention, please reach out to either Dean Padmore or Dr. Jon Davis for assistance in obtaining an immediate and confidential provider resource.

I hear other hospitals have peer support programs. Do we have that?

In addition to the virtual support groups, we have expanded the existing peer support network through the Care for the Caregiver program. You can use the information on the website to reach out to a peer to discuss current concerns, anxieties, and adverse events.

One of the residents in my program was having a really difficult time before COVID, and now it seems to be worse. As a resident group we are trying to cover for him as much as possible, but I’m getting worried about him and his ability to cope. He doesn’t want us to discuss this with our Program Director.

Obviously, the need for confidentiality is important. However, as residents/fellows, you should not be in a position of having to provide this level of support. If your colleague doesn’t want the Program Director to know, you should contact either Dean Padmore or Dr. Davis for assistance. They can confidentially help your colleague to get immediate access to resources to assist.

ACCESS TO FOOD/MEAL CARDS

Is there anything being done to address access to food during shifts, especially during the evening and overnight hours?

Our food vendor, Sodexo, has launched their new Bite App that enables all residents and fellows to order food 24/7 regardless of your location.

For residents/fellows based at MWHC, MNRH, or our Baltimore hospitals, our food vendor—Sodexo—has launched their new Bite App that enables you to order food anywhere you are 24/7.

Additionally, for all house staff, we are working with various companies (e.g. Uber Eats, KIND Bars) to bring delivery and individually packaged healthy snacks to you whenever possible.

Where can I use my Sogo card?

Sodexo or “Sogo” cards are issued by MedStar Health for use at Medstar Health hospitals. GME loads money on your Sogo card for your meal allowances. These cards can be used at:

- MedStar Baltimore – can be used in all hospital cafeterias and coffee bars
- MedStar Georgetown University Hospital – can be used in the Georgetown Café (PHC ground floor), Scrubs and Grub (2 CCC), and the coffee shop on 1 Main.
- MedStar Washington Hospital Center – can be used in the hospital cafeteria
- MedStar National Rehabilitation Hospital – can be used in the hospital cafeteria and small café on the first floor

Why do some of us have “GoCards” and some of us have “Sodexo” cards? Why can’t we use these cards everywhere?

GOCards” are issued by Georgetown University and were previously administered to residents/fellows based at MGUH. Due to University changes stemming from COVID-19, the University has discontinued the Debit Dollars program that GME used to add funds for meals at University locations.

Can GOCards and Sogo Cards be set up so we can use them at additional locations, like Panera at MWHC, or the Coffee Cart at MGUH?

At this time, cards can only be used as listed above. However, we have received many requests about this, and are exploring additional locations.

We’ve had a lot of challenges with transportation due to limited public transportation. Are there any other options for residents and fellows?

MedStar Health now is offering Uber rides, at no expense to associates and residents/fellows, as an option during this time of reduced public transportation. To take advantage of this service, you must add the Uber application to your smart phones. Please contact Jennifer Remington for details and authorization.

Your Voice

PARTICIPATION. How can residents and fellows be involved in decisions that impact trainees?

There are many opportunities for trainees to participate in MedStar decision-making, including:

MedStar Health Physician Leadership Council (PLC): 2 residents (appointed)
MedStar Health (system) GME Committee: 5 residents (peer selected)
Baltimore Hospitals GME Committee: 15 residents (peer selected)
MWHC/MNRH GME Committee: 4 residents (peer selected)
MGUH GME Committee: 2 residents (peer selected)

Additionally, residents and fellows participate in many hospital committees and working groups. If you would like to participate more actively but you are not sure how, contact GME for additional information and guidance.

Salary and Benefits

PAY/COMPENSATION

“What are the current salary levels for this year?”

MedStar GME PGY-Level 2020-2021 Annual Stipend

PGY-1 $62,250

PGY-2 $63,200

PGY-3 $65,500

PGY-4 $69,000

PGY-5 $71,000

PGY-6 $74,000

PGY-7 $79,000

PGY-8 $84,000

How are salaries determined?

GME conducts a market analysis to assess what other regional hospitals are offering with regard to wages, and then compares that to our current salary levels. Our goal is to assure we offer fair and market competitive wages at each PGY level. Once we have conducted this analysis and proposed new levels, we present this information to the GMEC for review and approval.

VACATION/PTO

Why do some residents get more vacation than others? What if I lose my vacation time because I’m pulled to provide clinical coverage during the COVID-19 crisis?

If your vacation was cancelled by your Program Director due to staffing requirements, then your Program Director may roll over up to two weeks vacation into the next academic year for you.

DISABILITY COVERAGE

How does Short Term Disability (STD) work? When do I have to enroll in this if I become sick?

Short-Term Disability (STD) coverage is designed to ensure continuing income for those house staff who are unable to work due to a non-work related injury or illness. STD is available for full-time house staff with qualifying medical documentation. Coverage begins on the first day for an accident and after a 7-day waiting period for an illness and can continue for up to 25 weeks or until clearance to return to work is granted, whichever occurs first. The STD program replaces 60% of salary. Disabilities arising from pregnancy or pregnancy-related illness are treated the same as any other illness that prevents and employee from work. After six months, if you still cannot return to work, you will be transitioned to Long Term Disability.

Can you explain our Long Term Disability (LTD) policy? Given that most of us are fairly young, do we really need to even bother with this?

Regardless of your age, LTD is an important benefit that you need to have in the event of an unexpected illness. This is a benefit that you may not necessarily think about until you need it!

MedStar Health provides residents and fellows with a special LTD benefit that has unique provisions for you as physicians. Some of those provisions include:

Maximum $3,500 monthly benefit
The ability to take this policy with you when you leave MedStar Health for a reasonable annual premium. As you transition from MedStar, you can increase to $5,000 of monthly coverage. Other options are available for you to tailor your policy.

Graduates should have received a letter from our vendor, Guardian, regarding porting of your policy. If you have not, please contact GME for more information.

How do I find out exactly what benefits I’m enrolled in, and what the conditions or terms of those benefits are?

From any location (even outside of the MedStar network) you can log into the website www.myHRMedStar.net to access all of your employee benefits and information. You will need your MedStar network ID to set up a password for your account. On this website you can also:

Download your W2
Update your tax withholdings
Get an employment/pay verification letter
Enroll, update and view your benefits
Access COVID-19 updates and SiTEL resources

FLEXIBLE SPENDING ACCOUNTS

Dependent Care Accounts: I want to stop my Dependent Care Account contribution since I am not incurring the same child care costs from the pre-COVID time. Can I change this contribution?

Yes, MedStar is offering you the opportunity to change or discontinue your contribution. You can do this change either through StarPort or the MyHRMedStar portal:

In StarPort, click on the “myHR” link (on the right under HR Information)
Hover over the “Benefits” button on the top navigation bar
Click on “Enroll, update or view my benefits” link from the drop-down menu
Click the “Add a Life Event” button
Under Employee, select “Change in Day Care Expense”
- Uses for this life event include stopping, starting, or changing dependent day care contributions based on current childcare costs. If childcare is suspended, associates may decrease their Dependent Care election mid-year to as low as the amount already contributed (refunds for contributions already made cannot be issued). Once childcare is resumed, this counts as another QLE and will allow you to increase your elections at that time.

BENEFITS

How do I find out exactly what benefits I’m enrolled in, and what the conditions or terms of those benefits are?

From any location (even outside of the MedStar network) you can log into the website www.myHRMedStar.net to access all of your employee benefits and information. You will need to login with your MedStar email address and password.

On this website you can also:

Download your W2
Update your tax withholdings
Set up direct deposit/ follow link to view paystubs
Get an employment/pay verification letter
Enroll, update and view your benefits
Access COVID-19 updates and SiTEL resources

FAQs About Unions

Why are we talking about unions? I haven’t heard anything about union organizing here.

Some residents have raised questions about “organizing” with or without a union. Because the decision to have third party representation can have a significant impact on our GME program and your working relationships with GME leaders, we want to provide you with the information you may need if faced with the decision to sign a union petition or other type of authorization form. We respect every resident’s right to decide whether or not to support unionization, but believe it is important that these decisions be made with a thorough understanding of what union representation could mean to you.

How does union organizing work?

Union organizing is a multi-step process during which a labor union works to convince employees to vote in the union as their exclusive representative in the workplace. First, union “organizers” try to collect signed authorization forms from the employees they seek to represent. By signing one of these documents – which could be a card, petition or online form – you are authorizing the union to be your sole and exclusive representative at work.

If a union tried to organize at MedStar GME, it would have to get signatures from at least 30% of the residents and fellows to petition the National Labor Relations Board for a secret ballot election that would determine whether all residents and fellows would be represented by the union. As with a political election, the outcome would be determined by a simple majority of those who vote.

Why should I care if my colleagues want a union? It won’t impact me; I just won’t join.

While no one can be forced to join a union, if elected, the union would nonetheless represent ALL MedStar residents and fellows in D.C. and MD. There is no opting out of representation. So, even if you decided to not formally join the union, you would still be subject to the terms and conditions negotiated in the union contract and would be required to pay dues or an agency fee to keep your job at MedStar as outlined in the contract.

How much would I have to pay in union dues if a union is elected?

CIR-SEIU dues are the equivalent of 1.6% of your salary. At current PGY salaries, that totals nearly $1,000 a year for a PGY-1 and up to $1,344 a year for a PGY-8. Across the entire GME program, union would bring in more than $3.5 million from MedStar residents and fellows over a typical three-year contract.

How much money are unions required to spend on those they represent?

Unions are not required by law to use the dues they collect from members on behalf of those members. Dues revenue is the principal source of income for unions, and they use members’ dues to pay their leaders and union staff, to support their political activities, to finance organizing campaigns at other facilities. According to financial reporting required by the Department of Labor, the CIR-SEIU spends 65.5% of their members’ dues money on administrative costs or running its business.

Can we try out the union for a while, and then tell them to leave if they don’t like it?

Once the union is voted in, it is very difficult to vote the union out. The process is complex and would require residents and fellows to gather enough signatures to file a petition for a decertification election with the National Labor Relations Board (NLRB). Residents and fellows would be responsible for initiating and organizing this effort on their own; according to the law, MedStar could not assist.

I support policies that promote racial equity and social justice in healthcare. Would a union give residents a stronger voice on that subject?

There are many social justice organizations that you can participate in that would not impose the obligations, costs, and constraints of a labor union. Unlike other advocacy organizations, a labor union would be your sole and exclusive voice on all employment matters and would likely demand a clause in the contract with MedStar that would require you to pay union dues or an agency fee as a condition of your employment.

I am getting texts from someone I don’t know asking me to support the union. How did the union get my personal contact information? Did MedStar provide it?

No, MedStar has not shared your contact information with a labor union. Unions often buy mailing lists from affiliated organizations, from academic organizations or collect data from online petitions or surveys that you may have completed. In some cases, colleagues who support the union may share the contact information of others in their program. While there is rarely an option to “unsubscribe,” you can block the number or ask the sender to remove you from the list.

If I signed a union authorization form, card or petition and change my mind, can I get it back or rescind my authorization?

The union isn’t required to return your signed authorization document even if you signed without understanding the implications or later change your mind. You can try to rescind your authorization by sending a letter via certified mail to the union’s local office along with a copy to the National Labor Relations Board regional office. You also can attempt to revoke the card by asking the organizer to return it, but they have no obligation to do so.

Unions say that collective bargaining begins with our current pay and benefits and can only go up. Is that true?

No. Collective bargaining is a give and take process where you could get the same, more or less than you have now. Regardless of the outcome of bargaining, you would still have to pay union dues or an agency fee as outlined in the contract. There are no guarantees in collective bargaining.

What rights do I have if I don’t want to sign a union authorization document or to be represented by a union?

You have the right not to sign an authorization document, and to not be coerced or threatened by any union organizer or supporter. If you feel you are being coerced or threatened to sign a document or support a union, you have the right to tell the individual you are not interested, to report this to your Program Director or GME, or file a complaint with the National Labor Relations Board.

Where can residents and fellows get more information about issues relating to unions and organizing?

National Right to Work – www.nrtw.org
Center for Union Facts – www.UnionFacts.com
National Labor Relations Board – www.nlrb.gov

Ask Us Responses

What should we do if we not feel like it is safe to speak up against discrimination since retaliation can come in the form of less support/less opportunities for career advancement?

Thank you for asking this question. MedStar Health will not tolerate retaliation in any form or in any way (i.e., overt or by omission) against someone speaking up about discrimination in the workplace. GME is committed to providing a safe environment for bringing forward such complaints. If at all possible, the identity of the individual lodging the complaint will not be disclosed. However, in some situations, due to the nature of the issue or interaction, it cannot be avoided. In this case, we advise the individual bringing the concern forward to let them know if we believe their name is likely to become known as part of the investigatory process.

Concerns about discrimination or other forms of mistreatment can be brought directly to Jamie Padmore, your program director, chair, or anyone in the GME office. Human Resources is another resource where trainees can report concerns. Concerns can be communicated either verbally or in writing.

After a concern or complaint is brought forward, an inquiry typically follows. This means GME gathers as much information as possible from the individual raising the issue, including a list of other individuals whom we may speak with to learn even more information. Once this information is gathered, then the accused person(s) would be notified of the complaint, asked to respond, and to share their side of the story. Based on what the accused says, this will determine how the inquiry proceeds. The purpose of an inquiry is to obtain enough information to draw a fair conclusion. See more about this in the June 25, 2020 issue of Academics This Week.

If you have lodged a complaint and feel you are the subject of retaliation of any kind (overtly or by omission), please make Jamie Padmore, Human Resources, your program director, chair, or anyone in the GME office aware.

I have been approached by a union saying that if I were to join, they can help with my visa so I can get there faster. Is this true?

No. The union has no standing to help you individually with your visa status. As your employer, MedStar Health is your visa sponsor and applies for the visa on your behalf. MedStar Health has retained legal counsel to help facilitate the visa process for you. In addition, our lawyers and our GME team have been diligent in taking all other available steps to expedite the process so that we can welcome you to our program as soon as possible. If you have additional questions, please contact Jennifer Remington at Jennifer.Remington@medstar.net.

Archive

REDEPLOYMENT – DC CONVENTION CENTER ALTERNATIVE CARE SITE (ACS)

How will redeployment decisions for the D.C. Convention Center ACS work? How will decisions be made regarding who (and what specialties) will redeploy to the ACS and when?

The GME Leadership team (including the Associate DIOs at each entity) is working together to follow the redeployment algorithm established and shared broadly via email with the GME community by Dean Padmore on April 14, 2020.

Consistent with the principles contained in the algorithm:

The clinical needs for the D.C. Convention Center ACS will be determined by MedStar Clinical Leadership, led by Dr. Jack Sava.
Any D.C. Convention Center ACS redeployments affecting GME will be jointly managed between the ADIOs, the Program Director, and GME.
We intend to take qualified volunteers first. If we are able to meet patient care needs with volunteers, we will not need further redeployment. If you are a fellow who is interested in volunteering to be redeployed, please advise your Program Director and entity ADIO TODAY – Dr. Amy Burke at MGUH, Dr. Stephanie Detterline at MedStar Baltimore, and Dr. Eric Wisotsky at MNRH, or Dr. Owen Schwartz at MWHC (who is covering for Dr. Pindiprolu).
We will follow a team approach. Teams of attending physicians, fellows functioning in an attending capacity, and advanced practice clinicians (NPs, PAs) will be assigned to work at the D.C. Convention Center ACS as shift “teams.” At all times, there will be at least one non-fellow attending physician on duty who will serve as the shift “lead.”
The duration of assignments will be a 2-week commitment: One week working at the D.C. Convention Center in the capacity of an attending physician coupled with one week in the capacity of a supervised “resident” typically on a medicine floor or IMC/ICU. The two weeks may not be concurrent.

PATIENT CARE

What types of patients will be cared for in the ACS?

In its initial phase, the ACS will care only for low-acuity COVID-positive patients. The ACS will not care for patients who are:

Less than 18 years of age
Less than 14 days from first onset of COVID signs/symptoms
Likely to need further hospital-based inpatient care
Considered immunocompromised or otherwise high risk
Need admission directly from an ICU, IMC, or Emergency Department

Generally speaking, patients cared for at the ACS should be nearing readiness for discharge to home or to long-term care facility (like a nursing home or rehab facility).

What services will be provided for patients in the ACS?

The ACS will provide medical, pharmacy, nursing, laboratory, basic radiology (x-ray and ultrasound) capabilities and limited physical, occupational, and speech therapy. The ACS will also provide case management and discharge planning services for these patients.

Will patients at the ACS receive oxygen therapy and intravenous fluids?

Patients at the ACS may receive oxygen therapy (no greater than 6L/min to maintain O2 saturation of >90%). Patients may receive very limited intravenous fluids, although no IV narcotics will be administered. Specific admissions criteria have been developed and can be shared upon request.

COMPENSATION & TIME

If fellows are redeployed to their primary specialties as full attendings (taking on full attending decision making, full liability, etc.), would compensation reflect standard attending pay? Are fellows currently credentialed as attendings?

Fellows redeployed will be compensated as attending physicians for their service in the capacity as an attending during the one week at the D.C. Convention Center ACS. The coupled week in the capacity of a supervised “resident” on the medicine floor or IMC/ICU would be paid at the fellow’s regular trainee rate.

Qualified fellows have already been credentialed through our disaster privileging process to work as attendings, which includes the D.C. Convention Center ACS as this site is part of MedStar from an administrative perspective.

What is the compensation for fellows redeployed to the D.C. Convention Center ACS?

Fellows will be compensated $1,300 per 12-hour daytime shift or $1,500 per 12-hour nighttime shift above the baseline PGY level salary for time worked at the D.C. Convention Center ACS. The goal is for redeployed fellows to work ~3 shifts during the week assigned to the D.C. Convention Center, thus the extra compensation would be $3,900 for 3 daytime shifts or $4,500 for 3 nighttime shifts.

The coupled week in the capacity of a supervised “resident” on the medicine floor or IMC/ICU would not qualify for additional compensation as an attending physician or other compensation outside of routine fellow pay.

When is the go-live date for the D.C. Convention Center ACS? Do I get compensated for being placed on the schedule in this capacity?

The forecasted go-live date is May 12^th. We are rolling out the D.C. Convention Center ACS redeployment plan for fellows initially as a 3-week pilot program. If the pilot is cancelled before the end of the 3-week period, or if your shift is cancelled by MedStar after you are placed on the schedule, you will still receive the deployment rate for each day you are placed on the D.C. Convention Center ACS schedule, $1,300 per 12-hour daytime shift or $1,500 per 12-hour nighttime shift.

What is the orientation required for the D.C. Convention Center ACS?

Required in-person orientation at the D.C. Convention Center will occur sometime in the May 9^th to May 11^th timeframe; specific details to follow. Fellows placed on the D.C. Convention Center schedule anytime during the 3-week pilot program would be required to be available to attend on-site orientation as scheduled. Orientation is forecasted to take ~4 to 6 hours, and orientation time will be paid at a rate of $110 per hour.

What is the rationale for the two-week commitment, coupling a week in the capacity of an attending physician at the D.C. Convention Center ACS with a week in the capacity of a supervised “resident” on a medicine floor/IMC/ICU?

For several weeks, we have been experiencing increased clinical volumes across our institutions, with increased demands on our medicine floor/IMC/ICU teams in particular. We have already welcomed several volunteers to support these inpatient teams – including attending physicians, fellows, and residents from numerous specialties – in the capacity of a supervised “resident,” but we recognize these teams are fatigued and need additional support. With the standing-up of the D.C. Convention Center ACS, we need to balance the need to adequately serve the needs of our patients both within our acute care hospitals as well as at the new ACS. Coupling of the D.C. Convention Center ACS redeployment in the capacity of an attending physician with in-house redeployment in the capacity of a supervised “resident” allows us to better meet these needs.

Where will the coupled week in the capacity of a supervised “resident” on a medicine floor/IMC/ICU occur?

Supervised “resident” assignments will be based on patient care needs. We will make every effort to maintain fellows within their institution or region. Based on our current needs, work in the capacity of a supervised “resident” would be most likely to occur at one of our D.C. hospitals (MGUH or MWHC), though this could change depending on patient care volumes and needs at our teaching hospitals.

What if my week as a supervised “resident” occurs first and the D.C. Convention Center ACS is decommissioned before I have the opportunity to work in the capacity of a redeployed attending – will I still get paid?

If the week in the capacity of a supervised “resident” occurs first and the D.C. Convention Center ACS is decommissioned in the interim, you will still get paid for the shifts that you were scheduled to work at the D.C. Convention Center ACS, and for the orientation if you attended. Likewise, if the time at the D.C. Convention Center ACS occurs first and there are no subsequent needs within our teaching hospitals to work in the capacity of a supervised “resident,” this component of the redeployment pairing would be waived with endorsement of the ADIO and GME.

What specialties will optimally serve patients cared for at the D.C. Convention Center ACS?

Fellows with extensive experience in the floor medicine setting, particularly those who are Board Eligible or Board Certified in Internal Medicine, are ideally suited and thus volunteers from programs that map to Internal Medicine will be considered first. Redeployments will be balanced among various programs to ensure that education and service line needs can continue to be adequately met. Qualified fellows from specialties outside of the realm of Internal Medicine will also be considered for redeployment, with the endorsement of their Program Director.

What about medical malpractice/liability coverage?

All work within MedStar, including work at the D.C. Convention Center ACS, is fully covered by MedStar’s risk management program, including medical malpractice/liability coverage and worker’s compensation program, etc. Liability coverage for work at the D.C. Convention Center in this capacity is no different than working at any of our acute care hospitals or ambulatory care sites throughout the MedStar Health system.

What about fellows with sponsorship (visa) status?

J-1 visa holders are not authorized to work outside their ECFMG-sponsored training program, thus they cannot be assigned to work as attending physicians. Fellows with other types of visas (i.e., H-1B, O-1, J-2 EAD holders or Greencard holders) that are clinically eligible to participate in the capacity of an attending physician at the D.C. Convention Center ACS may be considered for this deployment. Please contact Jennifer Remington, AVP for GME, with any questions about your individual eligibility to work in this capacity.

What about non-fellow MedStar Health attending physicians? What is their role in supporting the D.C. Convention Center ACS?

Attending physicians – including those from the hospital medicine, emergency medicine and other service lines – have been engaged in providing staffing for the D.C. Convention Center ACS. At all times, there will be at least one current non-fellow attending physician on duty who will serve as the shift lead. Employed attending physicians who are currently working a reduced schedule will be redeployed to the D.C. Convention Center to fill their regular schedule. For employed attending physicians who are already working their regularly scheduled hours, additional work at the ACS will be treated as extra duty hours.

HOUSING AND OTHER BENEFITS

Will hotel accommodations be provided?

Yes. Hotel accommodations will be provided for MedStar associates working at the ACS who wish to stay closer to the ACS. Accommodations will be at the Marriott Marquis, located adjacent to the D.C. Convention Center at: 901 Massachusetts Ave NW, Washington, DC 20001 (202-824-9200)

Registration details will be provided upon request. Associates will need to show their MedStar ID upon check-in and provide a credit card for incidentals. The cost of the room will be covered, but associates are responsible for incidentals.

The hotel will not be providing full housekeeping services, but toiletries, towels, and extra linens will be made available. Grab-and-go food options will be provided and parking is available on-site. Access to the hotel is restricted to MedStar associates only; guests will not be allowed.

Will meals be provided?

Meals will be provided on-site at the Convention Center during all shifts; grab-and-go options will also be provided at the hotel if you choose to stay there following your shift.

If I’m not staying at the hotel, will parking still be available?

If you live locally or choose to commute, you may still utilize the parking at the designated hotel (specifics forthcoming).

Will I be reimbursed for mileage if I need to drive?

Yes. You may submit a request for reimbursement of mileage, calculated from your primary place of employment. Information on process for calculating and submitting mileage reimbursement can be provided upon request.

Will scrubs be provided?

Yes, scrubs and all necessary Personal Protective Equipment (PPE) will be provided for staff upon entry to the ACS.

SCHEDULING

Who should I contact for additional information?

We stand ready to answer any questions you may have. Please reach out to your Program Director, entity ADIO, or GME for additional information.

If you are interested and available for this opportunity, please immediately email Dean Padmore (Jamie.S.Padmore@MedStar.net), with a cc: to your Program Director.