Do not apply to Rutgers RWJ for any residency... stand with your friends who are suffering there... there is a big scandal.

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amestramgram

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Rutgers is currently cutting faculty and GME salaries (across all residencies) due to a budgetary crisis - however, they failed to reveal that they had around 500 million of reserve funds on hand for crises like COVID 19. Our resident and fellow friends there are having their previously promised ACGME salaries further reduced; the faculty are having their salaries reduced as well. Do not stand for upper leadership bullying the most vulnerable trainees among us. Help your friends who are stuck there at the moment. Don't let the upper leadership get by with even an IOTA of gaslighting about our professionalism. Rutgers crew have had to work incredibly hard to help their hospital through coronavirus, and there is no hope of resident/ fellow hazard pay. They are unilaterally breaking their ACGME contracts by doing this.

Don't let Rutgers get away with any more of this.

Here is a quote from a faculty there:

They declared a financial emergency which is a stipulation in every single Union that Rutgers negotiates with about 22 I think. This includes the Medical School faculty and the resident Union. They are both separate. This emergency allows the university to 4 go already agreed-upon stipulations in each contract such as a salary raise for the next year.
not all of our residency spots are covered by Medicare. Medicare pays the institution money per resident. This is typically about 180% of the salary and includes benefits and some overhead. They do NOT set the salary.
What is unfortunate about this is our medical school is reopening offices and procedures starting last week and the true deficit is coming from the other schools in the Rutgers University. Every physician knows procedures delayed still need to happen, but the administration of the school have not taken this into account and instead consider it lost revenue.
The actual deficit is 1.5% of the Rutgers budget, which was 4.5 billion for fy 19-20.The university also has a 600 million dollar fund that is unrestricted for emergencies but they're refusing to touch it to cover the loss, which is nonsense. They also claimed a loss of 200 million that was closer to 40 million when they revised the numbers. The union also found they were booking their expenses by using a new provision allowed by the state to count benefit payments as university expenses since 2015, when the payments themselves are from the state and the university has no financial responsibility for.
As faculty we have not had a contract in 2 years and they are now trying to renegotiate raises from the last two years and blame it on coronavirus
Lastly, the rwj foundation has nothing to do with Rutgers or rwjms. They donate money and share a name. That's the extent of the relationship. Has nothing to do with the anti physician pro np agenda of the rwjf of which I do not agree and neither does Rutgers support.
Every Union is having benefits cut due to the financial emergency. The only legal options are to sue the university on the grounds that there is no actual Financial emergency.

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Who writes "4 go" for "forego"? And, Rutgers is capitalized, but RWJMS is in all small letters?

My point is that the statement given has a writing style not consistent with a faculty member. I could be wrong.
 
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Who writes "4 go" for "forego"? And, Rutgers is capitalized, but RWJMS is in all small letters?

My point is that the statement given has a writing style not consistent with a faculty member. I could be wrong.
It looks like a dragon voice recording that an intern didn’t clean up after dictating (which doesn’t necessarily mean the story isn’t true)
 
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Rutgers is currently cutting faculty and GME salaries (across all residencies) due to a budgetary crisis - however, they failed to reveal that they had around 500 million of reserve funds on hand for crises like COVID 19. Our resident and fellow friends there are having their previously promised ACGME salaries further reduced; the faculty are having their salaries reduced as well. Do not stand for upper leadership bullying the most vulnerable trainees among us. Help your friends who are stuck there at the moment. Don't let the upper leadership get by with even an IOTA of gaslighting about our professionalism. Rutgers crew have had to work incredibly hard to help their hospital through coronavirus, and there is no hope of resident/ fellow hazard pay. They are unilaterally breaking their ACGME contracts by doing this.

Don't let Rutgers get away with any more of this.

Here is a quote from a faculty there:

By those numbers posted, with a $4.5b FY budget, $500m is not even able to cover 2 months operating expenses. With income still not back to normal, I can understand why they don't want to dip into that fund at this time.
 
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Please see the post above. It would be nice not to have money cut, but it is a reality across the country.
 
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I don't see anything in the MSM about this yet, I expect we will shortly.

Almost certainly, something's wrong with the numbers in the first post. I don't doubt that salaries are being slashed at Rutgers. But not because of a 1.5% deficit. A healthy non-profit business has a 4% margin -- that's enough to invest back into the business and improve. A 2% margin is workable but causes long term problems. Breakeven works for a short while, ultimately you run out of money. A 2% loss for a year is not a problem, but needs urgent assessment to reverse. So a 1.5% deficit = not really a problem. 1% of 4.5b = $45 million.

Rutger's budget is 4.4 billion or so. Source: Fiscal Year Budget | University Budget Office

Back in April, there were multiple articles about Rutgers freezing pay and cutting high salaried folks. At that time, they were forcasting a $200 million shortfall for the next quarter. That, in itself, was not the end of the world represents a 4-5% loss.

I'm guessing that they are now facing a shortfall that is far greater than that. They easily could be looking at $500 million - $750 million. I'm guessing, I'm not an insider. But most likely, the deficit is huge.

The hospital (and all of it's GME programs) are part of the university. So, when the univ needs to cut, it's going to look everywhere. And the hospital's budget isn't so good to start with: http://www.uhnj.org/about/board/financial_statements/Audit_Report-FY_2018.pdf This is 2018, but you can see mounting losses. It's hard, as a loss center for the university, to say that you don't want your budget cut. They were losing $370 million a year in 2018. Maybe their budget turned around, but I doubt it.

So, the losses are certainly more than 1.5%. They are likely 8-10%. And that's catastrophic zone.

So should the Univ tap into it's rainy day fund? Well, that's complicated. The biggest problem is that this isn't a one time problem -- these losses are probably going to continue for some time. Most places don't want to use their emergency funds to pay for payroll like this -- it's a losers game, you end up in the same place with no money left really quick. It's like paying your mortgage on a credit card - rarely works out well. And, the Univ does NOT have $500 million in cash -- almost certainly it's invested, and now is worth much less, and they really don't want to sell when the market has tanked.

Because it's a state university, they probably are also looking at big state budget cuts also. If you look back at their budget, you'll see $200 million in state funding. The state probably can't afford that anymore, and they can't run a deficit or print money like the feds. Then add in lost revenue (dorms, tuition, etc) and they are probably in big trouble.

Cutting GME salaries and salaries at the bottom of their payscale is a terrible choice for a million reasons. People may leave as the economy improves and others can pay more (as it will take time for the Univ to catch up). Resident recruiting may be a nightmare if they can't even promise what anyone's salary will be. Faculty may leave for the same reason, which will only worsen the problem. It will turn around at some point, but could take awhile. So, this means one of two things: Either the people who run the place are complete idiots (which honestly seems unlikely). Or, their financial situation is so bad that they have no choice. I expect that if they left all of those salaries alone, the salary cuts to physicians and other high earners would be so awful they were worried the whole thing would collapse. I would hope that they used a "sliding scale" for the cuts -- the more you make, the more they cut. But even that is risky -- if your Orthopedic surgeons, Gastroenterologists, and Cardiologists all leave because you cut their salary, you lose all of your income.

The hospital really has no choice but to be part of the university, as it loses so much money every year it needs funding from someone. If it was on its own, it would need $300-400 mil infusion every year, which is 40% of its budget.

Don't get me wrong -- this sucks. And I'd fight tooth and nail to protect residents and their benefits. But there may be no choice here at all.

Honestly, the part of this story that I find the most irritating is that there is a union, who apparently didn't notice or didn't object to a clause in the contract that says that salaries can just be decreased at the Univ choice if there is a financial mess. If that clause wasn't there, there would still be decreases -- or without, the whole place will likely go bankrupt and no one would have a job (pensions lost, etc). But at least the employees would have some say in the matter as to how those cuts are distributed. If I were at RWJ, I'd want my union fees back.
 
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It definitely sucks, no doubt. But it also doesn't seem outlandish in the current climate.

I've heard from friends in private practice and academics. One friend in academics got a salary cut both this year AND next year. One friend in private practice got a significant salary reduction for a few months that was voted on by the partners (i.e. he didn't have a say in it); he had a signed contract. That same group furloughed a significant number of ancillary staff and even some part-time doctors.

In the Rutger's residents shoes, I'd surely have been bitter too. But the fact remains that everyone can be on the hook financially in extraordinary down times.
 
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It definitely sucks, no doubt. But it also doesn't seem outlandish in the current climate.

I've heard from friends in private practice and academics. One friend in academics got a salary cut both this year AND next year. One friend in private practice got a significant salary reduction for a few months that was voted on by the partners (i.e. he didn't have a say in it); he had a signed contract. That same group furloughed a significant number of ancillary staff and even some part-time doctors.

In the Rutger's residents shoes, I'd surely have been bitter too. But the fact remains that everyone can be on the hook financially in extraordinary down times.

Yes. It's absolutely understandable to be angry and disgruntled. Especially when all one sees are the raw numbers without explanation.

But as a frontline hospitalist in this COVID mess, seeing large numbers of COVID patients we had to take out loans to cover payroll because our overall numbers have gone down. All these "Hero" acts, stimulus means NOTHING for us except that we make less money yet pay the taxes to support and pay for those who get to stay home.

I feel especially bad for the nurses who have to stay next to the patient and their rooms 12 hours at a time, they don't get hazard pay or a raise. A lot of them were furloughed or reduced hours.

Bottom line: It's an extraordinary mess
 
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Furloughs of residents/fellows are unacceptable to the ACGME.

When reductions or cessations of patient care are due to extraordinary circumstances necessitating program and/or institutional closure, Sponsoring Institutions and programs must adhere to ACGME policies, procedures, and requirements concerning withdrawal of accreditation, disasters, and institutional/program closures, as applicable.


Under all circumstances, Sponsoring Institutions, in partnership with their programs and participating sites, must ensure educational continuity and the fulfillment of their obligations to residents, fellows, and others in the clinical learning environment. Sponsoring Institutions, including those that have declared Pandemic Emergency Status, must comply with the ACGME Institutional Requirements.

When implementing patient care reductions or cessations in response to COVID-19, Sponsoring Institutions are expected to follow all institutional GME policies and procedures that pertain to resident/fellow appointments, and to honor the conditions of appointment specified in resident/fellow contracts. Conditions of resident/fellow appointment that are required by the ACGME include, but are not limited to, salary, benefits, vacation, leaves of absence, grievance procedures, due process, and the provision of information related to board eligibility.


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Residents and fellows should be as untouchable as not paying the power bill. There are contracts and obligations you make to trainees, if you don’t want to meet that then cancel your residencies at the end of the year and replace them all with attendings

the acgme should issue probation/cancellation to any hospital trying to cut residents mid year.
 
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The point about CARES funding is reasonable, and I have no idea how much funding they have received. The medicare advance funding sounds complicated -- if it's going to be deducted from future billing it's money now but just pushing the hole off to the future.

The posts about the president's salary, and the 5-10% cuts that they were taking, are both from January. Back then, leaders were taking cuts and everyone else was left alone. I'd hope that if Rutger's will be cutting salaries across the board, that the cuts would be higher for leadership and on top of prior cuts. So I don't think this supports your position (unless when this does get publically reported, it turns out that leadership is not taking another big cut). We will see.

The ACGME statement is interesting and hard to interpret. It says that programs have to follow their policies / contracts. Sounds like Rutgers might just be doing that -- their contracts probably incorporate all of the hospital policies, their financial catastrophe policy states that they can decrease contracted salaries if needed (this is assumed from the content of this thread, I have not seen their policies / contracts). The ACGME policy is mostly about a furlough -- telling residents they no longer can come to work and either not paying them or paying them a reduced salary while furloughed. A salary reduction while maintaining a full workload really sucks, and I'd be incredibly angry, but it's not a furlough (at least not technically).

Again, I'm wholeheartedly against this. Given the hyperinsane news cycle, I'd like to see exactly what Rutgers has to say before condemning it outright. So far, we have vague details of what is afoot. Maybe it will be just as horrible as presented here. Maybe better, maybe worse. But if Rutgers is really looking at cutting salaries for all -- including housekeeping and other low wage workers -- it's hard to insist that resident salaries remain intact.
 
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Actually it's not hard to insist resident salaries remain intact. None of the housekeeping and other workers were forced to go through a legally binding NRMP match. The NRMP match even has an antitrust exemption and residents are not free to negotiate their contracts individually.

Under the Match system, a student cannot receive multiple offers. Consequently, an applicant cannot use one offer as leverage to obtain either a more prestigious position or to bargain for better terms of employment with an equally or less prestigious hospital. The fact that during the application and interview process applicants can compare different employment contracts and rank programs accordingly does not mitigate the problem. An applicant can most certainly rank programs based on salary, prestige, or both. However, a given applicant does not know how many programs are actually willing to extend an offer to him, therefore, he is in no position to leverage his marketability. Further, because the Match rules forbid applicants and programs from making promises in an attempt to affect how both parties rank each other, any negotiations that could theoretically occur between a program and an applicant would either violate the Match agreement (with the concomitant consequences) or would be completely irrelevant, as there would be no way to assure that the negotiations would in the end bear any fruit.

Those who have not learned from history are doomed to repeat it. You need to do your research on why the match was created in the first place.

The second issue is that the idea that an organization would be willing to bargain with a resident is ludicrous. They are all fungible. A resident provides no benefit to the program; they can always replace you with someone just as good and they will not even notice the difference. Swap the guy who wants to do family medicine with the incoming neurosurgery resident and the programs won't notice the difference.

Do you really think that a resident is going to bring in a healthcare organization an extra million dollars in patient care? Or that they care that you get a job at a slight more prestigious private practice group?

The most prestigious residency program can fill one of its slots through SOAP and they won't notice the difference. Residents are fungible. There is no great benefit for a residency program, let alone a medical school, to fill its residency slots with "better" residents.

What do you think you will provide to that "less prestigious hospital" that will make it worth their while so as for them to give you anything?
 
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Under the Match system, a student cannot receive multiple offers. Consequently, an applicant cannot use one offer as leverage to obtain either a more prestigious position or to bargain for better terms of employment with an equally or less prestigious hospital.

Here's how the bargaining would go:

Prestigious Program: Here's our offer. You have until next week to decide.

Applicant: Can I wait until I see if I get additional offers?

Prestigious Program: No.

Applicant: Ok, well can I get an extra $2k per year?

Prestigious Program: No.

Prestigious Program moves on to next candidate.

Not to mention that any "free market" system would be just as likely to depress wages at more desirable residencies when candidates underbid each other in an attempt to secure the spot.
 
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Residents and fellows should be as untouchable as not paying the power bill. There are contracts and obligations you make to trainees, if you don’t want to meet that then cancel your residencies at the end of the year and replace them all with attendings

the acgme should issue probation/cancellation to any hospital trying to cut residents mid year.

Agreed.

Regardless of the reasons behind it, RWJ is now going to only attract bottom of the barrel candidates.

Hearing that a residency program cut residents' salary is completely unforgivable, and if I was a MS4 this would plummet them to the bottom of my rank list. The fact that MS4s need to ask the question "did you ever cut resident salaries during the coronavirus crisis" is mind-boggling in and of itself. But they do need to ask current residents (because faculty aren't going to admit this) themselves.

I wish ACGME would revoke all their future residency spots (so as to not hurt current residents) and leave them resident-less, but I know ACGME doesn't have the teeth or the balls to do that.

Those who proclaim equivalency of residents to attendings, nurses, even janitors and house keepers are making false equivalencies. Any of the latter can say "**** off" and find a job, somewhere, doing the same thing. Residents can't.
 
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Those who proclaim equivalency of residents to attendings, nurses, even janitors and house keepers are making false equivalencies. Any of the latter can say "**** off" and find a job, somewhere, doing the same thing. Residents can't.

Are there many hospitals that aren't on hiring freezes? Normally I agree with you, but with the current financial issues most hospitals across the country are having I suspect most people who work in a hospital would have difficulty finding another job right now. Possibly excepting attendings in certain fields.
 
Agreed.

Regardless of the reasons behind it, RWJ is now going to only attract bottom of the barrel candidates.

Hearing that a residency program cut residents' salary is completely unforgivable, and if I was a MS4 this would plummet them to the bottom of my rank list. The fact that MS4s need to ask the question "did you ever cut resident salaries during the coronavirus crisis" is mind-boggling in and of itself. But they do need to ask current residents (because faculty aren't going to admit this) themselves.

I wish ACGME would revoke all their future residency spots (so as to not hurt current residents) and leave them resident-less, but I know ACGME doesn't have the teeth or the balls to do that.

Those who proclaim equivalency of residents to attendings, nurses, even janitors and house keepers are making false equivalencies. Any of the latter can say "**** off" and find a job, somewhere, doing the same thing. Residents can't.

I don't disagree with your sentiments about RWJ; its a ****ty move.

But your notion that all those other groups have easy job mobility in the midst of a global pandemic and unprecedented economic depression is an illusion at best. Definitely have a hard time believing those residents are financially doing worse than furloughed janitors.

Reminds me of that comedian story where the audience is all cool until the comedian talks about one particular subject that an audience member cares about and then suddenly the jokes aren't funny anymore. It's okay if the attendings, nurses, janitors and housekeepers lose part of their livelihood but if a resident does? Game over.
 
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I don't disagree with your sentiments about RWJ; its a ****ty move.

But your notion that all those other groups have easy job mobility in the midst of a global pandemic and unprecedented economic depression is an illusion at best. Definitely have a hard time believing those residents are financially doing worse than furloughed janitors.

Reminds me of that comedian story where the audience is all cool until the comedian talks about one particular subject that an audience member cares about and then suddenly the jokes aren't funny anymore. It's okay if the attendings, nurses, janitors and housekeepers lose part of their livelihood but if a resident does? Game over.

Yes, currently there is likely a temporary struggle in terms of lateral job moves for normally unaffected professions, I agree.

However, there is a permanent lateral job move struggle for residents.

Not all hospitals are on a hiring freeze, FWIW, and others if they are noticeably short-staffed can make exceptions for in-demand services (including janitors/cleaning staff).
 
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However, there is a permanent lateral job move struggle for residents.

"Permanent" for the duration of residency...which is temporary. The fact that residency is a finite period of time is a mitigator in this discussion.

Few other jobs lack the lateral mobility of residency. But they also lack the guaranteed upward mobility at 3-7 years.
 
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Having interviewed at RWJ for a surgical sub residency (in 2016), I think I ranked it 15th out of 16. That place was clearly struggling financially even before the global pandemic. I would advise future applicants to be careful there in general. Don't want to inadvertently walk into a Hahnemann hospital situation that screws up your entire training process.
 
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Actually it's not hard to insist resident salaries remain intact. None of the housekeeping and other workers were forced to go through a legally binding NRMP match. The NRMP match even has an antitrust exemption and residents are not free to negotiate their contracts individually.

Under the Match system, a student cannot receive multiple offers. Consequently, an applicant cannot use one offer as leverage to obtain either a more prestigious position or to bargain for better terms of employment with an equally or less prestigious hospital. The fact that during the application and interview process applicants can compare different employment contracts and rank programs accordingly does not mitigate the problem. An applicant can most certainly rank programs based on salary, prestige, or both. However, a given applicant does not know how many programs are actually willing to extend an offer to him, therefore, he is in no position to leverage his marketability. Further, because the Match rules forbid applicants and programs from making promises in an attempt to affect how both parties rank each other, any negotiations that could theoretically occur between a program and an applicant would either violate the Match agreement (with the concomitant consequences) or would be completely irrelevant, as there would be no way to assure that the negotiations would in the end bear any fruit.

(sigh).

THIS argument again...
 
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Residents and fellows should be as untouchable as not paying the power bill. There are contracts and obligations you make to trainees, if you don’t want to meet that then cancel your residencies at the end of the year and replace them all with attendings

the acgme should issue probation/cancellation to any hospital trying to cut residents mid year.

Considering that the we academic year starts in a week and a half, do we even have evidence that such a thing is even happening?

Agreed.

Regardless of the reasons behind it, RWJ is now going to only attract bottom of the barrel candidates.

Hearing that a residency program cut residents' salary is completely unforgivable, and if I was a MS4 this would plummet them to the bottom of my rank list. The fact that MS4s need to ask the question "did you ever cut resident salaries during the coronavirus crisis" is mind-boggling in and of itself. But they do need to ask current residents (because faculty aren't going to admit this) themselves.

I wish ACGME would revoke all their future residency spots (so as to not hurt current residents) and leave them resident-less, but I know ACGME doesn't have the teeth or the balls to do that.

Those who proclaim equivalency of residents to attendings, nurses, even janitors and house keepers are making false equivalencies. Any of the latter can say "**** off" and find a job, somewhere, doing the same thing. Residents can't.

And sorry if I missed it but has anyone in this thread actually specified what % the "cut" of resident pay was? Rutgers isn't the only program I've heard of who've lowered the expected COL raise for 2020-21. Is there evidence out there it's anything more than that?
 
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So @Infestedzerg, do you have a counterpoint or more detailed information, or are you just going to pout through this thread by "disliking" posts the disagree with your priors?
 
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