Med students caught in the crossfire

Residents are asking for pay parity, but are medical students the ones paying the price?

On July 11, 2011, the 3000 members of the Fédération des Médecins Résidents du Québec suspended their teaching activities indefinitely in hopes of accelerating negotiations with the government for the renewal of their collective agreement. The residents await an offer that would meet their demands, particularly on the issue of salary increases.

Every year, a new batch of medical students enters the hospital system to develop the skills required to become competent physicians. Residents, doctors completing their obligatory postgraduate training in the field of their choice, are a crucial part of that learning process. Along with tending to patients during their seventy hour plus work weeks, they double as teachers and mentors. However, with the residents now abstaining from teaching, Quebec medical students are left wondering how their education will be affected.

Negotiations with the government have been sluggish since the expiration of the last collective agreement in March 2010. The residents’ primary demand is a pay adjustment aimed at bringing their salaries up to par with those of their peers in other provinces. The annual salary of Quebec’s residents is currently 37 per cent below the national average. One way they are looking to decrease the pay gap is with a teaching premium, a demand the government has ignored. In response to this lack of attention regarding the value of their teaching duties, the residents have decided to stop teaching.

“Our question was how to have our demands heard so that the government would take us seriously,” explained Dr. Joseph Dahine, the president of the Residents Association of McGill. “And during brainstorming sessions and general assemblies, we decided to suspend teaching activities, though it was not an easy decision.”
With their demands, residents contend that they are not solely looking for a pay increase.

“Why are we fighting for this? We’re not doing it out of greed,” said Dahine. “We’re doing this so that in 5, 10, 20 years, we are not faced with an even worse shortage of physicians or less well-trained physicians. By getting better working conditions and eliminating the salary discrepancy we can attract the best doctors in North America here and keep our own residents here in Quebec.”

However, the medical students feel they are caught in the crossfire. They sympathize with the residents’ demands, but feel strongly that any tactic which jeopardizes their education is inappropriate.

“Under normal circumstances, it is the residents who teach us the nuts and bolts of how to function in the hospital,” explained Sameer Apte, President of the McGill Medical Class of 2013. “If this teaching strike continues for too much longer, it will mean that the future physicians of Quebec will be less well trained than their predecessors. We will be less confident in managing patient illness, and we will be less efficient in how we use medical resources.”
In the meantime, medical students are being taught by staff physicians, doctors who have completed all required postgraduate training. This is not enough to fully compensate for the absence of residents because staff physicians already have a full load of patients to care for and regular teaching obligations.

“Students are getting better quality teaching directly from staff, but the quantity of patients they’re seeing is less,” said Dr. Robert Primavesi, Associate Dean of Medical Education and Student Affairs. “I think what the students feel they’re missing out most on is integration and learning how to function in the hospital environment.”

According to Natacha Joncas-Boudreau, a press aide to Health Minister Yves Bolduc, the government wants to reach an agreement as quickly as possible, a sentiment the residents share. However, the residents have yet to receive an offer they deem satisfactory. Joncas-Boudreau insisted that patient care is not affected, but that may change if the residents take further action in the form of a general strike.

A general strike is on the table, but the residents hope it won’t come to that. “Nobody is interested in a prolonged strike or a general strike,” said Dahine. “After all, we love working with patients, we love working with students and we love to teach. That’s why we’re here.”