Some of the Benefits SDHSA has Obtained for House Staff

SDHSA’s Beginning. Although the SDHSA was incorporated back in 1978, it was not until 2002 that PERB (California’s Public Employment Relations Board) certified SDHSA as the “exclusive representative” (union) of UCSD Residents. Beginning in 2005, the SDHSA began negotiating the Labor Contracts (called a “Memorandum of Understanding” or “MOU”) between UCSD and UCSD’s House Staff. Since then, SDHSA has changed the very nature of the relationship between UCSD Teaching Hospitals and their House Staff and along the way, obtained significant benefits for UCSD House Staff including:

Welcome Fellows! Over the years, SDHSA has argued that the Fellows should be covered by SDHSA’s umbrella. Because they were not, until 2018, Fellows were denied many of the benefits negotiated by the SDHSA (what used to call the “Fellows’ Penalty.”) Commencing in 2017, the SDHSA began organizing UCSD Fellows. After a vote with 100% of the participating Fellows voting in favor of joining SDHSA, in April of 2018, PERB confirmed that SDHSA was to be the exclusive labor representative of UCSD Fellows and included in SDHSA negotiated BENEFITS.

Annual Salary Increase: SDHSA has negotiated automatic annual increases in the salaries of House Staff to stave off inflation and keep UCSD in step with national wage averages. For the 2020 Academic Year:  “The University will establish salary rates for year 2020-2021 in an amount equal to the 2019- 2020 UCSDH salary scale plus 3%.”

Annual Housing Stipend: We all know how great it is to live in San Diego with the endless sunshine and beautiful ocean. Yet residents know that there is also what is called a “Sunshine Tax” meaning that the Cost of Living in San Diego is significantly higher – especially the cost of housing. That meant that UCSD pay was in reality less than when compared to other UC campuses. SDHSA sought to remedy this inequity and introduced the “Housing Stipend” concept. Finally, UCSD agreed to pay UCSD Residents an additional “Housing Stipend” to help offset the high cost of living in San Diego. In 2007, the Housing Stipend was $1,500. With the current MOU: “For academic year 2020-2021 the Housing Stipend for all House Staff covered positions will be a total of six thousand dollars ($6,000).” To avoid excessive taxation on one payday, said Housing Stipend is paid in two installments, 50% on October 1 and the second 50% on February 1 of each Academic Year.

Educational Stipend: Prior to 2007, a separate fund paid an Educational Stipend of $1,000.00 per Resident directly to the Resident’s respective Departments. The problem was that there was no control over the Departments on how it was used. Believing that the intent of these funds was to help Residents offset educational costs, in 2007, SDHSA got UCSD to agree to pay each House Staff Physician a portion of the Educational Stipend upon submission of proof of an authorized educational expenses. When this system turned out to be awkward and administered differently by the Departments, SDHSA negotiated that UCSD would thereafter pay $500 per year directly to each Resident. This continues under the current MOU and paid on October 1 of each year.

Protecting and Improving Medical Benefits: As we all know, the cost of medical treatment and accordingly, Medical Insurance has increased dramatically over the years. This has resulted in pressure on UCSD to cut benefits and/or increase co-pays and premiums on House Staff. SDHSA has vigorously fought to protect House Staff from any erosion in these benefits, for both House Staff and their dependents. SDHSA continues to monitor and affirmatively advocate to protect House Staff Benefits.

Meal Allowance: In recognition of the long hours worked by House Staff, and the fact that it is difficult for House Staff to “take a lunch” off-site, the SDHSA negotiated an on-call “Meal Allowance” for represented House Staff. Under a prior Contract, the Meal Allowance was increased to twelve dollars ($12.00) per meal. Pursuant to the latest MOU: “An eligible Represented House Staff individual will receive an on-call meal allowance of twelve dollars ($12.00) per meal to be used at the University of California at San Diego (UCSD) Health System cafeteria(s) in comportment with the criteria below. . . .” (See MOU for details.) Recent university level cuts have resulted in limiting the hours for UC cafeterias causing SDHSA concern in regard to this benefit. SDHSA is continuing to negotiate to make sure House Staff are able to get a meal nutritious hot meal during their long shifts. 

Professional Fees: Prior to 2007, the UC did not pay for, nor reimburse for Residents’ Licensing and Licensing renewal fees. Obviously, this was a cost that should be borne by the employer. As a result of the 2012 negotiations, SDHSA moved UCSD to agree to pay for various House Officer Professional Fees. Subsequent negotiations increased the coverage of these reimbursements. In 2018, SDHSA obtained inclusion of Fellows’ renewal fees. We are continuing to negotiate for full reimbursement for all House Staff. See Section 9 of the current MOU.

Lounges and Amenities: We recognized that you need a place to take a break, grab some coffee and to complete paperwork. As a result, the SDHSA negotiated for the “Resident Lounges” located at the Hillcrest and then the Jacobs Hospitals. SDHSA continues to negotiate for maintaining and improving these spaces for House Staff. 

Travel Expenses Reimbursed: § 26 of the MOU states that: “The University shall reimburse House Officers for authorized expenses incurred during required employee-related University business or travel in accordance with the requirements of the appropriate section of the UC Business and Finance Bulletin. See GME Guidelines Memo and UC Travel Reimbursement Form on Agreements Page.

Sleeping Quarters: All House Staff sleeping quarters must meet minimum criteria including: a bed, desk, computer, reading light, sink and toilet; rooms to be maintained clean with linens changed daily. Showers will be accessible for House Staff use on the same floor as the assigned on call quarters.

Uniforms/Laundry: House Staff should be able to have clean lab coats and scrubs provided by the UC. Currently, SDHSA negotiated these benefits to include: (1) Three (3) sets of embroidered uniforms (lab coats) will be provided to the House Officers at the time of initial appointment. Embroidery includes the House Officer’s name and department. (2) The lab coats will be laundered by UCSD Health System at no charge to the House Officer. Upon request, one (1) new embroidered lab coat may be provided each year by the UCSD Health System as a replacement for uniforms that deteriorate through normal wear and tear. (3) House Officers shall have access to three (3) sets of scrubs in accordance with UCSD Health System procedures. Certain Departments will provide two (2) additional sets of scrubs to House Staff.


Why Members’ Only Benefits? Briefly, anti-union interests have been trying to destroy public sector unions for years. They wrongly feel that employee wages and welfare should be sacrificed for profit. One of their tactics was to attack the decades old law that required all persons who benefited from a Union’s work, to financially contribute to the union obtaining the benefits they enjoyed. This was achieved by what were called “Fair Share Fees.” Essentially, no one was required to join a union but if you partook of the benefits – you had to contribute. Unfortunately conservatives stacked the US Supreme Court and in 2018, they were partially successful in the Case called “Janus.” (See Janus Discussion elsewhere herein). In short, that case ruled that “Fair Share Fees” were no longer allowed while also allowing employees to take the negotiated benefits, i.e., be what are called “free-riders.”

At the same time, as more fully explained elsewhere, the Association believes that it would be unfair to allow “free-riders” to take advantage of benefits [which are not directly derivative from the current Labor Contract (MOU)] and are paid for by the Members. In fact – the Janus case stated that: “Individual nonmembers could be required to pay for (such) service(s) or could be denied union representation altogether” (See Janus at page 17; fn. # 6). So the other side of that coin is that SDHSA will not ask its Members to pay the additional benefits that SDHSA provides for Member’s protection and comraderie, Accordingly, SDHSA reserves certain of its benefits for “Members Only.” This is why we ask everyone to encourage all your colleagues to join – we really are stronger together! 

As a result, non-members (and those who join late (during the probationary periods) do not have access to certain SDHSA benefits, Including:


1. Protection of House Staff Individual Issues: There are numerous situations where members are faced with unexpected individual issues which might significantly have an effect on the completion of their program and/or future employment. These are generally “Individual” (as opposed to collective) Employment Related Issues. These issues might include unfair employment discipline, personality conflicts with supervisors or the unexpected interference of their personal life (outside people) with their professional responsibilities. SDHSA has elected to only use its resources to assist Members with such issue who have demonstrated that they have been and continue to support SDHSA’s mission. In other words, Non-Members may not “free-ride” by only joining SDHSA when they find themselves in trouble and in need of assistance with Individual Issues.

2.  General Non-Labor Issues: SDHSA is continually working in many ways in looking out for Members and their families. SDHSA was on the front-line protecting House Staff during COVID-19 pandemic. When the COVID-19 pandemic started we jumped in to make sure the house staff had access to proper PPE and that the departments followed ACGME rules. SDHSA also involves its members in the community – ultimately the people we serve.

3. Examples of SDHSA Stepping In: In recent years, the SDHSA has had to come to the table on behalf of House Staff who have claimed to have been wrongly disciplined and/or UCSD attempts to unilaterally change benefits and rights. One example, in 2014 UCSD discovered they had failed to properly deduct employment taxes from House Staff who had “domestic partners” ( A small but significant group). After 9 months of contentious negotiation, UCSD finally agreed to pay the back taxes, penalties and interest (along with the cost of refiling tax returns) for all affected House Staff. The important point here is that the SDHSA is there protecting House Staff every day in numerous ways. You need to be a Member. In 2014, the Fellows were not part of the SDHSA and therefore they did not participate in any part of the settlement (i.e., they had to pay the back taxes penalties and interest).

4. Social & Educational Functions: SDHSA hosts regular social functions for Members so you can get out and get to know your colleagues. These are very popular and we hope to start them up again after when social distancing allows.

5. Discounts & Other Membership Benefits: In addition, your SDHSA Membership will allow you to obtain discounts and many other Members-Only benefits.

Members Only Benefits & Probationary Periods

Because of the financial havoc caused by the Janus case and the need to protect Members from the exploitation of their Memberships by people who elect to be “free-riders,” the SDHSA has found it necessary to reserve certain benefits for Members and institute a probationary period for full access to benefits which tend to deplete resources. The reason is that we have found that some people have tried to abuse the Post-Janus System of funding by only joining the SDHSA when they have discovered that themselves in some sort of trouble and so changed their mind about Membership. Obviously, this is wrong and would be an injustice to all the people who have joined and supported SDHSA with their dues all along. (Note – the Board may override these periods upon a showing of good cause). Accordingly, the following three stage system apply:

Probationary Periods & Benefits


A member becomes instantaneously entitled to Level 1 Benefits upon joining. Level 1 Benefits include all Social and Educational Programs that are put on or sponsored by the SDHSA.


A member becomes entitled to Level 2 Benefits upon completion of a probationary period and having paid dues for at least two (2) months. Level 2 Benefits include access to SDHSA staff, including attorneys, to research, investigate and answer questions in regard to UCSD employment matters.


A member becomes entitled to Level 3 Benefits upon completion of a probationary period and having paid dues for at least six (6) months before they knew, or should have known of the issue for which they will be requesting SDHSA’s staff’s assistance, including SDHSA’s paid attorneys, to be representing them in any employment matter. Level 3 Benefits include having access to SDHSA’s staff, including SDHSA’s attorneys, to research, investigate answer answers in regard to employment matters with the possibility of SDHSA having to represent the individual and for their staff to make appearances representing said Member at formal investigations and/or hearings. These include, but are not limited to: (a) All Weingarten rights matters, (b) Grievance handling (c) Investigatory or disciplinary interviews with the employer and/or (d) All employees’ representational rights that are afforded public sector employees by PERB other federal authorities interpreting section 7 of the National Labor Relations Act (NLRA). It is understood that SDHSA does NOT and cannot represent individuals, whether they are members or non-members, in regard to any individual matter which is not related to their employment at UCSD.

Waived by the Board Upon Good Cause

The above limitations, may be waived or over-ridden by a majority vote of the then sitting Board of Directors upon a showing of “good cause” to the Board by the applicant. It is incumbent solely upon the non-member or “new member” to provide sufficient evidence to the Board, in a timely manner, to allow for a full investigation and consideration by the Board. Failure to do so in a timely manner shall be deemed a waiver of all rights thereto. If the applicant’s submission of an application to become a SDHSA Member is close in time to the primary facts / incident(s) resulting in the need for SDHSA Level 3 Services, the Board may use this fact alone as evidence of bad-faith and deny the application based thereon.

Representation Paid for by Individual

Without limiting the above, the SDHSA Board may (but is not obligated to) offer to an individual, who is not a SDHSA Member, or who has belatedly joined the SDHSA, to be represented by SDHSA’s staff, including SDHSA’s attorneys, at the actual cost to the SDHSA. Once again, it is incumbent solely upon the non-member or “new member” to provide sufficient evidence to the Board in a timely manner to allow for a full investigation and full consideration by the Board before they vote on this exception. Said individual will be required to enter into a retainer agreement with the SDHSA and may be required to pay a deposit as a retainer in an amount sufficient to secure their performance on the retainer agreement.


The Full SDHSA Membership Policies & Procedures Manual is available to Members upon written request to

Some Other Benefits

Mirowski & Associates acted as the Manager/Attorney for SDHSA from 2005 – 2021. Mirowski & Associates is no longer associated with SDHSA. If you require legal services such as an Employment Contract Review or setting up a professional corporation,  you may directly contact Mirowski & Associates at