Nearly 700 resident physicians and fellows at Rhode Island Hospital rallied outside the Providence facility this week, demanding executives approve their first union contract after nearly a year of negotiations. The doctors say they work more than 80-hour weeks for pay that barely clears minimum wage, and they are furious that hospital leadership recently created a high-salaried security executive post for a former U.S. Customs and Border Protection official even as the system announces cost cuts elsewhere.
Doctors Reject Latest Offer, Set New Bargaining Date
The resident physicians and fellows, represented by the Committee of Interns and Residents and the Service Employees International Union, reportedly rejected the hospital's latest contract offer on September 29, according to WPRI.com. The proposal failed to meet the doctors' demands, and the two sides are set to meet again on October 6. The dispute follows a landmark moment for Rhode Island labor history: in January 2025, Rhode Island Hospital residents voted 464 to 27 in a National Labor Relations Board election to unionize, becoming the first doctors' union in the state, according to The Public's Radio.
Raphaela Posner, a triple-board resident physician, said residents were getting closer to a fair contract but had not reached one yet, per WPRI.com. Posner and other residents say they are fighting for a fair contract that would provide a living wage in Rhode Island, where residents face rising housing costs. David Morales, the Democratic nominee for Providence mayor, spoke in solidarity with the doctors at the picket, the station reported.
Pay Gap With Neighboring Hospitals
According to the union, Rhode Island Hospital's resident physicians and fellows earn barely minimum hourly wages given their workload. CIR-SEIU organizers put a sharper number on it during a June demonstration, estimating residents earn roughly $18 an hour once 80-hour weeks are factored in, per Steve Ahlquist's Substack. First-year resident pay at Cambridge Health Alliance is $79,662.
The picket this week was not an isolated event. The same coalition organized a rally outside Rhode Island Hospital in June and marched to I-195 District Park on July 23, according to the same Substack account. The contract fight also extends beyond this one hospital — CIR-SEIU represents more than 650 resident physicians across four major Rhode Island hospitals, including Care New England's Kent, Butler, and Women & Infants facilities, per Providence Business News.
Security Leadership Draws Fire
Much of the anger at the picket centered on Rhode Island Hospital's parent company, Brown University Health, and its security leadership.
Physicians and fellows accused Brown Health CEO John Fernandez of disregarding the community's needs, per WPRI.com.
Christopher Botelho, who worked at Brown University Health for more than a decade as a data coordinator, quit the position amid the controversy. By Botelho's account, physicians earned unlivable wages and faced increasing health insurance costs, and he resigned the same day he met with hospital HR.
Hospital Points to Financial Strain and Bargaining Progress
A Brown University Health spokesperson said Rhode Island Hospital is committed to reaching a first collective bargaining agreement with CIR, per the hospital's statement to WPRI.com. The two sides have made substantial progress since negotiations began in June 2025, reaching 90 tentative agreements. The hospital said it has responded thoughtfully to CIR's proposals, made meaningful movement at the table, and continues to negotiate in good faith toward a fair, sustainable agreement that recognizes interns' and residents' contributions while upholding commitments to patient care, its workforce and the community.
The picket took place October 2, the day after Brown University Health announced sweeping cost cuts on October 1: voluntary buyouts for 200 non-clinical supervisors and layoffs of 10 executives, citing $90.5 million in three-month expenses tied to charity care, uncompensated debt, and insurer denials, according to Rhode Island Current. Brown University Health, formerly known as Lifespan Health System, is a Rhode Island health system, according to Fierce Healthcare.
