Comments from Dr. Dellit on Last, Best, Final Offer Made to Residents and Fellows (8/8/2025)
To the GME Community:
Last night, following months of negotiations on a 2025-2028 contract, the UW presented its last, best and final offer to the Committee of Interns and Residents Northwest (CIR NW).
Our proposed three-year agreement, which is valued at nearly $47 million in new benefits, includes increases to wages, fringe benefits, allowances, the childcare fund, professional development funds and more. The proposal reflects our deep appreciation for our residents and fellows’ important contributions in caring for our patients. It also demonstrates our ongoing commitment to their training, development and overall well-being.
This offer is made at a time of unprecedented financial pressures and uncertainties for UW Medicine. The University recently experienced a 6.5% reduction in state funding by the Washington State Legislature, leading to the requirement that all UW schools and colleges, including the School of Medicine, reduce their budgets by 5%. We are being forced to close some of our clinics, and we are navigating the hard realities of potential staffing changes in order to sustain our mission. The state has also decided to reduce reimbursement when providing care for state and school employees, which will cause our hospitals to lose over $49 million per year beginning in January 2027.
In addition to reductions in state funding, the U.S. Senate and House passed the H.R.1 reconciliation bill that cuts over $1 trillion in healthcare spending with an anticipated loss of healthcare coverage for over 11 million individuals in the U.S., including over 300,000 Washington residents. Simply put, this is devastating for the entire academic medicine community and larger healthcare systems. As the safety net healthcare system for our state, this will result in our caring for more uninsured individuals as they lose their Medicaid coverage. As we emerged from the pandemic, we were able to put into place Medicaid directed payment programs for a total of $369 million per year for UW Medical Center and Harborview Medical Center, which helped to stabilize our finances and to support our over $688 million in uncompensated care per year. The passed bill will now reduce that supplemental program by 10% per year starting in 2028 until it reaches the level of Medicare, essentially eliminating all of this Medicaid supplement over time. This not only creates significant financial risk for UW Medicine but will also lead to further difficult decisions regarding reductions of clinical programs and services. We have a responsibility to ensure the long-term viability of our hospitals in service to our community.
Despite these constraints, by negotiating in good faith and responding to feedback, we have arrived at what we believe is a fair and equitable proposal. Our final offer includes the following increases:
- Salary: 4% salary increase for each R level in the first year of the contract, and 3% salary increase for each of years two and three of the contract.
- Allowance: increase in annual allowance from $8500 to $10,000 in year one. The allowance increases to $11,000 in year two and $12,000 in year three of the contract.
- Chief resident/fellow allowance: increase to the chief resident/fellow allowance from $225 to $250/month in year two, and to $275/month in year three of the contract.
- Professional Development Fund: increase annual professional development fund amount from $400 to $450 (reimbursed) and from $450 to $500 (allowance) beginning in year two of the contract.
- Meals: increase meal reimbursement from $13/meal to $14/meal.
- Childcare: increase annual childcare fund from $75,000 to $100,000.
- Bereavement: increase in paid time off for bereavement from 3 to 5 days.
When combined with annual R level increases, the cumulative increases to salary, allowance and professional development together total a 10% increase in year one of the contract, a more than 8% increase in year two and another increase of more than 8% in year three of the contract. We urge our labor partners and CIR NW members to accept this last, best and final offer and vote “Yes” on the proposed contract.
This offer is the culmination of a months-long process during which the UW negotiations team spent many hours listening to and learning from our trainees. By negotiating in good faith and responding to feedback, we have proposed what we believe is a fair and equitable outcome.
In the absence of a new agreement, the terms of the existing contract remain effective for up to one year while we continue to bargain in good faith. As we have indicated to CIR NW leadership, due to the UW’s funding and reimbursement structure, there can be no retroactive compensation for trainees.
We appreciate everything our residents and fellows do to care for our patients and for each other. Now is the time for us to reach agreement and move forward together.
Sincerely,
Timothy H. Dellit, MD (He, Him, His)
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Paul G. Ramsey Endowed Dean of the School of Medicine,
University of Washington