Amid a pandemic that underscores the vital role they play, residency trainees at Santa Clara Valley Medical Center say they struggle to make ends meet in Silicon Valley.

Frustrated with one huge hangup in contract negotiations, the Committee of Interns and Residents [CIR-SEIU]—the largest housestaff union in the U.S.—took part in what they dubbed a Solidarity Break this past week to call attention to their fight for a fair contract.

“We all believe in the mission to take care of our patients who need services regardless of their ability to pay for them,” said Keri Garel, one of the 112 physicians-in-training at Valley Med. “We all care about the patients a lot—we just want to be able to live here.”

According to the CIR-SEIU, the union has been in negotiations since March with Santa Clara County, which operates the Valley Health and Hospitals System. In the six months since the talks started, the county and union have come to a tentative agreement in all aspects of a new contract—except for one key clause governing recruitment and retention of resident doctors. This would give resident physicians a stipend to help with housing and other needs to survive in one of the most expensive housing markets in the country.

The CIR-SEIU argues that a stipend to cover housing costs would go a long way in making Valley Med more competitive as it recruits new doctors for residency. According to the union, nearby hospitals already offer that benefit.

County officials, however, contend that they’ve put forth a fair offer.

“We have offered a proposal that is comparable to those agreed to by the county’s other unions,” county Employee Services Agency Director John Mills said in a statement to San Jose Inside. “The county recognizes the interns and residents for their contributions to the patient care provided to our community during these challenging times, and we are very close to reaching a tentative agreement.”

Garel lives in an apartment that’s about a 30-minute walk from the medical center off of Moorpark Drive in Midtown San Jose. Yet she said it would be impossible for her to afford rent if she didn’t live with a partner who helped cover it.

“The average cost of rent ends up being well over half our take-home pay,” Garel said. “The county says they simply do not have the money to cover the cost of a housing stipend, but our thoughts on that is the stipend would primarily be covered by federal funding, which doesn’t come out of the county budget.”

Garel said that it’s typical for resident physicians to work 70 to 80 hours a week. Based on those calculations, she argued “our hourly wage would be below minimum wage.”

In a statement, the CIR-SEIU said: “It is unacceptable that [we] cannot rent nearby apartments without cosigners because [our] salaries do not meet required minimums. [Resident physicians and interns] are overworked, underpaid, in debt and experience significantly higher burnout rates than most other professions.”