[ v08 p289 ]
08:0289(69)RO
The decision of the Authority follows:
8 FLRA No. 69 VETERANS ADMINSTRATION MEDICAL CENTER, BROOKLYN, NEW YORK Activity and VETERANS ADMINISTRATION LOCAL NO. ONE, AN AFFILIATE OF THE COMMITTEE OF INTERNS AND RESIDENTS, AN AFFILIATE OF PHYSICIANS NATIONAL HOUSESTAFF ASSOCIATION Petitioner /1/ Case No. 2-RO-16 DECISION AND DIRECTION OF ELECTION UPON A PETITION DULY FILED WITH THE FEDERAL LABOR RELATIONS AUTHORITY UNDER SECTION 7111(B)(1)(A) OF THE FEDERAL SERVICE LABOR-MANAGEMENT RELATIONS STATUTE (THE STATUTE), A HEARING WAS HELD BEFORE A HEARING OFFICER OF THE AUTHORITY. THE HEARING OFFICER'S RULINGS MADE AT THE HEARING ARE FREE FROM PREJUDICIAL ERROR AND ARE HEREBY AFFIRMED. /2/ UPON THE ENTIRE RECORD IN THIS CASE AND IN CASE NO. 8-RO-2, LONG BEACH VETERANS ADMINISTRATION MEDICAL CENTER, SUPRA, INCLUDING THE POST-HEARING BRIEFS FILED BY THE PARTIES AND THE AMICUS CURIAE, /3/ THE AUTHORITY FINDS: THE PETITIONER, VETERANS ADMINISTRATION LOCAL NO. ONE, AN AFFILIATE OF THE COMMITTEE OF INTERNS AND RESIDENTS, AN AFFILIATE OF THE PHYSICIANS NATIONAL HOUSESTAFF ASSOCIATION, SEEKS AN ELECTION IN A UNIT OF ALL "INTERNS, RESIDENTS AND FELLOWS (COLLECTIVELY KNOWN AS HOUSE STAFF OFFICERS)" /4/ PAID BY THE VETERANS ADMINISTRATION MEDICAL CENTER, BROOKLYN, NEW YORK (THE ACTIVITY), EXCLUDING ALL OTHER EMPLOYEES IN ADDITION TO THE STATUTORY EXCLUSIONS. THE ACTIVITY AND THE AMICUS CURIAE CONTEND THAT THE PETITION SHOULD BE DISMISSED, IN ESSENCE, BECAUSE: (1) THE PETITIONED-FOR MEDICAL INTERNS, RESIDENTS, AND FELLOWS ARE NOT "EMPLOYEES" WITHIN THE MEANING OF SECTION 7103(A)(2) OF THE STATUTE; AND (2) THE PETITIONED-FOR UNIT IS NOT APPROPRIATE FOR EXCLUSIVE RECOGNITION WITHIN THE MEANING OF SECTION 7112(A)(1) AND (B) OF THE STATUTE. /5/ THE ACTIVITY IS A LARGE MEDICAL CENTER WITHIN THE DEPARTMENT OF MEDICINE AND SURGERY, WHICH IS A MAJOR SUBDIVISION WITHIN THE VETERANS ADMINISTRATION (AGENCY). THE ACTIVITY IS UNDER THE OVERALL SUPERVISOR OF A MEDICAL CENTER DIRECTOR. THE ACTIVITY'S PROFESSIONAL SERVICES ARE UNDER ITS CHIEF OF STAFF. THE PROFESSIONAL SERVICES ARE EACH HEADED BY A FULL-TIME CHIEF OF SERVICE AND INCLUDE, FOR EXAMPLE, ANESTHESIOLOGY, MEDICAL, PSYCHIATRY, RADIOLOGY, AND SURGERY. THE PETITIONED-FOR MEDICAL INTERNS, RESIDENTS, AND FELLOWS ARE PHYSICIANS WHO HAVE COMPLETED THE FOUR YEAR COURSE OF STUDY AT A MEDICAL SCHOOL ("UNDERGRADUATE MEDICAL EDUCATION"), HAVE BEEN AWARDED THE DOCTOR OF MEDICINE DEGREE, AND HAVE CHOSEN TO PURSUE GRADUATE MEDICAL TRAINING IN VARIOUS SPECIALTY FIELDS. ALMOST ALL PHYSICIANS UPON RECEIVING THE DOCTOR OF MEDICINE DEGREE ENGAGE THEMSELVES IN GRADUATE MEDICAL TRAINING PROGRAMS, AND MOST OF THESE PHYSICIANS ARE IN PROGRAMS IN TEACHING HOSPITALS (SUCH AS THE ACTIVITY) THAT ARE ASSOCIATED WITH A MEDICAL SCHOOL. AS NOTED IN LONG BEACH VETERANS ADMINISTRATION MEDICAL CENTER, SUPRA, THE ACTIVITY'S AUTHORITY TO APPOINT HOUSE STAFF IS CONTAINED IN 38 U.S.C. SEC. 4114(B)(1) (1976), AND ITS GENERAL AUTHORITY TO CONDUCT GRADUATE MEDICAL TRAINING PROGRAMS IS FOUND IN THE AGENCY'S STATUTORY MANDATE UNDER 38 U.S.C. SECS. 4101(A) AND (B) (1976). GRADUATE MEDICAL TRAINING PROGRAMS, OR "RESIDENCY PROGRAMS" MAY BE ORGANIZED AND DESIGNATED AS: (1) INDEPENDENT (INTRAMURAL) -- A PROGRAM CONDUCTED WITHIN A SINGLE INSTITUTION (THE ASSIGNMENT OF RESIDENTS IS LIMITED TO THAT INSTITUTION); (2) AFFILIATED -- WHEN TWO OR MORE INSTITUTIONS DEVELOP FORMAL AGREEMENTS AND CONJOINT RESPONSIBILITIES TO PROVIDE COMPLEMENTARY FACILITIES, TEACHING STAFF, AND TEACHING SESSIONS; AND (3) INTEGRATED -- WHEN A SINGLE PROGRAM DIRECTOR ASSUMES THE RESPONSIBILITY FOR A RESIDENCY PROGRAM INVOLVING MORE THAN ONE INSTITUTION, AND IS RESPONSIBLE FOR ALL APPOINTMENTS OF THE RESIDENTS AND OF THE TEACHING STAFF. THE ACTIVITY OFFERS ONLY INDEPENDENT AND INTEGRATED RESIDENCY PROGRAMS. THE ACTIVITY'S INTEGRATION ARRANGEMENTS ARE WITH THE DOWNSTATE MEDICAL CENTER OF THE STATE UNIVERSITY OF NEW YORK (DOWNSTATE). ALTHOUGH THE HOUSE STAFF WHO DO ROTATE TO AND FROM THE ACTIVITY MAY GO TO HOSPITALS AND MEDICAL CENTERS OTHER THAN DOWNSTATE, THE ACTIVITY'S "MEMORANDUM OF AFFILIATION" AND "DEANS COMMITTEE" ARRANGEMENTS ARE WITH DOWNSTATE. THE ACTIVITY AND DOWNSTATE ARE PARTIES TO A "MEMORANDUM OF AFFILIATION," THE TERMS OF WHICH PROVIDE THAT DOWNSTATE WILL PARTICIPATE THROUGH THE ACTIVITY'S DIRECTOR AND THE STAFF OF "CONSULTING AND ATTENDING SPECIALISTS" (PHYSICIANS HIRED BY THE AGENCY ON A FEE BASIS WHO HOLD FACULTY APPOINTMENTS AT DOWNSTATE) IN THE SUPERVISION OF THE EDUCATION AND TRAINING PROGRAMS OF THE AGENCY AND SUCH PROGRAMS AS ARE OPERATED JOINTLY BY THE AGENCY AND THE SCHOOLS AFFILIATED WITH THE ACTIVITY. THE MEMORANDUM OF AFFILIATION ALSO PROVIDES FOR THE ESTABLISHMENT OF A "DEANS COMMITTEE." THE GENERAL PURPOSE OF DEANS COMMITTEES IS TO PROVIDE THE AGENCY WITH THE BEST AVAILABLE MEDICAL, SCIENTIFIC, AND EDUCATIONAL ADVICE IN THE CONDUCT OF THE AGENCY'S EDUCATIONAL AND RELATED PROGRAMS. THE RECORD SHOWS THAT IN ACCORDANCE WITH PUBLISHED AGENCY POLICY, AN INDIVIDUAL MAY BE APPOINTED AS A HOUSE STAFF OFFICER IN A GIVEN SPECIALTY OR SUBSPECIALTY ONLY FOR THE NUMBER OF YEARS OF RESIDENCY TRAINING APPROVED BY THE LIAISON COMMITTEE ON GRADUATE MEDICAL EDUCATION (LCGME); IN EFFECT, THIS MEANS THAT MOST HOUSE STAFF CAN EXPECT TO BE IN A RESIDENCY PROGRAM IN WHICH EACH OF THE ALMOST 120 HOUSE STAFF AT THE ACTIVITY PARTICIPATE WILL DETERMINE HOW MUCH TIME DURING EACH YEAR OF RESIDENCY THAT HOUSE STAFF WILL SPEND AT THE ACTIVITY. FROM THE RECORD, IT APPEARS THAT HOUSE STAFF OFFICERS' TIME SPENT AT THE ACTIVITY DURING A YEAR VARIES FROM 3 1/2 MONTHS (FOR SURGERY SERVICE) TO 11 MONTHS DEPENDING ON THE PARTICULAR RESIDENCY IN WHICH THEY PARTICIPATE. /6/ IN CONTRAST TO MEDICAL STUDENTS WHO PAY A TUITION TO DOWNSTATE AND MAY BE ASSIGNED AS CLINICAL CLERKS TO THE ACTIVITY ONLY ON A WOC (WITHOUT COMPENSATION) BASIS IN ORDER TO FURTHER THEIR UNDERGRADUATE MEDICAL STUDIES, HOUSE STAFF RECEIVE A "STIPEND." HOUSE STAFF ASSIGNED TO THE ACTIVITY RECEIVE STIPENDS FROM EITHER THE AGENCY OR NON-AGENCY SOURCES. THE AGENCY ALSO SUPPORTS STIPENDED SLOTS FOR HOUSE STAFF ASSIGNED TO DOWNSTATE AND OTHER HOSPITALS AND MEDICAL CENTERS. HOUSE STAFF PAID BY THE AGENCY RECEIVE THEIR STIPEND PAYMENTS EACH REGULAR BIWEEKLY PAY PERIOD. THEIR PAY IS SUBJECT TO FEDERAL AND STATE INCOME TAX WITHHOLDING AND SOCIAL SECURITY DEDUCTION. THE PERIOD OF SERVICE OF HOUSE STAFF AT THE ACTIVITY IS CREDITABLE SERVICE FOR CIVIL SERVICE RETIREMENT. THEY ACCRUE ANNUAL AND SICK LEAVE. UNUSED SICK LEAVE AT THE TIME OF TERMINATION MAY BE RECREDITED UPON RETURN TO FEDERAL EMPLOYMENT WITHIN THREE YEARS. IN CONTRAST TO HOUSE STAFF WHO MAY BE ROTATED TO THE ACTIVITY AND YET CONTINUE TO BE PAID BY AND EARN FRINGE BENEFITS AT THEIR "HOME" HOSPITAL, HOUSE STAFF ASSIGNED TO THE ACTIVITY AND PAID BY THE AGENCY HAVE WORKERS' COMPENSATION TYPE BENEFITS FOR INJURY OR ILLNESS ON THE JOB, INCLUDING MEDICAL CARE AND HOSPITALIZATION, COMPENSATION FOR LOSS OF PAY, AND DEATH BENEFITS TO SURVIVORS. IN ADDITION, AGENCY STIPENDED HOUSE STAFF AT THE ACTIVITY ARE ELIGIBLE TO CHOOSE AMONG SEVERAL FEDERAL EMPLOYEES' HEALTH BENEFITS PLANS, AS WELL AS TO TAKE FEDERAL EMPLOYEE GROUP LIFE INSURANCE. ACCORDING TO THE RECORD, THERE ARE NO "OVERTIME" PAYMENTS TO HOUSE STAFF, RATHER, IT IS PUBLISHED AGENCY POLICY THAT HOUSE STAFF WILL NORMALLY BE APPOINTED ON A FULL-TIME DUTY STATUS AND CONSIDERED AVAILABLE AND RESPONSIBLE FOR THE CARE, TREATMENT, AND WELFARE OF THEIR PATIENTS 24 HOURS A DAY, 7 DAYS A WEEK. THE RECORD SHOWS THAT MOST OF THE TIME HOUSE STAFF SPEND AT THE ACTIVITY IS IN DIRECT PATIENT CARE ACTIVITIES. THE "GUIDE FOR RESIDENTS AND INTERNS" PUBLISHED BY THE ACTIVITY STATES THAT THE PRIME RESPONSIBILITY OF HOUSE STAFF IS THE CARE OF PATIENTS. ALTHOUGH THE ACTIVITY RECEIVES SUBSTANTIAL INPUT FROM DOWNSTATE THROUGH THE DEANS COMMITTEE REGARDING TRAINING OBJECTIVES FOR HOUSE STAFF, AND THE AGENCY REQUIRES THAT RESIDENCY PROGRAMS CONDUCTED WITHIN ITS MEDICAL CENTERS CONTINUE TO BE ACCREDITED BY THE LCGME, THE ACTIVITY RETAINS FINAL AUTHORITY TO SUPERVISE, EVALUATE, DISCIPLINE, PROMOTE AND RETAIN HOUSE STAFF APPOINTED BY THE ACTIVITY. THE ACTIVITY'S RETENTION OF THIS AUTHORITY IS NOT INCOMPATIBLE WITH THE INTERESTS OF THE LCGME, DOWNSTATE, OR HOUSE STAFF BECAUSE, ACCORDING TO PUBLISHED AGENCY POLICY, THE METHODS FOR ACCOMPLISHING EDUCATIONAL OBJECTIVES ARE ESSENTIALLY THE SAME AS THOSE FOR ACCOMPLISHING PATIENT CARE OBJECTIVES. THE RECORD DISCLOSES THAT THE FEDERAL TORT CLAIMS ACT APPLIES TO AGENCY HOUSE STAFF; THAT IS, THE FEDERAL GOVERNMENT IS RESPONSIBLE FOR THE NEGLIGENCE AND MALPRACTICE OF HOUSE STAFF ACTING WITHIN THE SCOPE OF THEIR EMPLOYMENT. IN ADDITION, ALL AGENCY MEDICAL CENTERS ARE CAUTIONED TO ADVISE HOUSE STAFF AND THE NON-FEDERAL INSTITUTIONS TO WHICH THEY MAY BE ASSIGNED THAT THE FEDERAL GOVERNMENT WILL NOT BE RESPONSIBLE FOR ANY CLAIMS AGAINST THEM ARISING OUT OF THEIR ACTIVITIES AT THE NON-FEDERAL INSTITUTION. THE AUTHORITY FINDS THAT THE ISSUES RAISED IN THE INSTANT CASE ARE ESSENTIALLY THE SAME AS THOSE RAISED IN LONG BEACH VETERANS ADMINISTRATION MEDICAL CENTER, SUPRA, WHICH HELD THAT HOUSE STAFF ASSIGNED TO THAT ACTIVITY AND PAID BY THE AGENCY CONSTITUTE AN APPROPRIATE UNIT. THE ONLY MATERIAL DIFFERENCE IS IN THE SCOPE OF THE PETITIONED-FOR UNIT. IN THE LONG BEACH CASE, PETITIONER SOUGHT A UNIT OF ALL HOUSE STAFF LOCATED AT THAT ACTIVITY. IN THE INSTANT CASE, PETITIONER SEEKS A UNIT OF ALL HOUSE STAFF PAID STIPENDS BY THE AGENCY THROUGH THE ACTIVITY REGARDLESS OF THEIR LOCATION. FOR THE REASONS FULLY SET FORTH IN LONG BEACH VETERANS ADMINISTRATION MEDICAL CENTER, SUPRA, THE AUTHORITY FINDS THAT HOUSE STAFF LOCATED AT THE ACTIVITY AND PAID STIPENDS BY THE AGENCY ARE EMPLOYEES WITHIN THE MEANING OF THE STATUTE. HOWEVER, THE AUTHORITY FINDS THAT HOUSE STAFF APPOINTED AND PAID STIPENDS BY THE AGENCY, BUT ASSIGNED TO WORK OUTSIDE THE ACTIVITY, ARE NOT EMPLOYEES WITHIN THE MEANING OF THE STATUTE. THUS, SUCH HOUSE STAFF DO NOT HAVE AN EMPLOYEE-EMPLOYER RELATIONSHIP WITH THE ACTIVITY, NOTING PARTICULARLY THAT THE ACTIVITY DOES NOT HAVE THE AUTHORITY EITHER TO CONTROL AND DIRECT SUCH HOUSE STAFF IN THE MATERIAL DETAILS OF THEIR PATIENT CARE RESPONSIBILITIES, OR TO CONTROL OTHER ASPECTS OF THEIR WORKING CONDITIONS AT OTHER HOSPITALS AND MEDICAL CENTERS. BASED ON ALL THE ABOVE, THE AUTHORITY FINDS THAT A UNIT OF ALL MEDICAL INTERNS, RESIDENTS AND FELLOWS EMPLOYED AT THE ACTIVITY AND PAID BY THE AGENCY IS APPROPRIATE FOR EXCLUSIVE RECOGNITION WITHIN THE MEANING OF SECTION 7112(A)(1) OF THE STATUTE, INASMUCH AS THE FACTS SHOW THAT THE UNIT WILL ENSURE A CLEAR AND IDENTIFIABLE COMMUNITY OF INTEREST AMONG THE EMPLOYEES IN THE UNIT AND WILL PROMOTE EFFECTIVE DEALINGS WITH, AND EFFICIENCY OF THE OPERATIONS OF, THE ACTIVITY. THUS, THE EMPLOYEES IN THE PROPOSED UNIT ENJOY A CLEAR AND IDENTIFIABLE COMMUNITY OF INTEREST AS EVIDENCED BY THE FACTS THAT THEY ARE ALL PHYSICIANS INVOLVED IN THE COMMON MISSION OF PROVIDING CLINICAL CARE OF PATIENTS AT THE ACTIVITY, ARE SUBJECT TO THE SAME CONDITIONS OF EMPLOYMENT IN A COMMON ENVIRONMENT, ENJOY THE SAME SOURCE OF COMPENSATION AND BENEFITS, ARE SUBJECT TO THE SAME PERSONNEL POLICIES AND PRACTICES, AND RECEIVE TRAINING WHILE EMPLOYED. MOREOVER, SUCH UNIT WILL PROMOTE EFFECTIVE DEALINGS AND EFFICIENCY OF AGENCY OPERATIONS AS EVIDENCED BY THE FACTS THAT THE EMPLOYEES IN THE UNIT HAVE A REASONABLE EXPECTANCY OF REGULAR AND CONTINUOUS EMPLOYMENT AT THE ACTIVITY FOR A SUBSTANTIAL PERIOD OF TIME, THE ACTIVITY HAS THE AUTHORITY FOR A SUBSTANTIAL PERIOD OF TIME, THE ACTIVITY HAS THE AUTHORITY AND CAPACITY TO CONDUCT EFFECTIVE LABOR RELATIONS AT THE ACTIVITY-WIDE LEVEL OF RECOGNITION, AND THE UNIT CONFORMS TO THE ORGANIZATIONAL AND OPERATIONAL STRUCTURE OF THE ACTIVITY. ACCORDINGLY, THE AUTHORITY FINDS THAT THE FOLLOWING UNIT OF EMPLOYEES IS APPROPRIATE FOR THE PURPOSE OF EXCLUSIVE RECOGNITION UNDER THE STATUTE: /7/ ALL MEDICAL INTERNS, RESIDENTS, AND FELLOWS ASSIGNED TO THE VETERANS ADMINISTRATION MEDICAL CENTER, BROOKLYN, NEW YORK, AND PAID BY THE VETERANS ADMINISTRATION; EXCLUDING ALL OTHER PROFESSIONAL EMPLOYEES, NONPROFESSIONAL EMPLOYEES, AND EMPLOYEES DESCRIBED IN 5 U.S.C. SEC. 7112(B)(2), (3), (4), (6), AND (7). DIRECTION OF ELECTION AN ELECTION BY SECRET BALLOT SHALL BE CONDUCTED AMONG THE EMPLOYEES IN THE UNIT FOUND APPROPRIATE AS SOON AS FEASIBLE. THE APPROPRIATE REGIONAL DIRECTOR SHALL SUPERVISE OR CONDUCT, AS APPROPRIATE, THE ELECTION, SUBJECT TO THE AUTHORITY'S RULES AND REGULATIONS. ELIGIBLE TO VOTE ARE THOSE IN THE UNIT WHO WERE EMPLOYED DURING THE PAYROLL PERIOD IMMEDIATELY PRECEDING THE DATE BELOW, INCLUDING EMPLOYEES WHO DID NOT WORK DURING THAT PERIOD BECAUSE THEY WERE OUT ILL, OR ON VACATION, OR ON FURLOUGH, INCLUDING THOSE IN THE MILITARY SERVICE WHO APPEAR IN PERSON AT THE POLLS. INELIGIBLE TO VOTE ARE EMPLOYEES WHO QUIT OR WERE DISCHARGED FOR CAUSE SINCE THE DESIGNATED PAYROLL PERIOD AND HAVE NOT BEEN REHIRED OR REINSTATED BEFORE THE ELECTION DATE. THOSE ELIGIBLE SHALL VOTE WHETHER OR NOT THEY DESIRE TO BE REPRESENTED FOR THE PURPOSE OF EXCLUSIVE RECOGNITION BY THE VETERANS ADMINISTRATION LOCAL NO. ONE, AN AFFILIATE OF THE COMMITTEE OF INTERNS AND RESIDENTS, AN AFFILIATE OF PHYSICIANS NATIONAL HOUSESTAFF ASSOCIATION. ISSUED, WASHINGTON, D.C., MARCH 26, 1982 RONALD W. HAUGHTON, CHAIRMAN HENRY B. FRAZIER III, MEMBER LEON B. APPLEWHAITE, MEMBER FEDERAL LABOR RELATIONS AUTHORITY --------------- FOOTNOTES: --------------- /1/ THE NAME OF THE PETITIONER APPEARS AS AMENDED AT THE HEARING. /2/ THE PETITIONER FILED A MOTION PURSUANT TO SECTION 2422.10(B)(2) OF THE AUTHORITY'S RULES AND REGULATIONS SEEKING TO REOPEN THE RECORD OF THE HEARING FOR PURPOSES OF SUBMITTING ADDITIONAL EVIDENCE. THE PETITIONER MAINTAINS THE HEARING OFFICER ERRED IN TAKING "OFFICIAL NOTICE" OF THE RECORD IN CASE NO. 8-RO-2, LONG BEACH VETERANS ADMINISTRATION MEDICAL CENTER, LONG BEACH, CALIFORNIA, 7 FLRA NO. 66 (1981), BY LIMITING EVIDENCE AND TESTIMONY IN THE PRESENT CASE TO FACTS AND EVIDENCE WHICH THE PARTIES COULD DEMONSTRATE WERE UNIQUE TO CASE NO. 2-RO-16 AND NOT CONTAINED IN THE RECORD OF CASE NO. 8-RO-2. IN VIEW OF THE DISPOSITION OF THE PETITION HEREIN, THE AUTHORITY FINDS NO PREJUDICIAL ERROR WAS COMMITTED BY THE HEARING OFFICER, AND HEREBY DENIES PETITIONER'S MOTION. /3/ THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES WAS GRANTED PERMISSION TO PARTICIPATE IN THIS PROCEEDING AS AMICUS CURIAE. /4/ FOR PURPOSES OF THIS DECISION, THE TERMS "HOUSE STAFF" (PLURAL) AND "HOUSE STAFF OFFICER" (SINGULAR) INCLUDE ALL SUCH CLASSIFICATIONS OR TITLES. /5/ SECTION 7112 PROVIDES IN PERTINENT PART: (A)(1) THE AUTHORITY SHALL DETERMINE . . . ANY UNIT TO BE AN APPROPRIATE UNIT ONLY IF THE DETERMINATION WILL ENSURE A CLEAR AND IDENTIFIABLE COMMUNITY OF INTEREST AMONG THE EMPLOYEES IN THE UNIT AND WILL PROMOTE EFFECTIVE DEALINGS WITH, AND EFFICIENCY OF THE OPERATIONS OF, THE AGENCY INVOLVED. (B) A UNIT SHALL NOT BE DETERMINED TO BE APPROPRIATE UNDER THIS SECTION SOLELY ON THE BASIS OF THE EXTENT TO WHICH EMPLOYEES IN THE PROPOSED UNIT HAVE ORGANIZED . . . . /6/ APPARENTLY THE PETITIONER ALSO WISHES TO REPRESENT FOUR DENTAL RESIDENTS WHO ARE IN AN INDEPENDENT PROGRAM AT THE ACTIVITY. HOWEVER, THE AUTHORITY FINDS INSUFFICIENT EVIDENCE IN THE RECORD UPON WHICH TO BASE A FINDING REGARDING THE STATUS OF DENTAL RESIDENTS. MOREOVER, THE RECORD APPEARS TO INDICATE THAT ONE OF THE DENTAL RESIDENTS IS A "CAREER RESIDENT." AGAIN, THE AUTHORITY FINDS INSUFFICIENT EVIDENCE IN THE RECORD UPON WHICH TO BASE A FINDING ON THE STATUS OF "CAREER RESIDENTS." NOTWITHSTANDING THE ABOVE, SUCH EMPLOYEES MAY DESIRE TO VOTE IN THE ELECTION AS DIRECTED INFRA PURSUANT TO THE CHALLENGE BALLOT PROCEDURE CONTAINED IN SECTION 2422.18 OF THE AUTHORITY'S RULES AND REGULATIONS. /7/ INASMUCH AS THE UNIT FOUND APPROPRIATE HEREIN IS DIFFERENT FROM THAT SOUGHT BY THE PETITIONER IN THAT AGENCY-PAID HOUSE STAFF ASSIGNED OUTSIDE THE ACTIVITY CANNOT BE INCLUDED, IF THE PETITIONER DOES NOT DESIRE TO PROCEED TO AN ELECTION IN THE UNIT FOUND APPROPRIATE, IT MAY WITHDRAW ITS PETITION. THE WITHDRAWAL MUST BE IN WRITING AND MUST BE RECEIVED BY THE APPROPRIATE REGIONAL DIRECTOR NOT LATER THAN 10 DAYS AFTER THE ISSUANCE OF THIS DECISION.