Why more medical residents are looking to unionize

Resident doctors work long hours for relatively low pay. They have few opportunities to determine their schedule and are usually locked in their position for several years. These factors are among the reasons some residency programs across the country are turning to unionization.

In recent months, physicians in a number of residency programs have voted in favor of unionization. Anna Yap, MD, is an emergency medicine resident at the University of California, Los Angeles (UCLA), Olive-View Medical Center, and participated in a UCLA organizing effort in 2019.

For Dr. Yap, the reasons residents consider unions are similar to those of most other workers who choose to organize.

“A union is the only real way to ensure that you have protections as an employee and that you have better working conditions,” she argued. “The gains you gain from becoming unionized far outweigh the disadvantages.”

WADA has policy on unions in higher medical education which “strongly advocates the separation of academic matters from employment conditions in determining the negotiable elements for the trade union organizations representing medical residents”.

Unions, the policy says, should follow the AMA’s Principles of Medical Ethics, which prohibits “these organizations or any of its members from engaging in a strike by denying patients essential medical services.” .

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Dr. Yap entered residency in 2018. As a member of the AMA House of Delegates, she viewed union involvement as an extension of her work in organized medicine. The importance of union representation has been reinforced by the experience of COVID-19, she said, noting that residents have been on the front lines of care but have not been the first to have access to l personal protective equipment or life-saving vaccines.

“When the pandemic hit, we – as residents – felt like we were being taken advantage of,” Dr Yap said. “It’s damaging when residents can’t talk or even know how to talk to leaders and tell them what’s going on and they don’t feel safe.”

Dr. Yap and his fellow interns at UCLA won benefits when they reached a settlement with the administration, facilitated by the Intern and Resident Committee, the largest union for housekeeping staff in the United States and a local of the Service Employees International Union. These benefits included salary increases and housing allowances.

The Trainee and Resident Committee says it represents more than 20,000 residents and fellows, or about 15% of physicians in post-graduate medical training positions.

Dr Yap said the residents’ union movement will continue to grow out of necessity.

“We see residents across the country continuing to collect these signatures [to certify for a union] and say we’re going to come together and unionize,” she said.

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“As more and more residents unionize, they tell their friends and peers about it,” she added. “It’s the best way to do it, at this individual level. It’s amazing how active he has been over the past few years. For his part, Dr. Yap did not see any sort of retaliation or reprisal associated with joining the union. “Most of the time it’s your big bosses in the hospital system who are against a union,” she said. “He’s not your program director. Your program director’s goal is to ensure that you become a good doctor and that you will be supported throughout the process. And you’re going to make good doctors when you have happy residents, and you’re going to have happy residents when they’re better paid and better cared for.

Learn more about the AMA’s Residents and Fellows Section, which gives voice and advocates for issues that affect residents and fellow physicians.

Andrew B. Reiter