A healthy working life is good for both providers and patients.
The phrase “Medical resident” conjures a mental picture of someone exhausted, overworked, underpaid, and underappreciated. The image of bedraggled, baggy-eyed new doctors, dragging themselves through hospital halls, coffee in hand, has become an enduring image of the American healthcare system.
Up until recently, this was mostly accepted and seen as the cost of getting into medicine. You slogged your way through med school and your residency to eventually attain a high-paying job. Symptomatic of this, unions represented only about 20% of interns and residents as of October 2024.[1]
A new generation of residents and fellows, however, appear unwilling to accept exploitation during their medical training as a simple rite of passage. In the last month, there have been major unionization pushes in , Philadelphia, Boston, , , Rhode Island, and Delaware . For example, 950 Brown University Health residents recently voted to unionize, citing burnout and poor working conditions. Boston’s Beth Israel Deaconess, California’s Kaiser Permanente Northern California, DC’s George Washington University Hospital, and UChicago Medicine housestaff have also all recently voted to join the Committee of Interns and Residents – Service Employees International Union (SEIU), which now represents 37,000 intern and resident physicians.[2] This recent increase has been the union’s largest membership swell since the 1970’s.
Residents and fellows at Pennsylvania hospitals, including Temple Health, Jefferson Health, and Einstein Healthcare Network have also joined this national movement, and voted recently in union elections (as have their janitorial and support staff).[3]
Residents and interns are the backbone of our medical system, but they certainly aren’t treated like it. Most residents make less than $67,000 annually. When you consider that they also work (on average) 76 hours per week[4], that comes out to less than $20 per hour – to perform one of society’s most critical jobs. Working conditions aren’t anything to write home about either. Many hospitals are severely understaffed, which puts residents in the position of doing their jobs, plus many functions traditionally handled by skilled nurses, which only increases the strain.[5]
“(Being a resident) sucks” says Ahab D, an ER resident at a Philadelphia area hospital. “And there’s little-to-no incentive for hospital systems to treat you right because you need them. There’s a fresh crop of new residents every year, who have no idea what they’re getting into…so hospital systems see you as expendable.” He checks his time tracking app, then turns the phone around with a sigh. 68 hours so far this week.
In October 2023, Penn Medicine residents voted to join CIR/SEIU. They demanded better pay, better parental leave, and break rooms where they can rest during 24-hour shifts. The contract also includes protections against out-of-title work, such as drawing blood, transporting patients, and scheduling. Shockingly, this was the first housestaff contract in Pennsylvania history, and it set a precedent not just for Pennsylvania, but nationwide.
“This is a huge deal.” said Bryce T, a cardiovascular surgery resident. The residents and interns at the hospital where he works have also recently voted to unionize, and the contract that CIR won for Penn Medicine staff gives him hope. “Well, I’m optimistic. We really don’t have any protection and seeing what happened there (Penn Medicine) made everyone realize that we could do better. That we’re important and we are going to be negotiating from a position of strength.”
The R&I’s current organizing wave illustrates yet again the importance – and transformative potential – of organizing and labor rights. Fair contracts and treatment for residents aren’t simply good for doctors, they’re good for us too. Who would you rather have by your sickbed? An underpaid, overworked physician with no work-life balance, or a physician who has time to sleep, eat, and care for their family?
Not a hard one.
[1] https://www.cirseiu.org/over-1400-resident-physicians-at-the-university-of-pennsylvania-are-unionizing-for-better-working-conditions-and-patient-care/
[2] https://www.cirseiu.org/who-we-are/
[3] https://www.phillyvoice.com/philly-resident-physicians-union-interns-jefferson-chop-temple-einstein/
[4] Mercer, National Institute of Health, how work hours affect medical resident performance and wellness.
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC4525347/