My residency class was the first to adopt the 80-hour work week restriction—a few decades too late, in my opinion. Even so, this restriction does little to mitigate burnout and poor mental health among residents. Residency is hard both physically and mentally, with effects that can extend beyond the training period. This is why some medical residents are advocates of unionization. 

I was not part of a residency union during that period in my life, but I recognize their worth in how they can improve residents’ pay and working conditions. At the same time, unionization can  negatively affect patient care and cause rifts between residents and other hospital staff. Personally, I support unionization among residents, but I know many other physicians who do not.  

 

Unions can improve conditions for residents and patients

 

Jake Jacob, MD: “First off, being in the medical field is intense—long shifts, high stress, and sometimes it feels like there's no time for anything else. That's where unions come in. They can advocate for better working conditions, like reasonable hours and proper breaks. Having a say in our schedules and making sure we're not pushing ourselves to the brink is crucial for our well-being.

“But it's not just about us—it's about patient care too. When residents are overworked and exhausted, mistakes can happen. Unions can fight for staffing levels that ensure we're not spread too thin, which ultimately means safer and better care for patients. Plus, they can push for fair compensation. Medical training is a long and expensive journey, and residents deserve to be paid fairly for their hard work.” 

Unions can be a powerful force to make sure our voices are heard and our rights are protected.

 

Unions can help when we’re most vulnerable

 

Abeeha Naqvi, MD: “I definitely support unions for residents. I feel like medical residents are such a niche group who cannot relate to many other healthcare providers and remain vulnerable throughout training. Many life decisions are altered due to stringent rules during residency, including financial and emotional stressors. 

“Because residency is seen as a temporary transition on our greater career path, it is thought we must all just suffer through it, but I disagree.”

 

Unions can help us stay strong during our training years, which will ultimately help prevent burnout in the medical field.

 

They can help initiate real change

 

Christina Pedro, MD: “Medical and academic institutions are often times complacent with their infrastructure. It’s easier to do nothing than to make effective changes to improve the work environment, flow, and experience of the consumer and employee.”

 

Unions are helpful to medical residents in these structured rigid organizations, because they remind employers they must continue to improve the worker experience.

 

Some opposing views on unionization…

 

• Mark Winfield, MD: “I don’t support unions for residents. Residency should be focused on training, not income or lifestyle.”

• Boyer Bran, MD: “They will bring too much politics into patient care.”

 

And more supportive stances

 

• Sunder Sham, MBBS: “I support unions because they help residents during this incredibly stressful time.”

• Ravi Patel, MD: “Unions promote better rights for residents, and thus improves patient care.”

• James Skinner, MD: “Some residency programs ask for too much in terms of working hours, and unionizing is the only way to make changes.”

 

Parting thoughts

 

Unionization among residents is a controversial topic—not only among hospital administration and attendings, but among residents themselves. Unions are specific to each hospital, meaning that if one residency program is unionized, it does not mean they all are, even if they are in the same state. 

 

Even though medical residency unions are becoming more talked about, most programs have not unionized. However, given the ongoing trend toward unionization among established physicians and other HCPs—something that has really only taken off in recent years—residents are almost certain to follow suit.