Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff

Published in the journal JAMA Network Open. Here is a link to the article.

Regenstrief Institute authors: Karl Y. Bilimoria, PhD

This qualitative study explored the role of labor unions in the wellness of general surgery residents, using interview data from the SECOND trial involving 15 U.S. residency programs. Unionization emerged as a theme in 22 interviews with residents, faculty, and administrators.

Unionization was driven by residents’ desire for greater voice and agency, with increased salary and housing stipends cited as clear benefits. However, unintended consequences included the loss of department-specific perks, strained resident-faculty relationships, and inefficiencies due to union administrators lacking clinical backgrounds. Some interviewees noted that union-negotiated benefits did not always align with surgical residents’ needs.

The findings suggest that while unions can empower residents, they may also complicate education and support systems if not aligned with training realities. Active involvement by surgical residents in union processes was seen as key to effective advocacy and reducing conflict. Broader research is needed to understand unionization’s evolving impact in surgical training environments.

Authors

Darci C. Foote¹, Audrey E. Rosenblatt^2,3, Daniela Amortegui⁴, Carmen M. Diaz², Brian C. Brajcich², Cary Jo R. Schlick^2,4, Karl Y. Bilimoria 4, Yue-Yung Hu^2,5, Julie K. Johnson^2,6

Author Affiliations

¹Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

²Department of Surgery, Northwestern Quality Improvement, Research, and Education in Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

³Department of Anesthesia, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois.

⁴Department of Surgery, Surgical Outcomes and Quality Improvement Center, Indiana University School of Medicine, Indianapolis.

⁵Division of Pediatric Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois.

⁶Now with Department of Surgery, University of North Carolina at Chapel Hill.