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

Area of Science:

• Medical Education
• Surgical Training
• Resident Wellness

Background:

• Labor unions serve as employee advocates, yet their impact on surgery resident well-being is not well understood.
• Understanding resident and faculty experiences with unionization is crucial for improving surgical residency programs.

Purpose of the Study:

• To explore the experiences of general surgery residents, faculty, and staff with labor unions.
• To identify the perceived benefits and drawbacks of unionization in surgical residency.

Main Methods:

• An exploratory qualitative study using semistructured interviews with residents, faculty, and staff from 15 general surgery residency programs.
• The Surgical Education Culture Optimization Through Targeted Interventions Based on National Comparative Data (SECOND) trial data was analyzed.
• Inductive coding and constant comparative analysis were used to identify emergent themes, including unionization.

Main Results:

• Unionization emerged as a response to a perceived lack of resident voice and agency.
• Key benefits identified included increased salary and housing stipends.
• Unintended consequences included irrelevant benefits, loss of existing departmental benefits, and adversarial resident-faculty dynamics.

Conclusions:

• While unionization can provide a platform for resident advocacy, it may also introduce challenges to benefits, flexibility, and teaching.
• Effective advocacy requires active surgical resident participation, whether through unions or other mechanisms.
• Further research with more institutions is needed to understand the long-term evolution of unionization in surgical residencies.