Radiology Resident Perspectives on and Experiences With Labor Union Participation

The aim of this study was to understand the perceptions of radiology residents regarding labor unions and the differences between unionized and nonunionized residents in perceived versus actual benefits of unionization.

This cross-sectional survey, focused on residents' experiences with and perceptions of unions, was sent to radiology residency program directors within the 50-member Radiology Residency Education Research Alliance, who subsequently forwarded it to 756 residents across 24 programs. Bivariable analyses were conducted to evaluate differences in opinions between unionized and nonunionized residents regarding benefits and drawbacks of union membership. Additional subgroup analyses were performed for current union members.

A total of 249 responses were received, with 20 excluded because of incomplete data (n = 229, a 30.3% response rate). The majority of residents were very supportive (n = 126 [55.0%]) or somewhat supportive (n = 47, 20.5%) of unions, believing that unions had a positive impact on time off (n = 151 [65.9%]), duty hours (n = 147 [64.2%]), the ability of residents to make their voices heard (n = 156 [68.1%]), resident salaries (n = 183 [79.9%]), resident benefits (n = 190 [83.0%]), and resident wellness (n = 137 [59.8%]). Unionized residents reported more vacation time (20 or more days: 90.4% vs 70.3%; P < .001), more subsidized housing (53.8% vs 5.7%, P < .001), and more technology and education stipends (90.4% vs 81.7%, P = .025) compared with nonunionized counterparts. Nonunionized respondents were significantly more likely to report that unionization positively affected duty hours (70.9% vs 53.9%, P = .026). Additionally, nonunionized residents were more likely to view disciplinary action as a drawback of union membership (14.6% vs 1.9%, P = .011). Although the majority of radiology respondents felt that unionization had neither a positive nor a negative impact on fostering resident-faculty relationships, those from nonunionized programs were significantly more likely than their unionized peers to perceive these relationships as both positively (22.2% vs 9.6%, P = .034) and negatively (33.5% vs 19.2%, P = .044) affected by union membership.

The majority of radiology residents surveyed were supportive of resident unions, believing that unions positively affected time off, duty hours, ability of residents to make their voices heard, salaries, benefits, and wellness.