A contextual review of trainee unions in the United States

Trainee unions have been a source of great contention between resident physicians, staff physicians, hospital administrators, and the public since their inception in the 1930s. Resident physicians strike a unique balance between being students learning medicine under the watchful eye of attendings and being employees without whom the healthcare system in the United States would struggle to function. Unions seek to improve the working conditions for residents and to protect them from exploitation by hospital systems but have often been perceived as conflicting with professional ideals, patient care, and the educational environment. The goal of this review was to examine the history of resident physician unions, contextualize the arguments for and against them, and describe the best available evidence on the impact of unions on the lives of resident physicians.