Resident Labor Unions

By: Jonathan Cluett, MD

Dateline: 12/01/99

In the past several days the structure of academic medical centers has been potentially reworked as interns and residents working at private hospitals were awarded the right to form labor unions in a landmark trial. The ruling by the National Labor Relations Board states that residents employed at private hospitals have the right to form unions under federal law.

The NLRB voted 3-2 in favor of the residents stating essentially that the primary responsibility of these individuals was that of employee, rather than student.

Residency is the period of time following medical school where recently awarded M.D.s train under the supervision of fully trained doctors. The first year of residency is usually referred to as an internship. Following residency, many physicians choose to further specialize by participating in a fellowship. The ruling applies to interns, residents, and fellows.

The last ruling, in 1976, stated that interns and residents were primarily students rather than employees, and thus they did not have the right to unionize or form bargain collectively. Interns and residents at most public hospitals and a few private hospitals had already been granted these rights by local and state agencies, but this new ruling would open the door to about 100,000 additional interns and residents, about 80% of the workforce.

The implications of this ruling are not exactly clear at this point in time, but it is a step in the direction of giving labor rights to a group of individuals who have long been regarded as the most underpaid skilled workforce. Residents regularly work an 80-100 hour work week, and sometimes many more hours. The compensation of residents averages 35,000 dollars annually.

The defense of hospital administrations has been that the interns and residents were receiving valuable training in return for their hard work and modest pay. In an interview with the New York Times, Jordan Cohen, president of the Association of American Medical Colleges, stated “these periods are for medical training… It’s critical that the educational aspects of these programs be the primary issue.”

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